• Appeals and Grievance Analyst

    Point32Health (FL)
    …in related field **Experience** + Required (minimum): 2-4 years' experience as a customer service or member services representative in health care or ... member 's authorized representative and must demonstrate superior customer service and benefit interpretation skills in all interactions. This individual prepares… more
    Point32Health (08/16/25)
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  • Bilingual Telephonic UM Coordinator

    Humana (Tallahassee, FL)
    …+ Proficient and/or experience with medical terminology and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, ... within a managed care organization. **Additional Information** **Language Proficiency Testing** Any Humana associate who speaks with a member in a language other… more
    Humana (08/16/25)
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  • Sr. Program Coordinator (A)

    University of Miami (Coral Gables, FL)
    …in the School of Nursing and Health Studies' (SONHS) Office of Student Services (OSS) reports to the College Recruiter and provides support for the graduate ... as well as collaborative to work effectively as a member of the OSS team. Approximately 3 years of...for any new academic programs + Works with the Associate Deans and Program Directors to create a working… more
    University of Miami (08/28/25)
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  • Grievance & Appeals Representative

    Humana (Tallahassee, FL)
    …or face to face, further/support quality related goals. Investigates and resolves member and practitioner issues. Decisions typically focus on methods, tactics and ... **Required Qualifications** + At least 1 year of customer service experience + Leadership experience - indirect or direct...Please note that training is a critical stage of associate development. Attendance is vital for success, so no… more
    Humana (09/02/25)
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  • Onboarding Program/Strategy Advancement Principal

    Humana (Tallahassee, FL)
    …collaborative Onboarding Program/Strategy Advancement Principal to lead Humana's enterprise member onboarding transformation program. This role offers a unique ... reimagine one of the most pivotal moments in a member 's journey - when they first join Humana. You'll...that every workstream stays aligned, on track, and in service of a seamless, high-impact onboarding experience. Humana is… more
    Humana (08/29/25)
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  • Utilization Management Administration Coordinator…

    Humana (Tallahassee, FL)
    …+ Proficient and/or experience with medical terminology and/or ICD-10 codes + Prior member service or customer service telephone experience desired + ... for the policies and procedures ensuring best and most appropriate treatment, care or services for members. The Home Solutions UM Team is hiring for a UM… more
    Humana (08/23/25)
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  • Delaware Valley ACO Fellowship

    Humana (Tallahassee, FL)
    …care organization that participates in the Centers for Medicare and Medicaid Services ' Medicare Shared Savings Program (MSSP), plus other commercial and Medicare ... with more than 2,000 physicians and approximately 70,000 Medicare fee-for- service beneficiaries. Additionally, DVACO currently holds performance-based contracts with… more
    Humana (07/30/25)
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  • Benefits Analyst, Account Manager

    CVS Health (Largo, FL)
    …**Primary Job Duties & Responsibilities** + **Research and Resolve:** Handle member inquiries and escalations related to benefits, claims, eligibility, and policy ... or virtual engagements to educate and inform members about available benefits and services . + **Reporting & Analytics:** Review and interpret data related to claims,… more
    CVS Health (08/22/25)
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  • CNA or Caregiver - Part Time

    Allegro Management Company Llc (Winter Park, FL)
    …reminders, and incontinence care. + Keep proper records of care including a resident service plan and documenting services provided. + Be familiar with resident ... earned starting Day 1 + Flexible schedule + FALA Member community - scholarship opportunities available Be part of...do. Our pledge to offer the highest quality of service begins with our commitment to finding qualified team… more
    Allegro Management Company Llc (08/30/25)
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  • (USA) Personal Shopper Lead - Sam's

    Walmart (Coral Springs, FL)
    …associates on processes and procedures providing direction and guidance to associates on member service approaches andtechniques to ensure member complaints ... and quality and communicating with others to ensureSams Club Pickup is properly staffedProvides member service by acknowledging the member and identifying … more
    Walmart (08/24/25)
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