- Centene Corporation (Tallahassee, FL)
- …risk adjustment audit performance and progress. + Provides operational and analytical support to the Risk Adjustment department. + Monitors and reviews risk ... landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: $86,000.00 - $154,700.00 per year Centene… more
- Humana (Tallahassee, FL)
- …its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- CVS Health (Tallahassee, FL)
- …presentation skills are required to maintain stakeholder engagement. They support downstream functions and vendors through performance analysis, trend ... trend and report on vendor performance data. + Familiarity with Medicare and Medicaid regulations. **Education** + Associates degree or equivalent experience.… more
- Banner Health (FL)
- …have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- AdventHealth (Orlando, FL)
- …of the home care patients and families. Optimizes schedule daily to support productivity, efficiency and maintain best practice visit utilization. + Performs an ... issued the license **Preferred qualifications:** + Recent, relevant experience in a Medicare -certified home health agency as a care-manager + Master's or Doctorate… more
- Mayo Clinic (Jacksonville, FL)
- …submits required National, State and Enterprise quality measures and Center for Medicare & Medicaid Services required data, assists Leadership team in all ... EMS, population and mobile integrate health research activities as needed. Provides system support to all staff in the areas of practice analysis and performance… more
- Humana (Tallahassee, FL)
- …its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and adjusting claims and other ... preferably + Medical terminology + Computer literacy + Knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA and… more
- TEKsystems (Orlando, FL)
- …Provider Services Representative to join our remote team, specializing in Commercial or Medicare Insurance Enrollment. In this role, you will serve as a key liaison ... communicate clearly, and maintain compliance with regulatory standards will directly support our mission to streamline access to care through efficient insurance… more
- Humana (Tallahassee, FL)
- …its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more