- Humana (Tallahassee, FL)
- …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping...EAPG + 2+ years of experience with Optum Rate Manager + 2+ years of experience with Optum WebStrat… more
- Aston Carter (Tampa, FL)
- …analyses, reports, and dashboards to meet changing reporting needs. + Perform monthly quality assurance reviews on data to ensure accuracy, identify issues, and ... results. Essential Skills + Seven years of experience in financial analysis, healthcare finance, or business administration with a CPA. Alternatively, a Master's… more
- CenterWell (Tallahassee, FL)
- …as ABQAURP, or other boarddemonstratingadvanced training in transitions of care, quality assurance ,utilizationmanagementand care coordination. + A current and ... reference materials, internal teaching conferences, and other sources of expertise . Medical Directors will learn Medicare and Medicare Advantage requirements… more
- University of Miami (Miami, FL)
- …assists leadership in the de velopment of contingency plans. Monitors and Ensures Quality Healthcare Practices Monitors own practices and assists in monito ring ... quality of care provided . The APRN demonstrates expertise and mastery towards patient care , p rovid...for the patient and family. + Actively participates in quality assurance programs and peer review activities.… more
- Elevance Health (FL)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a minimum of 5 years ... of medical audit activities. + Draws on advanced ICD-10 coding expertise , mastery of clinical guidelines, and industry knowledge to substantiate conclusions.… more
- MyFlorida (Lantana, FL)
- …for scheduling clerical staff for outreaches. Participates in departmental meetings, quality assurance , and/or other in-service trainings. Perform other duties ... Management Information System (FMMIS), Health Care District (HCD), Change Healthcare and Ariba/MyFlorida Marketplace (MFMP), Health Management System (HMS), cash… more
- AdventHealth (Ocala, FL)
- …related to patient care, including, ordering of medical supplies and pharmaceuticals, quality assurance , JCAHO, OSHA, maintenance of clinical equipment, and ... discipline, and staff evaluations. Instrumental in streamlining processes while promoting quality healthcare and increased patient satisfaction. **The value… more
- Community Health Systems (Naples, FL)
- …May contribute to development of departmental policies, procedures and protocols. + ** Quality Assurance and Regulatory Compliance** + Ensures compliance with all ... and supervising laboratory operations, ensuring the highest standards of quality , efficiency, and regulatory compliance. This role oversees staffing, scheduling,… more
- AssistRx (Orlando, FL)
- …team plays a crucial role in that mission - transforming complex healthcare data into actionable insights that improve outcomes for patients, providers, and ... Partner Across the Business - Work closely with the Manager , Client Reporting + Analytics and cross-functional stakeholders to...access programs, and key performance metrics. + Champion Data Quality & Accuracy - Ensure all reporting is delivered… more
- Elevance Health (Lake Mary, FL)
- …**How will you make an impact:** + Interfaces with internal and external clients, quality committees, and departments in the review of quality improvement data ... have been met. + Conducts the ongoing evaluation and interpretation of quality standards and accreditation standards to ensure compliance through reporting and… more