• Stars Program Delivery Senior Professional - HEDIS…

    Humana (Tallahassee, FL)
    …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...other business partners to understand goals and how initiatives support long-term strategy + Lead initiatives through ideation, working… more
    Humana (09/03/25)
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  • Insurance Strategy Consultant

    Humana (Tallahassee, FL)
    …consulting experience or professional experience leveraging core consulting skills, to support delivering some of the Insurance segment's highest priority projects ... and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you will deconstruct issues and… more
    Humana (08/29/25)
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  • Telephonic Counselor

    Medical Mutual of Ohio (Fort Myers, FL)
    …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides telephonic/virtual, ... management for Employee Assistance Program members who call for immediate support . Manages consultations with human resources managers, referrals, documentation, and… more
    Medical Mutual of Ohio (08/14/25)
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  • Stars Program Delivery Lead - HEDIS Controlling…

    Humana (Tallahassee, FL)
    …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...+ Identify gaps and new opportunities to improve performance Support key functions with strategic and analytical thinking: +… more
    Humana (09/03/25)
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  • Primary Care Physician

    CenterWell (Deerfield Beach, FL)
    …care supported by analytics and tools, and deep community relationships. This robust support allows our PCP to see fewer patients and spend more time with ... Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five… more
    CenterWell (08/22/25)
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  • Contract & Grants Analyst 1 - Hybrid/Remote

    University of Miami (Coral Gables, FL)
    …of Miami. CORE JOB SUMMARY The Contracts and Grants Analyst 1 ( Medicare Billing Coding & Financial) works independently to review internally and externally ... including agreements and proposals, as required for development of Medicare Coverage Analysis (MCA), facilitating research billing, financial compliance and… more
    University of Miami (07/23/25)
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  • Human Services Program Analyst

    MyFlorida (Gainesville, FL)
    …directly with new and existing eligible clients for Ryan White Services and support in Alachua County. This position: * Performs eligibility services for the Florida ... suppression. Participates in ADAP monthly telephone conference calls. * Maintain knowledge of Medicare Part C & D programs, Affordable Care Act and private insurance… more
    MyFlorida (09/05/25)
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  • Clinical Coding and OASIS Review

    BAYADA Home Health Care (Orlando, FL)
    …as it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations ... of MCM. + Prevent or decrease the occasion of Medicare denials by assuring proper coding on the plan...plan of care and accurate OASIS documentation. + Provide support and communication to all disciplines within the service.… more
    BAYADA Home Health Care (08/15/25)
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  • Senior Reimbursement Analyst- Cost Reporting

    BayCare Health System (Clearwater, FL)
    …home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy ... This position is responsible for government payer reimbursement related to Medicare , Medicaid and TRICARE/CHAMPUS, specifically completion of the annual Medicare more
    BayCare Health System (08/09/25)
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  • Medical Director - Northeast Region

    Humana (Tallahassee, FL)
    …includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical… more
    Humana (07/25/25)
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