Innovacare Health jobs

LE0016 MMMFL Holdings, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. MMM of Florida, a proud member of the Innovacare Health family of companies, a powerful combination and the foundation upon which we're expanding. Innovacare Health is the 9th largest Medicare Advantage provider in the U.S. MMM of Florida is a licensed HMO, NCQA accredited, that serves individuals enrolled in MedicareAdvantage plans. Join us, this is an exceptional opportunity to do innovative work for the benefit of those we serve. We currently have an opening for a Pharmacy Quality Assurance Team Lead. This position is responsible for assuring the quality and conformance of Pharmacy Operations to Centers for Medicare and Medicaid Services (CMS) and The Accreditation Association for Ambulatory Health Care (AAAHC). Evaluating current policies and procedures against CMS requirements to identify gaps and propose process improvements Assuring the compliance of system enhancements and implementations with required business needs Preparing and offering training to department staff on new CMS or AAAHC requirements, including exam administration as needed Performing monitoring and audits to internal and delegated pharmacy operations services and propose process improvements Executing all recovery efforts associated to Coordination of Benefits (COB), End Stage Renal Disease (ESRD), Hospice, Prescription Drug Events (PDEs), Low-Income Subsidiary (LICs), and any other related processes Analyzing claim data in the adjudication system and utilization files in order to ensure quality controls are in place according to regulatory and business requirements Performing reconciliation of vendor invoices for the Pharmacy department Executing member and/or provider issue resolution of work basket cases Supporting CMS compliance in PDE management Includes executing and managing error resolution Supporting FIR and COB backend processes as well as any other reconciliation processes Executing monthly marketing materials quality processes for print and web versions. Support and perform monthly audits and exam administration to pharmacy units Analyze and present recommendations to improve efficiency of systems/ processes ESSENTIAL DUTIES & RESPONSIBILITIES Assure the department stays abreast of and compliant with regulators' requirements, internal policies and procedures, and operationally efficient. Assess current policies and procedures against CMS requirements, identify gaps, and make improvements through: Internal monthly audits Monthly Exams to unit employees Delegated entities and vendor audits Perform Ongoing Compliance required Data Validation Audits Perform CMS Financial and Operations Audits Perform AAAHC yearly audits Generate and organize audit samples External monthly audits support/ coordination Metrics monitoring Assure the coordination and management of the, at least, annual Policies and Procedures updates. Manage and update at least yearly and as applicable the Pharmacy Department training log and assure training needs are included in log and executed as agreed. Manage and coordinate as needed the Pharmacy Internal Audit Plan including but not limited to the following procedures: Medicare Plan Finder FIR/ Nx Rejects Marketing Materials Troop PDE Rejects Monitoring MTM Program Coverage/ Organizational Determinations Quality Process Formulary Administration Overutilization/ Opioids P&T Committee Claims Processing Provider Call Center Recovery Process Create, update and manage the Pharmacy Corrective Action Plan/ Workplans Log and manage through completion its execution according to established timelines. Create, Update and manage the Pharmacy Compliance Burning Issues Log and manage through completion its execution according to established timelines. Coordinate and lead the Pharmacy internal monthly compliance meeting. Perform other duties as designated by supervisor or Pharmacy Department head. Lead and coordinate quality and compliance tasks for the pharmacy positions. Support RxOps workbasket activities. MINIMUM QUALIFICATIONS & EXPERIENCE Florida Board of Pharmacy Registered Pharmacy Technician and Certified Preferred. Bachelors' Degree or experience equivalent to 5 years in healthcare related job. Experience on query and report generation is a plus. Evidence of an advanced level of mathematical knowledge, and good communication, interpersonal, problem‑solving, orientation to detail, and strive for excellence skills. LANGUAGE SKILLS Fully Bilingual (English and Spanish). Read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Write speeches and articles for publication that conform to prescribed style and format. Effectively present information to top management, public groups, and/or boards of directors. . GENERAL SKILLS Basic business intelligence knowledge and techniques Ability to complete thorough comparative analysis and conclusions. Object-oriented analysis. Computer knowledge. Familiar with basic concepts of project management and business analysis. Ability to respond to a high volume of work and always maintain a polite and professional manner. Must demonstrate positive attitude. Strong interpersonal skills. Able to function with frequent interruptions. Ability to prioritize workloads for maximum efficiency. Able to sit for extended periods of time without compromising work performance. Teamwork: ability to work in a team environment to provide solutions to problems Can work flexible schedules including night shifts, weekends, and holidays. Business modeling techniques Technical writing MATHEMATICAL SKILLS Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages. Ability to apply concepts of basic algebra, Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. REASONING ABILITY Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. PHYSICAL AND MENTAL DEMANDS Working on computer and telephone for long periods of time; ability to effectively utilize office telephone equipment; repetitive motion using fingers and forearms in data entry, manual dexterity to access filing system, use fax and copy machines. This position requires that weight be lifted, or force be exerted up to 10 pounds. WORKING CONDITIONS The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Normal office environment. The noise is typically moderate. MMM of Florida is an equal opportunity employer. We are committed to providing a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the organization. