- Molina Healthcare (Tampa, FL)
- …proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and...appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. This position will be… more
- MyFlorida (Tampa, FL)
- …DESCRIPTION: This position will serve as a Bureau of Monitoring and Quality Improvement Regional Monitor, assigned to assess the performance of services provided ... work of those staff during an annual or supplemental review . Collecting and requesting information, completing work papers to...for proof reading and editing. Participates as a peer reviewer on annual or supplemental compliance reviews with other… more
- Elevance Health (Tampa, FL)
- …are not limited to: + Lead the development and execution of high quality assessments of the Company's complex processes and controls (including statistical data) for ... and collaborate with team leadership, business management and external auditors on audit planning, testing and evaluation procedures, which includes working with the… more
- Elevance Health (Tampa, FL)
- …systems and reference information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality standards as set ... issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending...Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality … more
- Elevance Health (FL)
- …and reference information to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality standards as ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make… more
- Florida Crystals Corporation (West Palm Beach, FL)
- …The Corporate Environmental Health, Safety and Security (EHSS) Process & Program Manager provides routine EHSS reports to key stakeholders within the company ... the incumbent will be actively involved in both the Quality & EHS Management System Document Databases on the...Acts as the global coordinator for the EHS internal audit program and the EHS Compliance Audit … more
- MyFlorida (Tallahassee, FL)
- …tests conducted under FS Chapters 487, 576, 578, 580. Assists the Bureau Quality Assurance Officer (QAO)/ Quality Manager in identifying, drafting, reviewing, ... control system. Conducts internal performance audits of the bureau's quality system and SOPs, prepares audit reports...in the absence of the QAO. Oversees the compilation, review and determinations of nutrient and mycotoxin analysis data… more
- Walgreens (Niceville, FL)
- …outcomes services. Responsible for ensuring the proper compounding, dispensation, review , and verification of prescribed medications within regulatory guidelines, ... Supports the efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory management and… more
- Walgreens (Palm Bay, FL)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... Supports the efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory management and… more
- MUFG (Tampa, FL)
- …across development and production environments, including code reviews + Review third-party application architectures and identify risk + Collaborate with ... and identify potential security risks + Create threat models for applications, review output from DAST and SAST reviews, penetration testing reports + Participate… more