- Molina Healthcare (Miami, FL)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Monte Nido (Miami, FL)
- …while providing the opportunity for people to realize their healthy selves. ** Director of Accounting and Compliance** **Monte Nido** **Remote** **Monte Nido** is a ... care that supports long-term recovery. We are seeking a Director of Accounting and Compliance to join our finance...your success and well-being, providing: + Competitive compensation + Medical , dental, and vision insurance coverage (Benefits At a… more
- Molina Healthcare (Miami, FL)
- …Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare , Medicaid, ... Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting software * ICD-9, ICD-10… more
- University of Miami (Miami, FL)
- …when necessary + Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population ... evaluations. This role also works directly with staff, administration, medical directors, and other relevant stakeholders to assure appropriate...preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of… more
- University of Miami (Medley, FL)
- …and maintains high-level accounting financial records and reports and assists the Director of Health System Pricing and Reimbursement in all physician and hospital ... reports on all supplemental Federal and State reimbursement matters. + Administers Medicare and Medicaid audits and prepares all supporting work papers and… more
- HCA Healthcare (Miami, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
- HCA Healthcare (Miami, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
- HCA Healthcare (Miami, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
- HCA Healthcare (Miami, FL)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
- Humana (Miramar, FL)
- …designs and monitors care plans that are unique and tailored specifically to the medical condition of the patient. + Gathers all pertinent medical information ... programs, and professional organizations as requested or directed by the Pharmacy Director . + Completes continuing education programs as required for position duties… more
- Molina Healthcare (Miami, FL)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/Risk, Director of Value Based Programs, medical economics/actuaries and local health ... program & contract design and implementation for marketplace, Medicaid and/or Medicare + Experience in a complex healthcare delivery environment, specifically with… more
- Grifols Shared Services North America, Inc (Miami, FL)
- …including HCPs and their staff, Market Access, the US Pulmonary National Sales Director and Regional Sales Directors and SP/Hub partners in the field, supporting ... and affordability solutions across multiple payer types and plans (ie, Medicare , Medicaid Managed Care, Commercial) Champion and manage the appropriate utilization… more
- ChenMed (Miami, FL)
- …+ Implements strategic planning for referral coordination that contributes to medical cost reduction and improves organizational performance. + Interviews Referral ... to improve referral outcomes. + Participates in executive team and Network Director meetings to collaborate for referral improvements and solutions. + Travels to… more