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. We are dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0028 Semoran Physician Group, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Report to: Regional Operations DirectorFLSA Status: ExemptJob Summary: Management position where individual executes strategies to deliver positive financial results and optimum patient care outcomes. Oversees the daily operation of a Medical Center to ensure maximum efficiency in the care and service of the patients.Responsibilities: Office/ Facility Manages and directs the day to day operations of office staff in accordance with company policies and procedures. Ensures the highest degree of customer service and patient quality care is maintained at all times. Identifies and resolves problems to improve services and patient satisfaction. Ensures all the administrative duties of the facility are completed in a timely manner. All patient records are accurate and complete while patient confidentiality is strictly maintained. Supervises the selection and ordering of medical and office supplies. Responsible to manage facility to the agreed upon procedures and objectives regarding office visit minimums, phone calls, insurance verification, coding, billing, fee collection, patient wait time, maintenance of equipment, safety, cleanliness, and licensing. Assures the readiness of the reception area for each working day, open the office at the designated time and have all front desk activities fully operational at the start of business hours. Closes the office. Professional and Corporate Monitors/ manages that all regulatory agency guidelines are implemented and in compliance. (i.e. AHCA, CLIA, OSHA and HIPAA). Maintains all regulatory binders with current and up to date information. Maintains a well prepared facility and staff for regulatory onsite visits and inspections. Financial Responsible to deliver revenue and profit plans. Manages budgeted plans. Daily bank deposit. Review and supervise internal systems for handling cash, recording mail receipts, etc. Follow-up audit control systems. Business Development Works with Regional Operations Director (ROD) and Marketing and Sales Manager to design and implement marketing strategic plan. Plans and assists in healthcare events. Markets facility to increase new patient base. Develops relationships with extended team members such as pharmaceutical representatives, insurance representatives, medical agencies, specialists, hospitals, pharmacists to ensure patients are referred to preferred service providers. Staffing Hires new staff and directs employee orientation and training. Adheres to all human resource requirements (e.g. maintaining employee field records). Supervision, including salary review and proposed salary adjustments and evaluations. Maintain records of vacations, sick leave, etc. Responsible for delegation of work and staffing hours. Organize regular office meetings and set agendas. Determine and change personnel assignments and job descriptions as needed. Assure the staff is trained and operated in compliance with all government and other regulatory agencies. Arrange for coverage for employees out sick or on vacation. Reporting Understands and follows the Code of Conduct and HIPPA guidelines. Completes end of day reports. Daily Visit Recap. Office Manager Checklist reports. Provides insurance company the proper documentation to obtain authorization for patient referral within preferred service provider network. Managed Care MRA/CAP Reimbursement analysis. Managed care contract Supplies Order clerical supplies and oversee ordering of all medical supplies. Maintain supply records, pricing studies, etc. Other Duties as assigned or requested by supervisor or leadership. Skills and Specifications High school diploma/ GED Healthcare industry experience required; minimum 3-5 years. Management experience; minimum 5-7 years. The ability to understand the goals of the practice and work to obtain these goals both independently and with direction. The ability to relate well to patients, physicians, employees and other professionals. The employee must be dedicated to the vision, goals and culture of the practice. The employee must have the ability to remain calm and exhibit tact in stressful and/or delicate situations The employee must have the ability to handle confidential issues with discretion. EMR experience College education preferred Bilingual (English/Spanish) preferred If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0020 Orlando Family Physicians, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Job Summary: To provide excellent customer service in a medical call center environment. Responsibilities: Phones efficiently answered and with proper etiquette Obtain 90% target for Inbound and Outbound calls to and from patients Schedules patients in the correct office with the proper physician. Follows the Best Practice Scheduling* Phone calls directed to proper area, if applicable Conversations documented in patient medical records Schedules new patients and verifies insurance. Updates Patient information in EMR Collects insurance information and updates personal data in patient EMR file Respects and maintains privacy and dignity of patients to assure client confidentiality at all times Understands and follows the Code of Conduct and HIPPA guidelines Skills and Specifications Excellent Customer Service Phone Skills High School Graduate 1 year Telemarketing, Call Center or Sales Experience Experience in typing and data entry Basic arithmetic skills Bilingual in English/Spanish One year experience in a medical office Electronic Health Records experience (EClinical Works a Plus) If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Family Care Partners of Northeast Florida, LLC General responsibilities of a quality coordinator are to provide quality support of the clinic team and patients; ensure medical records remain up to date; and the clinic meets regulatory and quality record standards and resolves any issues or discrepancies as they arise. In this role the coordinator will be expected to perform audits on all medical records; and review the data to ensure records are accurate as well as being able to assess the quality of patient care. It is crucial for the Quality Coordinator to have knowledge of CMS stars rating process, Medicaid Quality measures programs and clinical standards and outcomes. Essential Job Functions Daily review of and prepare for the next day of assigned provider's Cap patients. Daily review of quality in medical records, update records accordingly to aid preparing for the next day patient visits. Responsible for coordination of care regarding quality gaps measures pending with our office managers and QI director. Responsible for coordination of any quality gaps measures events with QI director. Responsible for coordination of quality chart review requests from insurance companies, document, and follow-up with insurance companies. Responsible to coordinate with clinic administrators regarding medical records from hospitals, specialist visits and/or SNH for office follow-up missing in a chart. Identify and follow up with errors regarding billing or medical assistant's documentation detailing quality measures. Send to QI Director Spreadsheet (is this OFP only?) report on time for process. Responsible for keep our EHR/EMR system (example, eCW, NextGen) up to date as: Identified and correct any patient's information error. Quality Spreadsheet CDSS/Alerts Quality Global Alerts Arcadia Quality Measures Portal. Minimum Required Education, Experience & Skills Must complete at least a two-year associates degree through a technical school or community college. Two years of EHR/EMR system experience (eCW, Next Gen preferred). 1-2 years healthcare experience - as a quality coordinator preferred. One year Stars Rating/Medicaid quality measures experience. Preferred Education, Experience & Skills Relationship Management skills. Effective written/verbal communication. Ability to effect or advocate for change. Perform critical clinical analysis. Plan and organize effectively reports.

