- Humana (Tallahassee, FL)
- …discharge orders and arrange a safe facility discharge. + Work with UM Nurses, Pharmacy , Medical Directors and other Departments. + During downtime make calls to UM ... + Document all calls and requests. + Search for Medicare and Medicaid Guidelines. + Process all incoming fax/emails...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.… more
- AdventHealth (Orlando, FL)
- …supervision. This position is responsible for developing and providing clinical pharmacy services to the general patient population, supervising pharmacy ... also include assisting with the daily operation of the pharmacy department, participating in performance improvement activities, educating staff, managing… more
- Prime Therapeutics (Tallahassee, FL)
- …+ Coordinate formulary management for the client including, client specific Pharmacy &Therapeutics (P&T) or business committee decision making and implementation, ... all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the… more
- Humana (Tallahassee, FL)
- …to make an impact** **Required Qualifications:** + **Bachelor's degree or Doctor of Pharmacy (Pharm.D.) from an accredited college of pharmacy ** + Active ... residence + Eligibility to participate in federal prescription programs (eg, Medicare /Medicaid) + Self-directed with the ability to work effectively both… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Prior Authorization Technician - Remote Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Remote Type Fully Remote Position ... Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry leader in both the Long-Term Care and… more
- Prime Therapeutics (Tallahassee, FL)
- …qualified entities across all lines of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs, including but ... meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid...) knowledge **Preferred Qualifications** + Contact Center experience + Pharmacy and/or PBM experience + 1 year of experience… more
- Cardinal Health (Tallahassee, FL)
- …negotiations and category management for Urology, Ostomy and Wound Care in pharmacy , DME and cash pay channels. **_Responsibilities_** + Leads strategy and plan ... and full portfolio management for Urology, Ostomy and Wound Care Categories in pharmacy , DME and cash pay channels. + Leads team of business development managers… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Billing Specialist Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Position Type Full Time Job Category Admin - Clerical ... Description BILLING SPECIALIST WHO WE ARE Polaris Pharmacy Services is an industry leader in both the...Verify insurance and Medicaid coverage * Handle Dual Coverage, Medicare Part D, and Commercial Plans related to Long-Term… more
- CenterWell (Delray Beach, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health… more
- CenterWell (Port Saint Lucie, FL)
- …screened for TB. **Preferred Qualifications:** Active and unrestricted DEA license Medicare Provider Number/ Medicaid Provider Number Experience managing Medicare ... coordinated care environment in a value based relationship environment. Knowledge of Medicare guidelines and coverage. Bilingual is a plus Knowledge of HEDIS quality… more