- MyFlorida (Tallahassee, FL)
- OPERATIONS REVIEW SPECIALIST - 64000845 Date: Dec 5, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 854850 Agency: Department of Health Working Title: OPERATIONS REVIEW SPECIALIST - 64000845 Pay Plan: Career Service Position Number: 64000845… more
- Molina Healthcare (Jacksonville, FL)
- **Job Description** **Job Summary** Provides support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. ... on the claims transactional system and COB tracking database. + Review of claims identified for overpayment recovery. **Job Qualifications** **REQUIRED… more
- Molina Healthcare (Tampa, FL)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- BayCare Health System (St. Petersburg, FL)
- …respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the daily operations ... discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Team Lead **Location** St Petersburg:St Anthonys | Clinical |… more
- University of Miami (Miami, FL)
- …apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University ... (coordination of information gathering and development of drafts for program leaders' review and approval): Program write up and review Quarterly Publications… 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
- Customs and Border Protection (Jacksonville, FL)
- …wide variety of administrative and analytical duties connected with the review and justification for reprogramming of funds, managing multiple appropriations. ... does not interfere or conflict with performance of your official duties. Please review further details via the following link. DHS uses E-Verify, an internet-based… more
- Oracle (Tallahassee, FL)
- …advances in generative AI, machine learning and deep learning. + Design and review the architecture of AI solutions, including data, model, training, and evaluation, ... for the best coding and engineering practices. + Participate in project planning, review , and retrospective sessions. + Identify and mitigate risks in our plans and… more
- Evolent (Tallahassee, FL)
- …or required. **What You Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially meet the applicable medical ... provides clinical rationale for standard and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD … more
- Carrington (Jacksonville, FL)
- …financial reconciliation is accurately completed on all liquidated loans. Key reviewer of loss analysis decisions which include validating the determined ... The target pay for this position is $23.00/hr - $26.50/hr. **What you'll do:** Review reconciliation of all loan advances once the GSE or Government Mortgage Insured… more