LE0053 Trinity Medical Physicians Services, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Job Summary: Under general supervision performs work in the operation of a company owned van to assure safe transportation of patients to and from our Medical centers and to assist patients on entry and exit from vehicles as necessary. Responsibilities: 1. Has a scheduled route to transport patients to and from our Medical Centers or other approved Medical facilities. 2. Maintain a travel record, such as time at each stop, number of passengers per day, mileage, and vehicle maintenance. 3. Independent judgment must be exercised in handling unusual situations arising with passengers. Treat all patients in a courteous, friendly and professional manner. 4. Driver is responsible for the safety of the passengers. Everyone in vehicle must wear seat belts. Vehicle is only driven by assigned driver. 5. Driver assumes responsibility for the care and maintenance of the vehicle. Inspects exterior and interior of vehicle at beginning of each shift for properly operating headlights, turn signals, brake lights, interior courtesy lamps, air conditioning or heating, warning lamps, mirror adjustment, properly inflated tires, windshield wipers, vehicle damage, etc. prior to moving vehicle. Responsible for ensuring inside and outside of vehicle are properly cleaned and fueled on an ongoing basis. Keep interior of vehicle neat and orderly. Monitors vehicle condition and alerts Office Manager and/or transportation's Supervisor of any malfunctioning items which need attention. No food or drink allowed. Vehicle is cleaned by hand inside and out once a week, oil change and tire rotation every 5,000 miles. Takes van to garage for maintenance and repair as required. Any repair must have pre-approval prior to commitment. 6. Driver is responsible for working with Office manager or designated Office member to ensure proper scheduling of patients for transportation the day before. Patients will be picked up no more than a 10 miles radius from their Medical Center, unless pre-approved by Transportation's Supervisor and/or Office manager. 7. Driver most call patients day before to confirm their appointments. Driver must call patient 30 minutes before pick up to insure patient is ready. Patients will be pick up 1 hr before their appointments. Assist passengers in getting in and out of van, and other courtesies. Assist passengers in securing wheelchairs or other mobility devices. Coordinate schedule with Office manger and patient coordinators. (Including adds or/and cancel appointments). Minimum amount of patients to be transported per driver 200 a month/10 patients per day. Use daily transportation logs and fax on daily and weekly basis to the transportation supervisor and Office manager. 8. Vehicle is only used to pick up scheduled patients during working hours. Vehicle is parked in medical center during non-working hours. 9. If necessary, ability to certify in special needs assistance training, defensive driver training, CPR, and first aid. 10. Work is reviewed through observation and review of records. 11. Perform related duties as required. Skills and Specifications · Experience in the operation of large vehicles; or an equivalent combination of experience and training. · Employee must possess a valid driver's license issued by the Florida Department of Motor Vehicles. Must have fewer than the following number of points on a motor vehicle record: 3 points in the past year, 6 points in the past two years, and 9 points in the past three years. · Must be at least twenty- one (21) years of age. · Must be able to pass Department of Transportation physical exam. · Must take and successfully complete an Alcohol/Drug screening process, as well as at random, reasonable suspicion, and post-accident drug and alcohol tests. Job Type: Full-time If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0066 InnovaCare Partners, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. The Senior Clinical Documentation Integrity (CDI) Specialist serves as a subject matter expert in diagnostic coding and RAF methodology. His or her performance ensures diagnostic coding accuracy and compliance for primary care clinics and Medicare Advantage health plans. The Senior CDI Specialist reviews clinical documentation and provides feedback to in-house coders, billers, and providers across the company's markets. He or she possesses an excellent ability to work directly with the provider's medical staff, physicians, and targeted groups using educational material, presentations, key performance indicator reports, and other tools. The Senior CDI Specialist works mostly remotely; however, he or she may be required to travel around different locations and states. RESPONSIBILITIES Analyzes the risk adjustment and other data based on diagnoses, medical services, codes, and other indicators for identifying opportunities for improvements. Reviews medical documents such as surgical reports, medical visits, and diagnostic reports in order to create educational strategies to ensure correct diagnosis code assignment by the provider. Reviews clinical documentation and assigns accurate diagnosis codes according to guidelines and projects. Performs coding compliance audits and coding assessments to potential business acquisitions. Be able to identify opportunities in diagnosis coding, clinical documentation, and billing within the clinical practice's day-to-day operations. Performs on-going educational interventions to providers to close gaps or related data Delivers training to physicians, targeted groups, and administrative staff regarding coding topics. Maintains a log of audits and education performed. Prepares and submits to the supervisor a monthly report of activities performed. Participates in training to maintain an understanding of CMS regulations Performs other duties relevant to the position. EDUCATION AND EXPERIENCE Educational requirements: Associates, (preferred) Bachelor's Degree or higher