- Highmark Health (Tallahassee, FL)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Tallahassee, FL)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Prime Therapeutics (Tallahassee, FL)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Harmony United Psychiatric Care (Clearwater, FL)
- Company: Harmony United Psychiatric Care Job Title: Inhouse Counsel / Manager Legal, Compliance & Risk Management / Outpatient Clinics / Full-time Employment / ... and administrative bodies. + Provide legal advice on healthcare management, compliance with federal healthcare laws (eg, HIPAA, Medicare/ Medicaid regulations),… more
- MyFlorida (Fernandina Beach, FL)
- …collections and Medicaid and third-party billing) are monitored to ensure compliance with federal, state, and local guidelines. Ensures random checks of the ... BUSINESS MANAGER III - SES - 64002508 Date: Jun...ensuring accounts payable process is performed effectively and in compliance with all applicable rules and policies. Acts as… more
- CVS Health (Tallahassee, FL)
- …problem-solving abilities **Preferred Qualifications** Clinical Coding Experience - Content Manager Claim Processing Medicaid Working with SQL Application ... and every day. Remote: can work anywhere in the US **Position Summary** Medicaid Claim Editing Content Management team. Must oversee ongoing content delivery and… more
- Prime Therapeutics (Tallahassee, FL)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- CVS Health (Miami Gardens, FL)
- …contract coordination. + Performs credentialing support activities as needed. + Educates Medicaid providers as needed to ensure compliance with contract policies ... relationships by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service, claims or… more
- Humana (Kissimmee, FL)
- …of our caring community and help us put health first** The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or ... the care and wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied and frequently...+ A good understanding of AHCA regulations, NCQA and Medicaid guidelines + Managed care experience + Certified Case… more
- HCA Healthcare (Tallahassee, FL)
- …Director Regulatory Compliance with HCA Healthcare, you can be a manager in an organization that is devoted to giving! **Benefits** HCA Healthcare, offers ... Come join our team as a(an) Division Director Regulatory Compliance . We care for our communities and employees! HCA...oversight for matters including the Centers for Medicare and Medicaid Services (CMS), The Joint Commission (TJC), state agencies… more
- Humana (Tallahassee, FL)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Prime Therapeutics (Tallahassee, FL)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- J&J Family of Companies (Fort Lauderdale, FL)
- …Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position. PECS is committed to setting the ... help overcome challenges to fulfillment, on-boarding, and adherence. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead… more
- Prime Therapeutics (Tallahassee, FL)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Molina Healthcare (Tampa, FL)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- Walgreens (Largo, FL)
- …growing the business at the site. Performs all duties of the Pharmacy Manager in their absence **.** **Customer Experience** + Ensures that store personnel provide ... eligibility and all required reporting and documentation. + Responsible for ensuring compliance of team members with regard to the documentation of patient… more
- CenterWell (Jacksonville, FL)
- …food insecurity, navigation of and application for benefits including, Medicaid , HCBS, working to reduce costs associated with prescription medications, ... navigating community-based resources **Preferred Qualifications** + Familiarity with state Medicaid guidelines and application processes preferred + Experience working… more
- AdventHealth (Orlando, FL)
- … Manager is responsible for department engagement, customer experience, compliance of regulatory standards, and employee evaluations. The Care Management ... 125,000 outpatients each year **The role you'll contribute:** **The Care Management Manager is under the general leadership of the Care Management Facility Director… more
- AdventHealth (Orlando, FL)
- …role you'll contribute:** OurLegacy is designated by the Centers for Medicare and Medicaid Services (CMS) as the only organ procurement organization (OPO) in east ... Indian River, Lake, Okeechobee, Orange, Osceola, Seminole, Sumter, and Volusia. The Manager Family Services leads OurLegacy's donor family care program. The … more
- HCA Healthcare (Gainesville, FL)
- …(CLIA) as well as compliance with standards of the Centers for Medicare & Medicaid Services (CMS). The Manager supervises all employees in the lab and is ... intrinsic worth of each individual is recognized. Submit your application for our Manager Cell Therapy Lab opening with HCA Florida North Florida Hospital today and… more