- Humana (Tallahassee, FL)
- …+ Master's degree in Social Work + Must have passed Master, Advanced Generalist, or Clinical ASWB Exam + Minimum 3 years of experience working as a licensed Social ... **Become a part of our caring community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by… more
- Humana (Tallahassee, FL)
- …+ One or more years administrative or technical support experience in a healthcare setting + Working knowledge of MS Office including Word, Excel, and Outlook in a ... **Become a part of our caring community and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to administration of utilization management. The UM Administration… more
- Humana (Miramar, FL)
- …Bachelor's Degree 6 or more years of technical 2 or more years of management experience Active, unrestricted Registered Nurse license in the state This role is ... **Become a part of our caring community and help us put health first** The Manager, Field Care Nursing assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate… more
- Humana (Tallahassee, FL)
- …The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national ... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion… more
- Humana (Tallahassee, FL)
- …+ Provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS ... requirements, Humana policies, clinical standards, and (in some cases) contracts. + Completes computer-based reviews of moderately complex to complex clinical scenarios, review of all submitted clinical records and communication of decisions to internal… more
- ProAmpac Holdings, Inc. (Orlando, FL)
- …ProAmpac is an **_ESSENTIAL_** employer that is **_ACTIVELY HIRING_** at our Orlando, FL facility! Our pay and benefits are competitive along with 11 paid holidays ... and a great wellness program. This is a fantastic opportunity to leverage your Maintenance experience and learn valuable niche skills that are in high demand, plus earn great pay and outstanding benefits! This position has the responsibility and will be… more
- Humana (Tallahassee, FL)
- …+ Serves as subject matter expert on NCQA Health Plan Accreditation Long-Term Services and Supports (LTSS) requirements, advising stakeholders on compliance, and ... facilitating NCQA LTSS file universe preparation and LTSS file reviews. + Works closely with operational areas to prepare documentation and files for presentation to NCQA. + Advises operational leaders and frontline associates in developing functional… more
- CDM Smith (Vero Beach, FL)
- …-Creates project definitions, schedules, budgets and objectives for projects. -Prepares detailed statements of work with associated work breakdown structures and ... gains concurrence and approval from internal and external stakeholders regarding various project aspects. -Assesses potential project risk and outlines risk mitigation solutions. -Ensures adherence to company and project management policies, procedures and… more
- Humana (Tallahassee, FL)
- …+ Recognizes a sensitive diagnosis and/or referral requiring Case Management and pend to appropriate point of contact for review. + Understands TRICARE ... benefits/limitations and Humana Military referral processes, MOUs with MTFs, and referral and UM policies. + Answers questions or contacts MTFs and/or civilian providers to obtain additional information that may be required to complete referral etc. + Requires… more
- Humana (Tallahassee, FL)
- …+ Generate reports and deliver them to the markets + Ability to become a SME in various reporting platforms (ex. Availity, PowerBI, PPCM) + Monitor program ... **Become a part of our caring community and help us put health first** Healthcare Quality Reporting & Improvement (HQRI) is an organization responsible for improving health outcomes and advancing the care experience of our members and provider partners through… more
- Humana (Fort Lauderdale, FL)
- …+ Bachelor's degree in related field OR 6 years of experience working in a community serving organization, healthcare or government program serving Medicaid ... beneficiaries, or vulnerable populations. + **Bilingual English AND Spanish/Haitian Creole -** Language Proficiency Assessment will be performed to test fluency in reading, writing and speaking in both languages before offer is extended. + Proficient in… more
- Humana (Port Saint Lucie, FL)
- …+ Active Florida Health Insurance license + Experience with technology to include high level use of laptop and mobile phone applications with an understanding of CRM ... tools or other sales/marketing resources + Experience with Microsoft Office products such as Excel and Outlook + This role is part of Humana's Driver safety program and requires an individual to have a valid state driver's license and proof of personal vehicle… more
- Humana (Tallahassee, FL)
- …+ Bachelor's Degree + 2 or more years of Healthcare experience + Comprehensive experience Microsoft Word, Excel (pivot tables, formulas, data manipulation) and ... PowerPoint + Understanding of metrics, trends and the ability to analyze and identify gaps in care **Preferred Qualifications** + Master's Degree + Progressive experience in the health solutions industry + Prior managed care experience + Experience with SQL… more
- Humana (Tallahassee, FL)
- …+ Bachelor's Degree + RN licensed in the state of Florida without restrictions -or- compact state license. + Over 1 year of Utilization Management (prior ... authorization) experience working in managed care settings/environments (health plan). + 2 years of nursing education or preceptor experience + Advanced Proficiency with MCG/Interqual criteria, CMS guidelines and clinical review processes. + Intermediate to… more
- Humana (Tallahassee, FL)
- …+ Bachelor's degree + Must have one of the following Ohio licensures: Licensed Clinical Social Worker (LCSW), Licensed Masters Social Worker (LMSW-ACP), Licensed ... Professional Counselor (LPC), or other professional license. + One or more years of post-degree clinical experience in private practice or other patient care + Must be passionate about contributing to an organization focused on continuously improving consumer… more
- Humana (Tallahassee, FL)
- …include, but are not limited to: * Develop and maintain sales and retention reporting systems (standard & Ad-Hoc reporting) using business intelligence tools such as ... **Become a part of our caring community and help us put health first** The Business Intelligence Engineer 2 for Group Benefits solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The… more
- ProAmpac Holdings, Inc. (Orlando, FL)
- …**ProAmpac** Small Facility Culture | Large Corporation Perks **Quarterly Attendance Bonuses | Shift Premiums | Great PTO | Encouraging Culture| Advancement ... Opportunities** **ProAmpac in Orlando, FL is hiring entry level & experienced Machine Operator Technicians!** **Who we are looking for:** + Entry Level & Highly Skilled + Positive, detail focused, and reliable individuals looking to start and build a career +… more
- Humana (Tallahassee, FL)
- …+ Bachelor's Degree + Less than 5 years of technical experience in data reporting + Comprehensive knowledge of Microsoft Office Applications including Word, Excel, ... Access and PowerPoint + In-depth experience in Microsoft Excel including formulas, pivots, charts, and graphs + Experience creating automated reports using self-service tool Microsoft Power BI. + Excellent organizational skills + Must be passionate about… more
- BJs Wholesale Club (Orlando, FL)
- …(Monday, Tuesday, Friday and Saturday: 2pm-9pm) Proofs and bakes all unfinished bakery goods by following each item's product handling information using ovens and/or ... Join our team of more than 34,000 team members, supporting our members and communities in our Club Support Center, 235+ clubs and eight distribution centers. BJ's Wholesale Club offers a collaborative and inclusive environment where all team members can learn,… more
- Walgreens (Tavares, FL)
- …+ Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient ... pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy technician. + Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Under the supervision of a pharmacist,… more