in health information management (HIM), health informatics, biology, nursing, business administration, or related to the health industry from an accredited school. Professional certifications and experience A certificated HIM professional with at least 3 years of experience in Risk Adjustment coding. A HIM certification by one of the following recognized organizations American Academy of Professional Coders (AAPC), American Health Information Management (AHIMA) or Association of Clinical Documentation Integrity Specialists (ACDIS). Examples are CRC, CPC, CIC, COC, CPC-P, CPMA, CDEO, CCS, CCS-P, CDIP, RHIA, RHIT, CCDS, or CCDS-O. Or foreign medical degree with at least 2 years of experience in CDI, medical coding, medical billing, and/or medical record reviewing. Or a certified medical assistant (MA), licensed practical nurse (LPN), or registered nurse (RN) with an active license and at least 3 years of experience in CDI, medical coding, medical billing, and/or medical record reviewing. Or at least 6 years of experience in CDI, medical coding, and/or medical billing. SKILLS AND ABILITIES Must have ability to work as a team player with excellent communication skills. Must solve resource issue in a creative, positive manner. Must possess the ability to make independent decisions when circumstances warrant such action. Stay updated on CMS rules and guidelines. Must be able to function with frequent interruptions, travel by car or plane to different locations when required, including but not limited to Miami-Dade, Broward, Palm Beach, Orange, Osceola counties. Accepts change and able to prioritize activities when faced with competing demands. GENERAL SKILLS Knowledge and interpretation of the systems of standard classification (CPT, ICD-10-CM and HCPCS) Knowledge and interpretation of the Risk Adjustment Factor and Stars Program payment methodologies of Medicare Advantage Knowledge of correct coding guidelines defined by CMS and other regulatory angencies LANGUAGE SKILLS (Preferred) bilingual (English and Spanish). Ability to read, analyze, and interpret general business periodicals, operating and maintenance instructions, procedure manuals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0021 Premier Health Network, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. covers Volusia County* Job Summary: Responsible for meeting monthly sales goal for an assigned marketing site or through the development and implementation of a strategic sales plan. This position will require field work in any of these counties in Florida: Volusia, Seminole, Orange or Osceola Responsibilities: Sells and promotes Orlando Family Physicians VIP Medicare Coordinating and delivering formal sales presentations Arrange appointments. Make outbound phone calls to prospect. Generate daily leads at an assigned marketing site. Skills and Specifications Strong presentation skills Organizational and planning skills Ability to build strong customer relationships and customer loyalty Manage administrative responsibilities, including submitting reports & expenses Daily travel within assigned territory will be required 2+ years of sales experience required - preferably business to business sales. Must demonstrate track record of success and related work experience. Quick learner with the aptitude to pick up technical knowledge and skills in a short period. Excellent communication skills and the ability to effectively present information and respond to questions from prospect patients. Go-getter with a passion for interacting with people, helping solve business problems, and closing the sale. Self-starter with the ability to work effectively and independently with little or no supervision. Bilingual English and Spanish is a plus. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

InnovaCare Partners, LLC DUTIES & RESPONSIBILITIES Balance previous day encounters with Check-In end-of-day reports Receive and review patient charts and documents for accuracy Ensure all codes are current and active Performs accurate charge entries Report missing or incomplete documentation - Work with providers to fix documentation errors Meet daily charge posting production Post patient phone payments Run insurance credit card payments Work tasks sent by DAS Scans and submit paperwork to DAS Creates superbills for procedures done in-house and nursing home charges Work with patients (and/or legal guardians) to establish payment plans Discusses with patients: questions about their balances/statements (as needed) Runs daily reports to identify: Preliminary superbills Queues superbill status to “Ready to Submit” for DAS to submit claims Provides management with feedback to allow for proper training Attends weekly DAS call meeting to address billing issues Attends training sessions as assigned Notify Financial Administrator of any standard process deviations Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations

LE0031 Village Physician Group, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Job Summary: The medical records clerk organizes and evaluates patients' health information and records. In addition, they perform a variety of record keeping and clerical duties in support of services provided in medical setting. Responsibilities: Generate and prepare/assemble medical records. Organize and evaluate medical records for completeness and accuracy. Pull and route records to appropriate personnel or department. Pull charts as needed for special audits and peer review. Prepare reports and forms as directed and in accordance with established policies. Maintain and search computerized medical records. Knowledge of chart control, access and storage in accordance with established policies and regulations. Knowledge of medical records regulations and release of health information. Prepare copy of records when presented with properly completed medical release forms. Receive, screen and coordinate telephone calls from patients and healthcare providers. Perform a variety of administrative