- MyFlorida (Tallahassee, FL)
- …and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, ... transparent, and high-quality health care system in the nation. The Medicaid program provides low-income families and individuals with access to health… more
- MyFlorida (Tallahassee, FL)
- …Medicaid /statewide\_mc/index.shtml) as directed. The incumbent will track and monitor the routing and approval of all the aforementioned policy ... and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities,… more
- MyFlorida (Tallahassee, FL)
- …Managed Care Plans to communicate decisions and guidance. Ability to draft, review , interpret and monitor encounter claims submission requirements. Knowledge of ... and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities,… more
- MyFlorida (Tallahassee, FL)
- …be found on the Agency's administrative rule webpage at http://ahca.myflorida.com/ medicaid / review /index.shtml. 8. Providing technical assistance to ensure ... and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities,… more
- MyFlorida (Tallahassee, FL)
- …and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, ... is a condition of employment. Position Overview: The Florida Medicaid program is one of the five largest in...fact finding research. Ability to work independently. Ability to review and comprehend applicable federal and state laws, rules,… more
- Public Consulting Group (Tallahassee, FL)
- …the important points of intersection and overlap between our Special Education/Case Management and school-based Medicaid services work within a state; regularly ... with state agencies, partners, and strategic clients + Understand and continually monitor Federal, state, and local Medicaid School-Based program policies and… 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
- HealthEdge Software Inc (Tallahassee, FL)
- …NCQA (National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other ... where they need it. We call it Digital Health Management . Our comprehensive suite of Digital Health Management...outcomes and the member experience. **Your Impact:** + Proactively monitor and interpret NCQA, URAC, CMS and key state… 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
- Prime Therapeutics (Tallahassee, FL)
- …**Responsibilities** + Manage and support the team through the full cycle contract management processes for Commercial, Medicare Part D, Medicaid , and Health ... leading and managing a Provider Relations department to ensure effective management of employees, departmental interaction, and process improvements. This position… more
- Humana (Tallahassee, FL)
- …Consult internally with other Dialogue Developers for knowledge share + Consult/ Review requirements with business partners, providing feedback and/or comments, and ... they come in - these require immediate attention and correction + Review requirements with business partners, providing feedback and/or comments, and troubleshoot… more
- Evolent Health (Tallahassee, FL)
- …process improvement practices and methodologies + Basic knowledge of health care management (CPT Codes, Medicare/ Medicaid + Strong facilitation and interpersonal ... **What You Will Be Doing:** + Support team responsibilities and project management activities as assigned + Manage day-to-day operational aspects of Medical Policy… 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
- Humana (Tallahassee, FL)
- …outline responsibilities of different parties (center and market admin, concierge, etc.) + Review Workday New Hire Report; compare new hire report to new provider ... screen, new hire Workday tasks for provider and provider hiring leader) + Monitor new provider and provider hiring leader preboarding tasks + Help resolve… more
- Cardinal Health (Tallahassee, FL)
- …benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred * ... rethink how far their products can go. **_Responsibilities_** * Monitor system accounts for new Patient cases * Conduct...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more