- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS… more
- CVS Health (Tallahassee, FL)
- …day. **Position Summary** CVS Health is looking for an experienced Business Analyst , QA and Technical SME with focus on balancing high-impact business management ... Qualifications** - Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims , Rebates, Network contracting, Sales, Call Center Ops and Pharmacy… more
- Navy Federal Credit Union (Pensacola, FL)
- …reported by our members. The investigators responsibilities include validating claims , processing chargebacks, responding to merchant disputes, and ensuring ... degree in business administration, statistics, or related field + Preferred internship analyst or full-time experience in data analysis and reporting + Ability to… more
- Molina Healthcare (Jacksonville, FL)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- JPMorgan Chase (Tampa, FL)
- …corporate events, ensuring timely settlement of trades and cash, management of claims and overdrafts, client / regulatory reporting and input into the production ... Book of Record delivery (IBOR). As a Investment Book of Record (IBOR) Analyst in the Investment Middle Office Services (IMOS) team, you will be responsible… more
- Molina Healthcare (Tampa, FL)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Citigroup (Jacksonville, FL)
- The Fraud Ops Sr Analyst is a senior level positions responsible for contributing to the development of fraud management policies, processes and procedures to ... of advanced statistical models + Proven experience in the Investigation and Fraud claims process + Experience in trend analysis and alerts in early fraud detection… more
- Cardinal Health (Tallahassee, FL)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... gaps + Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted HCPs/accounts touched)… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …areas, its products, and general functions. + Assists with the monitoring of claims . + Supports colleagues with gathering the data collection and analysis associated ... Standard Office skills. . Fundamental concepts of insurance policy renewals and claims handling. + Insurance industry and terminology. . Fundamental concepts of… more
- Molina Healthcare (St. Petersburg, FL)
- …Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required Education** ... encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's… more