duties including but not limited to: answering phones; faxing and filing of confidential documents; and basic Internet and email utilization. Provide excellent customer service to all internal and external customers. Skills and Specifications Knowledge of professional medical practices related to treatment. Knowledge of organizational and medical policies, regulations and procedures. Knowledge of common safety hazards and precautions to establish a safe medical environment. Skill in developing and maintaining records, writing reports, and responding to correspondence. Skill in developing and maintaining medical quality assurance and quality control standards. Skill in establishing and maintaining effective working relationships with patients, employees, medical staff and the general public. Ability to react calmly, objectively and effectively in emergency situations. Ability to communicate clearly with patients, staff and clients. Good telephone manners and etiquette. Strong organizational skills; orientation to detail. Excellent interpersonal skills. Ability to motivate and work effectively with others. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0016 MMMFL Holdings, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Medicare Sales RepresentativeJob DescriptionMMM of Florida, a proud member of the Innovacare Health family of companies, a powerful combination and the foundation upon which we're expanding. Innovacare Health is the 9th largest Medicare Advantage provider in the U.S. MMM of Florida is a licensed HMO, NCQA Accredited that serves individuals enrolled in Medicare Advantage plans.. Join us, this is an exceptional opportunity to do innovative work for the benefit of those we serve.POSITION DESCRIPTIONThis position is responsible for conducting seminar and in-home sales presentations to eligible Medicare beneficiaries. The Outside Sales Representative presents information about MMM to interested persons for which we have received a valid written authorization or a recorded phone call, and assists them to enroll after the seminar or 1:1 presentation. The Outside Sales Representative is responsible to conduct follow up calls according to CMS rules and regulations.RESPONSIBILITIES1. Primary job responsibility is to conduct presentations to potential prospects either by In-Home Visits or Seminars to close sale(s).2. Generate leads through referral development, doctor's visits, or follow up on direct mail or other direct response marketing.3. Qualify leads and set appointments for in home visits.4. Network to establish and maintain relationships with community contacts, providers, members and others who may refer potential leads.5. Responsible for sales results in their areas. Results are monitored by an "audit" system.6. Sales Representatives are independent and must manage the area to meet the companies' objectives.7. Create In-home reports, leads results & provider visits report and submits these reports daily to Sales Supervisor and Sales Coordinators before 7:45am.Compliance1. Responsible to do presentations and fill out applications based on CMS, MMM and our regulators Rules and Guidelines.2. Learn new policies and procedures and keep updated information of regulations related to Compliance and can comply with them.3. Is responsible to maintain their commissioner licenses and driving licenses up to date.Application Processing1. Assist the potential member in completion of the application and selection of a PCP, as necessary. Indicate such assistance on the application as appropriate.2. Check all applications for completeness and accuracy before the member signs it.3. Summit all applications and paperwork to the sales coordinator within 24 hours of member's signature.EDUCATION AND EXPERIENCEAssociate's degree or equivalent from two-year College or technical school.Minimum one-year sales experience in health care sales, preferable.Previous experience working with seniors and/or disabled population (nursing, teaching, and social work) LICENSES AND CERTIFICATIONS The employee must have a valid driver's license and should demonstrate a satisfactory record of safety. Must approve CMS Test with a minimum score of 80% to obtain the Commissioner HMO license. HMO License (215/220 Health, Life, Variable Annuities) is required. LANGUAGEBilingual Spanish or Creole and EnglishJob Type: Full-time If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0053 Trinity Medical Physicians Services, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. FULL TIME Medical Receptionist to join our dynamic team. Seeking individual who is looking for a long term opportunity, with growth potential. Ideal candidate possess the following characteristics: - Friendly, Outgoing Personality - Ability to work independently - Attention to detail with strong ability to multitask and prioritize work - Ability to follow policies and procedures for patient safety and privacy - Reliable - Dependable - Organized - Expert computer skills (internet use, Microsoft products, scanning/filing electronic documents) Must have strong customer service experience and a desire to learn new skills. As the face of the company, first impressions are incredibly important. Must be a "People Person." Duties include: - Greet patients with friendly demeanor at all times - Answering multiple phone lines - Scheduling appointments - Patient check in - Verify insurance eligibility and benefits - Utilize multiple websites to verify benefits, coordinate patient care - Collect balances, co-payments, deductibles - File electronic faxes/scans/documents - Retrieve and release medical records per office policy MUST HAVE 1 YEAR OF MEDICAL OFFICE, FRONT OFFICE EXPERIENCE. Job Type: Full-time work schedule: 3- 12 hours shifts If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0020 Orlando Family Physicians, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Responsibilities: Participates in design of call monitoring formats and quality standards. Performs call monitoring and