- Molina Healthcare (Tampa, FL)
- …improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Manages member services operations. + Ensures compliance with state and ... **JOB DESCRIPTION** **Job Summary** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and… more
- Molina Healthcare (Tampa, FL)
- …+ Participate in Member engagement work groups as needed to ensure Medicare member needs are being anticipated and addressed. + Participates in regular ... and manager . Basic understanding of managed healthcare systems and Medicare . **PREFERRED EDUCATION:** Associate's or Bachelor's Degree in Social Work, Human … more
- Elevance Health (Tampa, FL)
- …assessment skills to interpret complex guidelines and apply them across all Medicare service reviews, preferred. + Possesses understanding of Medicare ... **Nurse Appeals - Medicare ** **Location:** Virtual: This role enables associates to...make an impact:** + Conducts investigations and reviews of member and provider medical necessity appeals. + Reviews prospective,… more
- WTW (Tampa, FL)
- **Description** **Who we are:** TRANZACT is a leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, ... join our Sales Center team as a **Sales Performance Manager .** **How the Position Works** The **Sales Performance ...include:** + Directly manage and support a team of Member Care Representatives to deliver outstanding customer service… more
- USAA (Tampa, FL)
- …most valuable resource: our 35,000 employees. They are the heart and soul of our member - service culture. When you join us, you'll become part of a thriving ... to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the… more
- Kestra Medical Technologies, Inc (Lakeland, FL)
- …In addition to direct sales responsibilities for a given territory, the Territory Manager provides training, on-going product service and support, and assistance ... Team Member regardless of geography, position, and product or service . * Action/Results: High energy, decisive planning, timely execution. * Innovation:… more
- Harmony United Psychiatric Care (Clearwater, FL)
- …We are a network of outpatient mental health clinics. We provide comprehensive, full- service outpatient mental health services in Florida through in-person and ... Company: Harmony United Psychiatric Care Job Title: Inhouse Counsel / Manager Legal, Compliance & Risk Management / Outpatient Clinics / Full-time Employment /… more
- Molina Healthcare (Tampa, FL)
- …annually or as directed by the Centers for Medicare and Medicaid Services . * Trains grievance and appeals staff, customer/ member services department, ... Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and communicating resolution to members or authorized representatives in… more
- Elevance Health (Tampa, FL)
- …integration, and ensures essential face-to-face onboarding and skill development. **National Government Services ** is a proud member of Elevance Health's family ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Tampa, FL)
- …integration, and ensures essential face-to-face onboarding and skill development. **National Government Services ** is a proud member of Elevance Health's family ... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- HCA Healthcare (Largo, FL)
- …plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug ... and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options...3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
- HCA Healthcare (Hudson, FL)
- …the physician's office + You will prepare documentation for Notification of Non-covered Medicare Services or Advance Beneficiary notices to patients and notify ... include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay....3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
- AdventHealth (Tampa, FL)
- …department, including but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, ... Care Manager 's roles in Multidisciplinary Rounds, Care Transitions, team member engagement, team member evaluations and customer experience. The Care… more
- Molina Healthcare (Tampa, FL)
- …and procedures, and individual judgment and experience to assess the appropriateness of service provided, length of stay and level of care. + Applies appropriate ... denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports quality of care… more
- CenterWell (Tampa, FL)
- …of senior-focused primary care, one of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on ... staff + Knowledge of and experience working with Provider Communities + Medicare knowledge + Experience with Electronic Medical Record (EMRs) or Health Information… more
- ChenMed (Tampa, FL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... + Performs other duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS & ABILITIES:** **Competencies for Success**...phone calls and messages in a timely manner. + Service Orientation - PCP's provide care that they would… more