- Prime Therapeutics (Tallahassee, FL)
- …build the future of pharmacy with us. **Job Posting Title** Principal Pricing Analyst - REMOTE **Job Description** **The Principal Pricing Analyst leads complex ... to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field** **3 years of experience using Tableau,… 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
- 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
- CVS Health (FL)
- …we do it all with heart, each and every day. **Overview** The Senior Analyst supports Product Analytics by making data accessible and actionable for the care ... dashboards, and analytical tools using SQL, GCP, and/or R to support strategic decision-making and continuous improvement. + Apply statistical techniques (eg,… more
- Elevance Health (Tampa, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. +… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** The Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. This position designs and ... develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom ... health plan reports to support local interventions, provider outreach, and tracks outcomes of...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… 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 ... Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted...offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... information for quality initiatives, accreditation efforts, and regulatory mandates, and claims data coordination. + Manages small to large scale projects initiated… more
- Centene Corporation (Tallahassee, FL)
- …to link business needs and objectives for assigned function. + Support business initiatives through data analysis, identification of implementation barriers and ... management experience preferred. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Working knowledge of… more
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