- CVS Health (Tallahassee, FL)
- …sound data presentation * Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the ... data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, including… more
- Molina Healthcare (Jacksonville, FL)
- …claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed ... on databases and ensure adherence to business and system requirements of customers as it pertains...researching, presenting and documenting is required, + Experience with Medicare , Medicaid and Marketplace is required. + Medical coding… more
- CVS Health (Tallahassee, FL)
- …tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE + ... Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree in Criminal Justice or… more
- Centene Corporation (Tallahassee, FL)
- …with a focus on the auditing and monitoring functions. Collaborates with business areas to ensure effective prevention, detection, and correction of compliance ... landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: $68,700 -123,700 annual Centene offers a… more
- Molina Healthcare (FL)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) ... coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** ** Business Leadership & Operational Ownership**… more
- Molina Healthcare (St. Petersburg, FL)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) ... ability to synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and Marketplace lines of business . + Certified… more
- Zelis (St. Petersburg, FL)
- …that shape who you are. Position Overview At Zelis, the Clinical Dispute Analyst role is responsible for the resolution of facility and provider disputes as ... with providers + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Understanding of hospital coding… more