• Claims Manager

    CHS (Clearwater, FL)
    …for Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. * Responsibility for final hiring decisions ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met.… more
    CHS (08/08/25)
    - Related Jobs

  • QA Audit Manager - Operations

    Healthfirst (FL)
    …Medicaid, Family Health Plus, Child Health Plus, NH Family + Experience managing a Quality Assurance or Operations Audit team. + Experience working with ... optimize operational areas. + Contribute to the overall success of the Quality Assurance service organization by identifying opportunities to continuously… more
    Healthfirst (08/16/25)
    - Related Jobs

  • Pharmacy Quality Assurance…

    Elevance Health (Miami, FL)
    …we are actively defining our innovative role in the industry. **Pharmacy Quality Assurance Specialist** **Location:** This role requires associates to be ... as required by law._ **Schedule: Monday - Friday; 8:00am-5:00pm** The **Pharmacy Quality Assurance Specialist** is responsible for evaluating the quality… more
    Elevance Health (08/29/25)
    - Related Jobs

  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …diploma or equivalent is required + Experience in medical customer service, quality assurance , or insurance training is strongly preferred. **Certificates, ... **Overview** ** ** ** Claims and Call Auditor (Call Center QC) -...are in excess of payment authority limits in assigned audit queues. + Listen to and view all recorded… more
    CHS (06/14/25)
    - Related Jobs

  • Director, Business Process Ownership…

    USAA (Tampa, FL)
    …methodologies, eg Six Sigma and Lean, business operations, risk management, quality assurance and control, or internal audit (in addition to the minimum ... years of experience required) may be substituted in lieu of degree. + 8 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization. + 3 years of direct team lead, supervisory or management experience. +… more
    USAA (08/22/25)
    - Related Jobs

  • Executive Director of R&D Global Quality…

    Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
    …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical… more
    Otsuka America Pharmaceutical Inc. (08/14/25)
    - Related Jobs

  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least one ... responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of...Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (08/13/25)
    - Related Jobs

  • Auditor, Food Safety & Food Quality

    Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
    …+ Provide advanced super user support to functional groups (R&D, Procurement, Engineering, Quality Assurance , and Manufacturing) on QMS related issues. + Provide ... Audit Team with performing Food Safety & Product Quality audits at different venues to include but not...COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &… more
    Boar's Head Brand/Frank Brunckhorst Co., LLC (07/01/25)
    - Related Jobs

  • Treasury - Senior Quality Analyst…

    Bank of America (Miami, FL)
    …1+ years of experience working with customers (internal/external) + Experience interpreting quality assurance standards and procedures for the organization. + ... a plus)** + 1-2 years of experience in the Banking/Financial/ Audit industry + Ability to adapt to ongoing changes...and Testing + Policies, Procedures, and Guidelines Management + Quality Assurance + Attention to Detail +… more
    Bank of America (08/02/25)
    - Related Jobs

  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes...to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality… more
    Elevance Health (08/23/25)
    - Related Jobs