provides trend data to management. Uses quality monitoring data management system to compile and track performance at team and individual level. Participates in patient listening programs to identify customer needs and expectations. Provides actionable data to various internal support groups as needed. Provides feedback to call center team leaders and managers. Prepares and analyzes internal and external quality reports for management staff review. Perform other duties as assigned. Skills and Specifications • 6 months of call center customer care experience, preferably in a healthcare environment. • Excellent oral, written and interpersonal communication skills. • Exceptional listening and analytical skills. Intermediate level of knowledge/expertise with PC hardware and software (Word and Excel). Intermediate to advanced level of knowledge with Internet technology • Strong knowledge of customer care processes and techniques. • Demonstrated ability to work well in a team environment. • Dedication to providing exceptional customer service. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Develop project goals, work plans & timelines to accomplish companywide impact special projects. ESSENTIAL DUTIES AND RESPONSIBILITIES Developing sound, cost-effective strategies for the purchasing of materials used in the business. Maintaining relationships with suppliers while continually scouting for additional vendors. Evaluating spending operations while seeking ways to improve and enhance the quality of products purchased and the timeliness of deliveries. Conducting cost analyses and setting benchmarks for improvement. Developing risk management procedures to mitigate losses in the event of product shortages. Supervise purchasing team and delegating tasks across departments when necessary Working closely with the company legal department to make sure contracts and terms are favorable. BUSINESS CONTINUITY Update and conduct annual Business Impact Analysis (BIA) for MMM of Florida and Regional Offices. Update and analyze Business Impact Matrix from the BIA for DR testing. Maintain and update Disaster Recovery Plan, Emergency Plan, and Pandemic Plan Committee Oversight. Conduct Annual DR Testing with BTS Department between PR team and FL team. Maintain and update BCP plan. Maintain and update BC department policy and procedures. VENDOR MANAGEMENT Maintain and update supplier required documents. Maintain and update supplier vendor files. Supplier Verification Process. Vendor Demographic File Management. Maintain and update policy and procedures. Work cohesively with corporate vendor management to process and update suppliers in system. FINANCE SUPPORT Oversee and enter operational invoices for MMM of Florida and Achieve Mas (OTC). Maintain and Update Cost Center Codes as needed. Workday Roles for analyzing and resolving account issues: Budget Approver, Facilities. Officer, Service Coordinator, Accounts Payable Analyst and Cost Center Manager. Notarize company official documents. Analyze and review Workday Supplier Invoice Business Process for supplier events, report events, & asset registration events and Hierarchy for updates. Work cohesively with Finance Executive for providing any supporting operation documents pertaining to finance for Merger, Acquisitions, etc. Serve as Project Manager on Workday transition for MMM of Florida. COMMITTEES Business Continuity Management Program Leader Emergency Management Team Disaster Recovery Team Employee Engagement Committee EDUCATION AND EXPERIENCE Bachelor's Degree from accredited university or college and minimum two years of experience in similar position. Experience in procurement, preferably at least 2 years in supply chain management and in purchasing or procurement. Strong knowledge of specific industries and markets, as well as a strong grasp of negotiation techniques. LANGUAGE SKILLS Strong communication skills in English (write and speak). Spanish is a plus but not required. Ability to read, analyze, and interpret general business periodicals, operating and maintenance instructions, procedure manuals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. REASONING ABILITY Ability to define problems, collects data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. INTERPERSONAL RELATIONS The responsibilities of this position require continuous interaction with colleagues and visitors. Internal Contacts Executives Directors Managers Supervisors Staff External Contacts Suppliers Brokers General public GENERAL SKILLS Strong leadership and analytical skills. Excellent oral and written communication skills with employees, peers and senior management. Experience managing people effectively to meet quality and production standards. Ability to prioritize and meet deadlines. Ability to maintain respect and compliance with rules and established policies and procedures. Proven track record in motivating and coaching employees. Excellent time management skills. Knowledge of quality management and process improvement procedures. Ability to concentrate and pay closed attention to detail for compilation of data, scheduling and report preparation. Computer literate: Windows environment, Microsoft Office (all applications). PHYSICAL AND MENTAL DEMANDS While working the employee is sitting and standing associated with a normal office environment as well as stopping and bending to file and maintain orderliness; mobility to complete errands. Performs tasks requiring independent knowledge and judgment in addition to instructions and procedures provided. Must be able to function with frequent interruptions, accept change and able to prioritize activities when faced with competing demands. This position may require weight to be lifted or force to be exerted up to 10 pounds. ENVIRONMENTAL AND WORKING CONDITIONS Normal busy office environment. The noise in the working environment is moderated. Exposition to outdoor weather conditions, air particulates and gases. The employee will do internal traveling to sites.

