• Director Medical Management

    DOCTORS HEALTHCARE PLANS, INC. (Miami, FL)
    …Management Coordinator RNs, Medical Management Coordinators. + Manages the daily concurrent review process through department staff, including review of daily ... Minimum 5-10 years of progressively responsible experience in medical management, or utilization review within a healthcare plan, ACO, or provider system. + At least… more
    DOCTORS HEALTHCARE PLANS, INC. (08/29/25)
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  • Epic Sr. Analyst - Quality and Population Health

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... members, including participating in weekly project team meetings. + Review the status of projects and issues on an...and maintain Clinician's workflow and HEDIS quality measure for Medicare Advantage programs + Build and maintain CMS Quality… more
    University of Miami (08/29/25)
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  • Lead Analyst, Technical Configuration Information…

    Molina Healthcare (Tampa, FL)
    …reports and automated configuration processes/solutions + Assist manager in establishing peer review standards and methodology + Leads peer reviews + Leads the ... of large, complex, critical configuration maintenance processes/solutions + Research and review new tools and techniques and provide recommendations to management +… more
    Molina Healthcare (08/27/25)
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  • IT Business Systems Analyst Sr - Medicaid Pharmacy…

    Prime Therapeutics (Tallahassee, FL)
    …signoff of deliverables by all impacted parties + Lead solution design review discussions between IT resources and business requestors to resolve questions regarding ... software changes, and participate with Quality Assurance and UAT resources to review related test cases and/or scenarios + Lead highly complex projects where… more
    Prime Therapeutics (08/27/25)
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  • Lead Medicaid Actuary (Manager)

    Humana (Tallahassee, FL)
    …They will develop and maintain team best practices such as peer review and documentation. The Lead Actuary will be responsible for Medicaid-specific functions ... such as capitation rate review , drafting rate advocacy communications, actual-to-expected business analytics, forecasting market-specific financial results, and many… more
    Humana (08/27/25)
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  • Patient Care Technician - PCT

    Fresenius Medical Center (Trenton, FL)
    …the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness ensure nursing signatures are documented and ensure ... appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and… more
    Fresenius Medical Center (08/22/25)
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  • Auditor, HCC Risk Adjustment Coding - Full Time…

    Datavant (Tallahassee, FL)
    …vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring ... + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology,… more
    Datavant (08/08/25)
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  • Patient Access Specialist (On-Site)

    University of Miami (Fort Lauderdale, FL)
    …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Core Job ... + Assists in monitoring staff productivity and quality of work through proactive review of key performance indicators. + Serves as functional expert resource and… more
    University of Miami (08/08/25)
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  • Sr. Administrative Assistant

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... the Division of Rheumatology. + Draft of original correspondence for Chief Review and signatory (eg letter of recommendations, letters to editors, letters responding… more
    University of Miami (07/14/25)
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  • Coordinator Life Safety

    HCA Healthcare (Fort Pierce, FL)
    …implement and supervise the activities of the Safety Management Program by: Periodic review and update of all safety management policies and procedures to include, ... management plan, and fire safety and evacuation plan to comply with JCAHO, Medicare , OSHA, and other regulatory agencies; Coordinate and implement fire and emergency… more
    HCA Healthcare (08/31/25)
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