- The Cigna Group (Tampa, FL)
- …travel between Tampa, Orlando, Jacksonville.** **Role Summary** The Provider Performance Manager is a key member of a cross-functional, collaborative organization ... & Solutions). Reporting to the Provider Performance Director, the Provider Performance Manager ensures the effective management of the performance outcomes of the… more
- Elevance Health (Tampa, FL)
- **Audit & Reimbursement Senior -** ** Medicare Cost Report Audit** **Locations:** This is a virtual position, the ideal candidate will live within 50 miles of an ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Tampa, FL)
- **Audit & Reimbursement III - Medicare Cost Report Audit** **_Locations:_** _This is a virtual United States based position._ **National Government Services** is a ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Tampa, FL)
- **Audit & Reimbursement III- Medicare Cost Report Appeals** **Location** : This is a virtual position; US based **National Government Services** is a proud member of ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...independently on assignments and under minimal guidance from the manager . + Prepare detailed work papers and present findings… more
- Elevance Health (Tampa, FL)
- …member-centered, lasting pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director is tasked ... preserving and deepening relationships with clients which include Elevance Health Medicare Health Plans. This position, structured around geographic regions and… more
- Elevance Health (Tampa, FL)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... health programs. The **Audit and Reimbursement Senior-Appeals** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for… more
- AdventHealth (Temple Terrace, FL)
- …Reimbursement as it impacts care delivery + Recent, relevant experience in a Medicare -certified home health agency as a case- manager This facility is an ... offerings **The role you'll contribute:** The Home Health Physical Therapist (PT) Care Manager is a professional therapist who coordinates and directs the home care… more
- AdventHealth (Tampa, FL)
- …well-balanced work life balance **The role you'll contribute:** The Care Management Manager is under the general leadership of the Care Management Facility Director ... the departmental daily operations and supervision of team members. The Care Management Manager is responsible for, but not limited to: Coordination of Care, Centers… more
- BAYADA Home Health Care (Sun City Center, FL)
- …We are seeking a Registered Nurse (RN) to fill the position of **Nurse Manager /Home Health RN** for our Sun City Center, Florida Medicare Certified home ... + Monday through Friday opportunity + Advancement opportunities/Growth potential **As a Nurse Manager your day may look like this!** + Lead, inspire and motivate… more
- AdventHealth (Temple Terrace, FL)
- …the team:** . Demonstrates knowledge of home health care services and Medicare regulations/Conditions of Participation . Knowledge and compliance with all local, ... state, federal and other regulatory agencies . Understands and adheres to established AdventHealth policies and procedures. . Maintains patient confidentiality both on and off duty. . Comply with all department policies, procedures, practices and standards of… more
- Travelers Insurance Company (Tampa, FL)
- …reports driving improvements in key areas such as Operations Workspace, Medicare Compliance & Debt Resolution, Omnichannel platform, Claim and Centralized Service ... Delivery among other Claim capabilities. This is an individual contributor position. **What Will You Do?** + Use data visualization (Qlik Sense, Tableau, MicroStrategy, PowerBI, etc. ) and storytelling to leverage insights, communicate the business story, and… more
- Elevance Health (Tampa, FL)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs. The **Audit and Reimbursement II** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for … more
- Elevance Health (Tampa, FL)
- …Analytics Director** is responsible for high-priority analytical projects for the Medicare CAHPS Organization by leading the planning, direction, and management of ... leadership within a team of analysts specifically focused on Medicare Advantage CAHPS. + Conducts complex CAHPS analysis and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Conviva (Tampa, FL)
- …Medicine or Geriatric Medicine preferred * Active and unrestricted DEA license * Medicare Provider Number * Minimum of two to five years directly applicable ... experience preferred * Experience managing Medicare Advantage panel of patients with understanding of Best...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Elevance Health (Tampa, FL)
- …a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid ... who will be responsible for appeals reviews within our Medicaid and Medicare programs.** The **Behavioral Health Medical Director** is responsible for the… more
- Travelers Insurance Company (Tampa, FL)
- …Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where Wage ... to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome. +… more
- Publix (Lakeland, FL)
- …closely with and reports to a Represented Claims Supervisor and Manager . Additional responsibilities include: + analyzing, investigating, and adjusting asserted ... Reviewing and analyzing negotiation/settlement claim details, complying with federally mandated Medicare reporting on settled claims. + developing an action plan for… more
- Elevance Health (Tampa, FL)
- …or should be enrolled in other coverage. + Aides members in enrolling in Medicare when they are entitled. + Updates all of the company's membership system components ... correct forms are provided to assist members enrolling in Medicare . + Reviews claim history to reconcile processed, pended...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Tampa, FL)
- …+ Performs actuarial functions related to Elevance MMM (Puerto Rico) Medicare Advantage business + Responsible for assisting with forecasting, budgeting, and ... modeling + Frequent interaction with MMM Finance leadership team and Elevance Medicare Advantage pricing team. **Minimum Requirements:** Requires a BA/BS degree and… more
- Elevance Health (Tampa, FL)
- …are or should be enrolled in other coverage. + Aides members in enrolling in Medicare when they are entitled. + Determines primacy on each case using a complex set ... correct forms are provided to assist members enrolling in Medicare . + Reviews claim history to identify claims requiring...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more