- MyFlorida (Fort Lauderdale, FL)
- OPERATIONS REVIEW SPECIALIST - 60019169 Date: Aug 15, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 859025 Agency: Children and Families Working Title: OPERATIONS REVIEW SPECIALIST - 60019169 Pay Plan: Career Service Position Number: 60019169… more
- HCA Healthcare (Tampa, FL)
- …to join an organization that invests in you as a Pro Fee Coding Quality Review Educator? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... are looking for a dedicated Pro Fee Coding Quality Review Educator like you to be a part of...for coder education via coder reviews, stakeholder feedback, and review of data analytics that identify educational opportunities, trends,… more
- Centene Corporation (Tallahassee, FL)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of… more
- CVS Health (Tallahassee, FL)
- …guiding the team in determining correct coding and appropriate documentation during the review of medical records. This role requires a strong focus on meeting ... projects. + Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates findings effectively to investigators,… more
- SitusAMC (St. Petersburg, FL)
- …+ Assist with performing QC checks on input data to ensure accuracy + Review imaged documents, identify, and perform data input of relevant document data points of ... + Some mortgage-related document knowledge preferred + Attention to detail in the review and data entry of information from documents + Ability to compose… more
- BayCare Health System (Clearwater, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the primary ... related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and… more
- MyFlorida (Tallahassee, FL)
- OPERATIONS REVIEW SPECIALIST - 72003718 Date: Aug 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 859149 Agency: Management Services Working Title: OPERATIONS REVIEW SPECIALIST - 72003718 Pay Plan: Career Service Position Number: 72003718… more
- AdventHealth (Ocala, FL)
- …Practice Evaluation is responsible for facilitating the medical staff Peer Review , Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice ... Practice Evaluation Policy. This includes the analysis of events that require peer review and the examination of medical records as identified by clinical indicators… more
- Centene Corporation (Tallahassee, FL)
- …fresh perspective on workplace flexibility. **Centene is Hiring - Remote Clinical Review Nurse (Prior Authorization)!** **Ready to take your nursing career beyond ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- Ascension Health (Pensacola, FL)
- …health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned ... with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance to federally… more