LE0020 Orlando Family Physicians, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Responsible for providing coding services on all diagnosis and maintains a professional relationship with the Managers and Providers. Responsibilities: Audits records to ensure proper submission of services prior to billing on pre-determined charges Receives proper progress notes to properly bill provider services for services provided to patients Supplies correct ICD-10 CM diagnosis codes on all diagnosis provided Supplies correct HCPCS code on all procedures and services performed Supplies correct CPT code on all procedures and services performed Coding claims 100-150 a day Contacts providers to train and update them with correct coding information Remain current on coding issues Accurately follows coding guidelines and legal requirements to ensure compliance with federal and State regulatory bodies Determines the final diagnosis and procedures stated by the physician are valid and complete Qualitative analysis- evaluates the record for documentation consistency and adequacy. Ensures that the diagnosis reported accurately reflects the care and treatment rendered. Analyzes provider documentation to assure the appropriate Evaluation and Management (E&M) levels are assigned using the correct CPT code Performs other related duties, which may be inclusive, but not listed in the job description Skills and Specifications Certified Professional Coding Certificate (preferable) At least two years of Billing and Coding experience in Primary Care or Internal Medicine Electronic Medical Records (E-Clinical Works preferred) Thorough knowledge of CPT & ICD -10 coding, medical compliance, HIPPA, claim formatting issues that cause payment errors, and medical insurance follow up Computer proficiency, specifically Excel and Windows Strong organization and communication skills in order to interact effectively with others in the medical field Self-motivated to deliver results Work independently Work collaborative on projects Create channel of communication to obtain information necessary to perform job tasks, such as with payers, clinical staff, and billing department staff Ability to recognize individual and system problems and to communicate such information to Management/ Supervisor Excellent written and verbal communication skills Attention to detail and time management skills If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0053 Trinity Medical Acquisition,Physicians Services, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Seeking energetic licensed x-ray tech for high-volume fast-paced urgent care practice in Winter Haven, Florida; willingness to learn Experity (formerly DocuTap) and assist other office personnel in office in patient care processes. will consider candidates seeking part-time or full-time. Will consider new graduates.Will be trained medical assistant skills. Must have current Florida State License Fast paced work environment Will be trained to do BAT and URINE DRUG SCREEN MA duties Asking medical histories Preparing patients for examination Assisting the physician during exams Collecting and preparing laboratory specimens Performing basic laboratory tests Preparing and administering medications as directed by a physician Transmitting prescription refills as directed Drawing blood (will train) Taking electrocardiograms Removing sutures and changing dressings Administering TB Working shifts consist of 3 day - 12 hour shifts Job Type: Full-time If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0020 Orlando Family Physicians, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Job Summary: The Utilization Review Nurse will support the clinical review operations needed to assist our membership. This position is a member of a team of nurses, physicians, pharmacists, and program coordinators. This role evaluates the efficiency, appropriateness, necessity of the use of medical services, procedures, and facilities. This position is empowered to review medical services with evidenced-based criteria to ensure improved outcomes and appropriate utilization of medical resources based on a patient's condition. Responsibilities: Coordinate with the appropriate case manager(s) on a daily basis to assess the inpatient census for appropriate alternative health care service needs. Utilizes pre-approved criteria and guidelines to validate medical necessity of continued stay and appropriateness of treatment and discharge planning (e.g. Milliman Care Guidelines, Interqual). Performs on-site and/or telephonic concurrent review of acute and sub-acute services, as well as precertification review for all services following the plans authorization guidelines. Predicts and plans for patient's needs from pre-admission, through acute and sub-acute care and post-discharge, in collaboration with the member and providers. Coordinates with appropriate discharge planning with interdisciplinary health care team to coordinate timely discharge. Tracks and reports trends of inappropriate utilization of resources or quality issues to the Medical Director(s). Functions as a major contributor as it relates to discharge planning and readmission reduction strategies. Documents all activities in the appropriate system(s) on a timely basis. Participates in rounds with the Medical Directors from the practice and Health Plans. Monitors and facilitates appropriate utilization of resources using evidenced-based clinical criteria. Participates in an interdisciplinary health care team to achieve positive member outcomes. Functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options. Other duties as requested or assigned Skills and Specifications Degree in Nursing from an accredited college Required to have education, training or professional experience in medical or clinical practice. A current license, without restrictions 3-5 years of nursing experience (preferably in utilization management or hospital/acute care). Exceptional communication skills, both written and oral, ability to positively influence others with respect and compassion; bilingual is a plus. Strong work ethic built on a foundation of proactivity and teamwork. Ability to navigate ambiguity with the aid of structured problem solving techniques. Committed to the practice of inquiry and listening. Willingness to “roll up one's sleeves” and embrace the nitty gritty, bottom up task of building an organization and implementing new initiatives Personal and professional track record that demonstrates a commitment to quality in health care A positive attitude: ability to work hard, have fun, and operate efficiently in a fast paced, start up, work environment and in a highly complex and dynamic movement for health delivery reform. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

