• Medical Director - Medicaid N. Central

    Humana (Tallahassee, FL)
    …participation in care management. The clinical scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions ... duties include, but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy), and… more
    Humana (10/25/25)
    - Related Jobs

  • Care Review Clinician (RN)

    Molina Healthcare (St. Petersburg, FL)
    …a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high speed required Work Schedule ... for a RN with experience with appeals, claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment… more
    Molina Healthcare (11/01/25)
    - Related Jobs

  • Epic Solutions Architect 2 - Central (H)

    University of Miami (Miami, FL)
    …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . * REMOTE * The University of Miami Health System, ... or a related field. Master's degree is desirable + Coding Certification (eg CPC, CCS, CIC, CMC) from an...+ Knowledge of operational healthcare, hospital and/or ambulatory and inpatient workflows and medical terminology. + Ability to communicate… more
    University of Miami (10/24/25)
    - Related Jobs