• Medicaid Provider Hospital

    Humana (Tallahassee, FL)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (09/09/25)
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  • Medicaid Reimbursement Director

    AdventHealth (Altamonte Springs, FL)
    …Springs, FL **The role you will contribute:** This position leads AdventHealth's Medicaid reimbursement process across the entire company focusing on ... supplemental Medicaid payments, provider taxes, Medicaid ...team:** + Serves as AdventHealth subject matter resource for Medicaid reimbursement matters. This role is focused… more
    AdventHealth (09/09/25)
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  • Payer Manager

    AdventHealth (Maitland, FL)
    …supervision, provides necessary research, review and interpretation of Insurance Provider Manuals, payment methodologies, and reimbursement rates. Maintains ... hospital revenue cycle/patient financial services or healthcare insurance / provider relations related background Required Microsoft Office Strong analytical and… more
    AdventHealth (09/09/25)
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  • Physician Contract Administration

    AdventHealth (Maitland, FL)
    …contracts. * Performs necessary research to obtain and maintain non-contracted payer reimbursement including Medicare, Medicaid , Tricare and other govt payers. * ... needed. * Demonstrates and encourages a team environment between hospital departments, * regions, payors and provider ...on regulatory updates and rate changes that affect Medicare, Medicaid and TriCare reimbursement for contract loading… more
    AdventHealth (08/26/25)
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  • Dental Recontracting Professional - VSP

    Humana (Tallahassee, FL)
    …first** The Dental Recontracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... 2 - 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts and/or working with insurance in a… more
    Humana (09/03/25)
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  • Compliance Audit Manager

    Cardinal Health (Tallahassee, FL)
    …audit methodology, principles and techniques; CMS manuals; professional and/or hospital services reimbursement and repayment; confidentiality standards. + ... organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and correction of documentation,… more
    Cardinal Health (08/27/25)
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  • Pro Fee Coding Quality Review Educator

    HCA Healthcare (Tampa, FL)
    …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... CQR Educator will also collaborate with other external departments as needed to provide input on coding education opportunities and assist with creation of education… more
    HCA Healthcare (08/14/25)
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  • Inpatient Coding Denials Specialist

    HCA Healthcare (Orange Park, FL)
    …CMS/AHCA policies and regulations + Federal Register, Center for Medicare and Medicaid Services, American Hospital Association, Food and Drug Administration, ... spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal… more
    HCA Healthcare (07/26/25)
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  • Hospice Nurse Practitioner

    Gentiva (Pensacola, FL)
    …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… more
    Gentiva (09/09/25)
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  • Clinical Pharmacist

    Centene Corporation (Tallahassee, FL)
    …clinical programs to be initiated + Monitor prior authorization requests + Provide clinical support to internal departments and address clinical related questions + ... and implement programs designed to impact DUR for both Medicaid and Medicare + Develop, implement, and maintain policies...MS) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years… more
    Centene Corporation (08/26/25)
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