- CVS Health (Tallahassee, FL)
- …systems and on daily operations and programs + Responsible to support targeted quality audit projects. Report results and make recommendations eg, training ... service to our internal and external customers. **Position Summary** + Performs routine quality audits for network operations and claim testing for PPO … more
- MyFlorida (Tallahassee, FL)
- NETWORK SYSTEMS ANALYST - 77070073 Date: May 30, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 854101 Agency: Florida Fish and Wildlife Conservation Commission Working Title: NETWORK SYSTEMS ANALYST - 77070073 Pay Plan: Career Service Position Number:… more
- Cardinal Health (Tallahassee, FL)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... and continuous improvement. Accurately score interactions to gauge employee's quality performance based on organizational and departmental policies and requirements.… more
- MyFlorida (Tallahassee, FL)
- …Our Mission The mission of the Florida Department of Transportation is to provide a safe statewide transportation system that promotes the efficient movement of ... competitiveness, prioritizes Florida's environment and natural resources, and preserves the quality of life and connectedness of the state's communities. Our Vision… more
- Highmark Health (Tallahassee, FL)
- …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all...in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of… more
- CVS Health (Tallahassee, FL)
- …to support the review of the clinical documentation/information. - Local travel to network provider offices may be required. **Required Qualifications** - 3 ... of record, vendors, or internal Aetna departments to obtain additional information for Quality Management audit purposes or coordination of member services. -… more
- Cardinal Health (Tallahassee, FL)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... point of contact handling inbound calls, with ability to determine needs and provide one call resolution + Process enrollments via inbound fax, phone, and… more
- MyFlorida (Tallahassee, FL)
- …Our Mission The mission of the Florida Department of Transportation is to provide a safe statewide transportation system that promotes the efficient movement of ... competitiveness, prioritizes Florida's environment and natural resources, and preserves the quality of life and connectedness of the state's communities. Our Vision… more
- Humana (Tallahassee, FL)
- …with upstream business partners such as Claims, Clinical Guidance, and the Provider Network to identify opportunities and drives initiatives that will ... midst of a people, process and technology transformation that will improve quality , timeliness and the overall experience for our associates, members and providers.… more
- Cardinal Health (Tallahassee, FL)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced...inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related… more
- Cardinal Health (Tallahassee, FL)
- …experience, preferred. Diploma or degree in relevant field desirable. + 3+ years' call quality audit experience strongly preferred. + 3+ years' experience in a ... remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer...that can be improved or celebrated. + Analyze and provide weekly & monthly trend analysis to leadership. +… more
- Datavant (Tallahassee, FL)
- …presenting to leadership, clients, and your Team via Video or in person. + Solution provider and forward thinking + Detail and quality oriented as it relates to ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...with leadership on issues, opportunities, or challenges. + Lead Audit Team which receives requests from Payors + Review… more
- MyFlorida (Tallahassee, FL)
- …with respect to expenditure patterns and surplus/deficit expenditure reports. + Provide quality assurance activities, including programmatic, fiscal, and ... expected to demonstrate knowledge, skills, and ability to prepare, provide , and deliver quality work products representative...+ Child Care Resource and Referral (CCR&R) is a network that helps families identify and select quality… more
- Nelnet (Tallahassee, FL)
- …with the industry standards for compliance and information security issues to provide our customers with world class information security & compliance services. ... with the industry standards for compliance and information security issues to provide our customers with world class information security & compliance services. The… more
- Atlas (Tallahassee, FL)
- …at any and every step of the project, and with a heart-led approach that puts quality and safety at the center of everything we do. We're just built to be better. ... the Atlas Laboratory Information Management System (LIMS) across a nationwide laboratory network . Another major duty is the coordinating and management of Atlas… more
- Datavant (Tallahassee, FL)
- …the right format. Our platform is powered by the largest, most diverse health data network in the US, enabling data to be secure, accessible and usable to inform ... content to re-educate team on coding error trends + Train and provide ongoing teaching/technical assistance to internal staff/external partners + Oversee the… more
- Deloitte (Tallahassee, FL)
- …Professional Practice Directors, and other client service teams to understand and provide guidance on a variety of engagement-related independence matters, such as: ... globe + Positive attitude, initiative, good judgment, curiosity, and dedication to quality with the ability to react positively in an environment where priorities… more