LE0038 John Young Physician Group, LLC It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Job Title: Patient Care Coordinator Report to: Practice Administrator FLSA Status: Non-Exempt Job Summary: The role of the Patient Care Coordinator is to collaborate with clients by assessing, facilitating, planning and advocating for health needs on an individual basis. Successful outcomes cannot be achieved without specialized skills and knowledge applied throughout the process. These skills include, but are not limited to, positive relationship building, effective written/verbal communication, ability to affect change, perform critical analysis, plan and organize effectively and promote client/family autonomy. It is crucial for the Patient Care Coordinator to have knowledge of funding resources, services and clinical standards and outcomes. Responsibilities: 1. Maintain ongoing tracking and appropriate documentation on referrals to promote Team awareness and ensure patient safety. This tracking may use an IT database. 2. Ensure complete and accurate registration, including patient demographic and current insurance information. 3. Assemble information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist. 4. Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians. 5. Review details and expectations about the referral with patients. 6. Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance). 7. Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion. 8. Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers. 9. Ensure that referrals are addressed in a timely manner. 10. Remind patients of scheduled appointments via mail or phone. 11. •Ensure that patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health. Skills and Specifications • High school diploma, sometimes combined with medical assistant certification • Strong customer service focus • Effective verbal and written communication skills • Teamwork orientation • Organized and able to manage competing priorities • Good judgment • Resourcefulness in problem solving • Able to take and follow through with delegated tasks and accountability • Bilingual skills preferred (English/Spanish) ACKNOWLEDGMENT FORM The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed. Printed Name: _____________________________________ Signature: _________________________________________ Date: _____________________________________________ If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

InnovaCare Management Services Company, LLC InnovaCare Health is a dynamic physician-led healthcare organization that innovates change in value-based healthcare. We operate over 40 clinics employing more than 1,100 professionals who share our mission, vision, and values. Who We Are Seeking: We are seeking an amazing Physician for our Fleming Island office. This elegant office is housed in a gorgeous upscale area about 20 miles away from downtown Jacksonville bordered by beautiful water and wetlands on all sides. We are open to all Physicians including residents and fellows who are looking to secure the next step after residency or fellowship as well as seasoned physicians who are interested in growth. Benefit Highlights: Exceptional Benefits Package including Medical, Dental and Vision Malpractice Insurance and Tail Coverage Competitive Compensation including attractive bonus structure Generous Relocation & PTO package that allows for healthy work/life balance Up to (4) CME days per year & stipend annually Tuition Reimbursement & Employee Perks: Tickets at Work 401k Provider with 100% Company Match up to 3%, and 50% from 4% to 5% Eligibility after first paycheck, with match starting at 12 months of employment No Vesting Period on company matches Required Qualifications: Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.); BC or BE in Internal or Family Medicine and/or Geriatric Medicine Valid, unrestricted FL license For more information, please contact Shahana Rizvi, Physician Recruiter, InnovaCare Health at ********************************** or ************.

InnovaCare Partners, LLC Job Title: Quality Care Coordinator Job Summary: The role of the Quality Coordinator is performing audits on all medical records contained in ours health care facilities. Also known as medical auditors, they review the data to ensure the accuracy of the record as well as assess the quality of patient care. Medical reviewers must complete at least a two-year associate's degree through a technical school or community college. These skills include, but are not limited to, positive relationship building, effective written/verbal communication, and ability to effect change, perform critical clinical analysis, plan and organize effectively reports. It is crucial for the Quality Coordinator to have knowledge of CMS stars rating process, Medicaid Quality measures programs and clinical standards and outcomes. Responsibilities: 1. Daily review next day of assigned provider's Cap patients. 2. Daily review next day Quality actions found previous day Caps patients. 3. Responsible for coordination of care regarding quality gaps measures pending with our office managers and QI director. 4. Responsible for coordination of any Quality gaps measures events with QI director. 5. Responsible for coordination of Quality Chart review request from insurance companies in the offices. 6. Responsible to coordinate with office managers any medical records from Hospital, specialist visit and/or SNH for office follow up missing in chart. 7. Identified and follow up with billing department medical assistant's documentation errors regarding quality measures. 8. Send to QI Director Spreadsheet report on time for process. 9. Responsible for keep our EHR system (ECW ) up to date as: • Identified and correct any patient's information error. • Quality Spreadsheet • CDSS/Alerts • Quality Global Alerts • Arcadia Quality Measures Portal. Skills and Specifications • Comprehensive Chart Review abstraction based on current CMS Star Rating Medicaid Quality programs . • Capable to do clinical correlations to increase quality care of our members . • Critical Thinking / Problem solving/Computer / EHR system (ECW preferred) • Clinical background including disease and case management protocols. • Providers advocacy and empowerment /Conference and meetings • MD Degree (Foreign Physician) • Up to 2 years Stars Rating /Medicaid Quality measures experience