- MyFlorida (Tallahassee, FL)
- …to consumers, representatives and consultants of CDC+ Participants ineligibility for Medicaid services via email and/or letters. + Monitor activities ... OPS CDC+ BUDGET REVIEW SPECIALIST - 67930358 Date: Aug 21, 2024...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- Humana (Tallahassee, FL)
- …experience + 5 years or more years of experience in Medicare, Medicaid , risk management and/or legislative/regulatory guidance + Project leadership experience ... and help us put health first** The Senior Risk Management Professional role with the Contract Management ...reviewing regulatory changes and new rules pertinent to the Medicaid line of business. Your primary focus will be… more
- MyFlorida (Tallahassee, FL)
- …*Knowledge of state and federal Medicaid policy *Knowledge of the FL Medicaid Management Information System (FMMIS) *Knowledge of basic management ... entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000...information to support the development of APDs and OWPs. Review and edit APDs and OWPs to ensure clarity,… more
- Public Consulting Group (Tallahassee, FL)
- …surrounding Medicaid cost settlement and supplemental payment work. + Review and improve existing quality control and quality assurance mechanisms. + Create ... management in establishing and promoting quality standards. + Monitor and track data received from providers. + Complete...internal clients. + Ability to report and track findings, review documentation, and notify upper-level management of… more
- Humana (Tallahassee, FL)
- …an accomplished leader for the role of Vice President, Revenue Cycle Management in the Home Health division of CenterWell, our wholly-owned healthcare services ... In this role, you will lead and direct the revenue cycle management function (authorization, eligibility verification, payor change management , workflow … more
- MyFlorida (Tallahassee, FL)
- …of Florida, including in areas of criminal appeals, civil litigation, consumer protection, Medicaid fraud, and victims and civil rights. We invite you to visit our ... and programs, and conducting intake services for the OAG's Consumer Protection Division, Medicaid Fraud Control Unit., Lemon Law, and more. Training is provided for… more
- Prime Therapeutics (Tallahassee, FL)
- …subject matter expert (SME) with underwriters, other areas of Prime, and senior management on pricing initiatives, data analyses, and the Request For Proposal (RFP) ... process + Lead, manage, and review data analyses, reporting, and projections + Lead, manage,...+ Present results and analyses to key stakeholders, senior management , and clients; answer detailed and challenging questions regarding… more
- Public Consulting Group (Tallahassee, FL)
- …service for internal and external clients. + Ability to report and track findings, review documentation, and notify management of key issues. + Ability to ... . **Duties & Responsibilities** **Leadership and Supervision** + Assist in the management and distribution of tasks within the Quality Assurance team. + Provide… more
- Prime Therapeutics (Tallahassee, FL)
- …lines of business (Medicare Part D, Employer, Government, Coupons, Managed Medicaid , Migrations, etc.) to ensure benefit plans are programmed appropriately and ... **Job Description** + Operations: Manages team members in the project management , programming, testing and documentation aspects of the analyst responsibilities to… more
- Cardinal Health (Tallahassee, FL)
- …the future. The Director, Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible ... care contracts. This includes coordination of commercial, Medicare Advantage, Managed Medicaid and other third-party managed care contracts and payer relation… more
- CAI (Tallahassee, FL)
- …+ Ability to successfully interact with external customers, peers, colleagues, and management team + Demonstrate effective time management skills and demonstrate ... are familiar with Delaware, local resources and the DE Medicaid population but it is not required + 1-3...tasks on a computer, utilizing a mouse, keyboard, and monitor **Reasonable Accommodation Statement** If you require a reasonable… more
- Humana (Tallahassee, FL)
- …efforts, with accountabilities for the underlying processes, and assists with the strategic review of enterprise ESG metrics. This role will support the Office of ... of ESG metrics, disclosures and reporting to advance Humana's strategic objectives; + Monitor ongoing and rapidly changing dynamics in ESG reporting, with focus on… more