- Sedgwick (Tallahassee, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical and ... line of business experience in telephonic case management (TCM) and/or utilization review or equivalent combination of education and experience required. **Skills &… more
- American Express (Sunrise, FL)
- …identity theft, and other financial crimes. The GFCSU's Quality Control Review (QCR) Team performs ongoing monitoring of Anti-Money Laundering (AML) investigations ... if a material or non-material error is identified. + Close all cases after review is completed. This includes correcting any errors prior to submission for closure… more
- MyFlorida (Sarasota, FL)
- OPERATIONS REVIEW SPECIALIST OPS - 60932093 Date: Aug 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 858327 Agency: Children and Families Working Title: OPERATIONS REVIEW SPECIALIST OPS - 60932093 Pay Plan: Temp Position Number: 60932093 Salary:… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …research, and resolve problems. **Essential Duties and Responsibilities** + Conducts review of communications, through the use of various reports and systems. ... risk-based recommendations to Senior Management using extensive industry knowledge to review products, production, and asset value changes across the firm's business… more
- Molina Healthcare (St. Petersburg, FL)
- …experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. **Preferred ... License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE** **Individual state licensures which are not part of the compact states are required for: CA, NV, IL, and MI** **WORK… more
- Molina Healthcare (Jacksonville, FL)
- …+ Provides telephone, clerical, and data entry support for the Care Review team. + Provides computer entries of authorization request/provider inquiries, such as ... eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination, hospital census information regarding admissions and discharges, and billing codes. + Responds to requests for… more
- Molina Healthcare (Tampa, FL)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. To all ... current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE)… more
- Community Health Systems (Naples, FL)
- …improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs ... other duties as assigned. + Complies with all policies and standards. **Qualifications** + Associate Degree Graduate from an Accredited School of Nursing, ASN required or + Bachelor's Degree BSN required + 2-4 years clinical practice experience required +… more
- MUFG (Tampa, FL)
- …portfolios to identify deterioration or negative management control trends and review compliance with policies, guidelines, and regulations. + Prepare periodic Risk ... Profile & Monitoring Plans to outline key risk factors and allocate appropriate resources. + Analyze individual credits and/or credit relationships for quality, adherence to approval conditions, the accuracy of risk grading, and adequacy and accuracy of… more
- Terracon (Fort Lauderdale, FL)
- …of plans and specifications, observation and inspection, and the writing, preparation, and review of related reports for the services provided. Review drawings ... and recommend changes. Research and resolve design and construction problems. Assign, review , and evaluate laboratory or field data for inclusion in reports. Apply… more