Service Warranty Administrator - Nissan Pembroke Pines AutoNation IncService Warranty Administrator - Nissan Pembroke PinesPembroke Pines, FLWith a network of dealerships nationwide strengthened by a recognized brand, we offer a wide variety of new and used vehicles, customer financing, parts, and provide expert maintenance and repair services. AutoNation is one of the largest automotive retailers in the United States, offering innovative products, exceptional services, and comprehensive solutions, empowering our customers to make the best decisions for their needs.
Medical Review Nurse (RN) - UM/Appeals experience Molina Healthcare IncMedical Review Nurse (RN) - UM/Appeals experienceFlorida, FLREQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
Investigator, Special Investigative Unit Coding Molina Healthcare IncInvestigator, Special Investigative Unit CodingFLWorking knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.). In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
Project Manager JRM Construction ManagementProject ManagerBoca Raton, FloridaManage multiple concurrent projects up to approximately $10M in value, or serve as the primary Project Manager on a larger-scale project with a focus on financials, administration, and document management. Guided by integrity, teamwork, continuous improvement, and genuine care for our people, JRM provides an environment where employees can grow and help shape the company’s long-term success.
Member Service Assistant Tropical Financial Credit UnionMember Service AssistantMiramar, FLGENERAL RESPONSIBILITIES: As a Member Service Assistant (MSA), you will be responsible for delivering world-class service to our members by assisting with their financial needs, processing account transactions, and providing information about credit union products and services. You will play a key role in building strong relationships with members by actively referring and cross-selling products and services, achieving sales goals, and making outbound calls to promote credit union offerings.
Mgr, Business Consultant CVS Health CorpMgr, Business ConsultantFL$60,300–$132,600 / yearThe Manager will be responsible for ensuring the accuracy, completeness, and timeliness of encounter data submissions while partnering closely with internal business and technical teams, as well as external vendors, to meet regulatory and operational requirements across multiple states. As the Dual Special Needs Plan (DSNP) business continues to expand, we are seeking an experienced Manager, Encounter Data & State Submission Operations to lead the end-to-end management of encounter and claims data submissions to state agencies.
Lead Software Engineer Healthcare Payer SME — CapAdmin Platform Alivi HealthLead Software Engineer Healthcare Payer SME — CapAdmin PlatformMiami, FLFull timeAlivi is seeking a Lead Software Engineer with deep healthcare payer domain expertise to join our CapAdmin platform team, our proprietary claims administration system supporting our TPA (Third-Party Administrator) operations. The ideal candidate is a senior engineer who has lived inside a payer or TPA platform someone who understands not just how to build software, but how claims, eligibility, capitation, COB, UM, and UB04 workflows actually function in a real payer environment.
Sr. Oncology Sales Specialist- S2 - (Miami, FL) (Field Based) Eisai USSr. Oncology Sales Specialist- S2 - (Miami, FL) (Field Based)Miami, FLExperience working with key laws and regulations impacting the pharmaceutical industry (e.g., PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws) preferred. Collaborates appropriately with internal cross functional partners including but not limited to Oncology Thought Leader Liaisons, Oncology Field Reimbursement Managers, and other specialty roles to facilitate aligned, coordinated efforts with Customers in a compliant manner.
NewSr. Oncology Sales Specialist- S1 - (Miami, FL) Eisai USSr. Oncology Sales Specialist- S1 - (Miami, FL)Miami, FLExperience working with key laws and regulations impacting the pharmaceutical industry (e.g., PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws) preferred. Collaborates appropriately with internal cross functional partners including but not limited to Oncology Thought Leader Liaisons, Oncology Field Reimbursement Managers, and other specialty roles to facilitate aligned, coordinated efforts with Customers in a compliant manner.
["Client Manager, Personal Lines","Client Manager, Personal Lines"] Unison Risk Advisors["Client Manager, Personal Lines","Client Manager, Personal Lines"]Fort LauderdaleRemains current with respect to industry updates, carrier appetites and underwriting capabilities to ensure optimal program placement and pricing negotiations for each client; stays proficient in the use of all carrier systems that relate to the assigned book of business. Plan, prioritize, and complete daily workload while balancing new business, renewals, and service requests to meet internal and client deadlines.
Risk Management Consultant W. R. Berkley CorpRisk Management ConsultantMiami, FLRemoteWe''ll count on you to: Perform detailed surveys of client properties for the purpose of identifying underwriting concerns, potential hazards and most likely causes of loss, developing risk mitigation strategies, facilitating solutions to these concerns, determining appropriate levels of insurance to value and when appropriate, identify account rounding opportunities for our agency partners. By working collaboratively with our agency partners and internal stakeholders, the Risk Management Consultant will develop customized loss prevention strategies for our clients and help ensure their assets are covered by the most appropriate levels of insurance.
