- Centene Corporation (Tallahassee, FL)
- …and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to ... effectively, both verbally and visually, communicate findings and insights to non-technical business partners + Independently engage with customers and business … more
- CVS Health (Tallahassee, FL)
- …Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation ... + Make outbound calls, develop provider contacts, and understand production metrics ** Required Qualifications** + 3-5 years of experience in a medical claim… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …other groups within the firm, and insurance brokers to ensure delivery + of required insurance documents. + Develops and maintains an understanding of business ... areas, its products, and general functions. + Assists with the monitoring of claims . + Supports colleagues with gathering the data collection and analysis associated… more
- Molina Healthcare (St. Petersburg, FL)
- …+ Claims adjudication experience is highly preferred. **Job Qualifications** ** Required Education** Associate's Degree or two years of equivalent experience ** ... **Job Description** **Job Summary** Responsible for providing business process redesign, communication and change management for...Required Experience** * Four years proven analytical experience within… more
- World Insurance Associates, LLC. (Miami, FL)
- …cases + Create monthly financial reporting packages including detailed premium, claims , membership, commission, and cash reconciliation information + Create weekly, ... presentation to clients on financial performance of insurance programs + New Business Financial Evaluations, as needed by sales team + Provide timely, courteous… more
- CVS Health (Tallahassee, FL)
- …reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing patterns and reviewing ... to determine the impact of the scheme on Aetna business . + Keep current with new and emerging fraud,...and analysis if needed to identify suspicious billing patterns. ** Required Qualifications** + 3-5 years of data interpretation and… more
- CVS Health (Tallahassee, FL)
- …**Position Summary** We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance ... analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid regulatory &… more
- CVS Health (Tallahassee, FL)
- …provide fluid, combined financial and clinical, reporting, and trusted advising. ** Required Qualifications** + Business /Industry Knowledge: Minimum of 5-8 years ... **Position Summary** The Senior Manager Analytic Consultant is an experienced customer-facing analyst who supports the Account Team's ability to craft a compelling… more
- Highmark Health (Tallahassee, FL)
- …degree + 10-15 years experience in support of a Marketing function or Data Analyst role or in a business environment with responsibility for application of ... Support Analyst or equivalent training and experience in a business , specialty pharmacy, clinical pharmacy or clinical environment with direct responsibility for… more
- Elevance Health (FL)
- …location(s) will not be considered for employment, unless an accommodation is granted as required by law. _PLEASE NOTE: This position is not eligible for current or ... options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. The **Senior Health… more