- Intermountain Health (Tallahassee, FL)
- **Job Description:** The Pharmacy Government Specialist II is responsible for the day-to-day operations of Government programs, providing superior customer ... benefits support role. + Demonstrated ability to meet performance standards for a Pharmacy Government Specialist II + Demonstrated ability to provide superior… more
- Cardinal Health (Tallahassee, FL)
- …streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, ... a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred +… more
- Highmark Health (Tallahassee, FL)
- …requirements and CMS Stars rating measures including HEDIS, CAHPS, Pharmacy , HOS, PQA, PQRS. + Supportdevelopment of the overall conceptualization, ... share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing… more
- CenterWell (Tallahassee, FL)
- …has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary ... Identify and act on opportunities to better manage & coordinate with high-quality specialist , hospital, and community partners to serve patient needs and deepen our… more
- Molina Healthcare (St. Petersburg, FL)
- …or equivalent experience (such as specialties in: surgical, Ob/Gyn, home health, pharmacy , etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- CenterWell (The Villages, FL)
- …+ Complete End of Period claim workflow as part of Billing Specialist responsibilities. This includes confirming all orders are signed appropriately and coordinating ... and be able to problem solve effectively. + Must possess knowledge of Medicare guidelines governing home health and hospice agencies. + Must have exceptional… more
- Molina Healthcare (FL)
- …or equivalent experience (such as specialties in: surgical, Ob/Gyn, home health, pharmacy , etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- CenterWell (Deland, FL)
- …. Complete End of Period claim workflow as part of Billing Specialist responsibilities. This includes confirming all orders are signed appropriately and coordinating ... and be able to problem solve effectively. . Must possess knowledge of Medicare guidelines governing home health and hospice agencies. . Must have exceptional… more