["Regional Safety Manager - Miami, FL","Regional Safety Manager - Miami, FL"] CECO CONCRETE CONSTRUCTION, LLC["Regional Safety Manager - Miami, FL","Regional Safety Manager - Miami, FL"]MiamiPrimary responsibilities include conducting periodic on-site safety inspections, monitoring regional safety metrics and trends, documenting information in relevant reports, facilitating quarterly SQP reviews, ensuring all safety policies comply with OSHA rules, defending against OSHA citations, overseeing training programs, assisting in identifying safety issues, overseeing injury and claims management, supervising safety coordinators, developing regional safety strategies, providing mentorship, performing special projects, and maintaining communication with the Regional Safety Director. Minimum qualifications include five years of experience in safety and risk management programs, an associate or bachelor's degree in Occupation Safety and Health or related field, experience in high rise structural concrete construction, familiarity with OSHA regulations, understanding of state Workers Compensation laws, ability to travel, and bilingual (Spanish) preferred.
Full-Time, Hybrid Miramar Florida Personal Injury Litigation Attorney Opportunity - Base salary of $125,000 – $165,000 The Freelance FirmFull-Time, Hybrid Miramar Florida Personal Injury Litigation Attorney Opportunity - Base salary of $125,000 – $165,000Miramar, FloridaWe are a national network of experienced, high-level, freelance attorneys and paralegals who provide remote, on-demand support for both short-term and long-term legal projects for our client law firms. Due to increased demand, we are now interviewing for a qualified, experienced, and dedicated Florida Personal Injury Litigation Attorney for a full-time, hybrid opportunity with one of our client firms.
WAREHOUSE FLEET OPERATIONS COORDINATOR City Furniture IncWAREHOUSE FLEET OPERATIONS COORDINATORTamarac, FLWith over 50 years of experience, and several CITY HOME and Ashley HomeStore showrooms and distribution centers throughout Florida, CITY HOME continues to be recognized as a top furniture company in South Florida and nationwide. As a Fleet Operations Coordinator, the primary function of this position is to maintain all fleet vehicles and Distribution Center documentation to ensure that Operations runs efficiently and safely.
Senior Regional Director of Human Resources- South to Central Florida VITAS Healthcare CorpSenior Regional Director of Human Resources- South to Central FloridaMiramar, FLThe Regional Senior Director of Human Resources serves as a strategic HR leader and business partner for the South-to-Central Florida division, working closely with the Senior Vice President of Operations (SVPO), Vice Presidents of Operations (VPOs), and General Managers (GMs) to drive change and enable the achievement of strategic business goals. This role provides leadership and guidance on employee relations, talent management, and HR initiatives, ensuring alignment with VITAS Healthcare Corporation''s policies, procedures, guidelines, contractual commitments, and governmental regulations.
Electrical Engineer Career CollectiveElectrical EngineerMiami, FloridaRemoteBONUS : Specific design experience with interior & exterior lighting; power distribution systems including standby power generation; telecommunication systems - including voice, data, cable TV and Wi-Fi; security systems including closed circuit TV; grounding systems; lightning protection systems; audio visual systems; and site electrical distribution including medium-voltage distribution switchgear, substations, and transformers; site systems distribution; and overhead and underground distribution. Under the electrical recertification inspection, the engineer will look at: Electric services; Branch circuits; Conduit raceways; Emergency lighting; Gutters; Electrical panels; Grounding of equipment; Service conductor & cables; Wiring methods; Feeder conductors; Parking illumination.
Risk Program Delivery Professional Humana IncRisk Program Delivery ProfessionalFL$86,300–$118,700 / yearThrough our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. The In-Office Provider Programs organization within Risk Adjustment delivers products that help physicians provide optimal patient care and improve the accuracy of clinical documentation.
FLEET OPERATIONS & PERFORMANCE ANALYST City Furniture, IncFLEET OPERATIONS & PERFORMANCE ANALYSTTamarac, FL$19.50 / hourPart timeWith over 50 years of experience, and several CITY HOME and Ashley HomeStore showrooms and distribution centers throughout Florida, CITY HOME continues to be recognized as a top furniture company in South Florida and nationwide. As a Fleet Technical Analyst, the primary function of this position is to maintain all fleet vehicles and Distribution Center documentation to ensure that Operations runs efficiently and safely.
Medical Coder PROMD PRACTICE MANAGEMENT INCMedical CoderPinecrest, FLFull timeThe ideal candidate is detail-oriented with strong people skills and computer skills. You will be responsible for selecting the correct codes and functions to be assigned to each instance.
Customer Support Representative Johnstone Supply LLCCustomer Support RepresentativeDORAL, FloridaFull timeProvide prompt and courteous service to customers including: sales, technical product research, preparation of sales quotes and bids for large contractors and key customers, order processing, pricing, promotional activities and all aspects of customer service by handling unique, key account customer needs. We work with some of the largest companies in the world, including Daikin/Goodman, Bosch, Copeland, Honeywell, Johnson Controls, and Fujitsu, to provide contractors with world-class products, technical expertise, and quality service.