- Highmark Health (Tallahassee, FL)
- …business unit needs. May troubleshoot errors, conduct impact analyses, and/or solve data rejection. Performs business analyses in one or more operational areas. ... based role - looking for someone who has some claims experience and looking to become familiar with risk...3 - 5 years of experience in a Business Analyst or Business Process Analyst role or… more
- Molina Healthcare (St. Petersburg, FL)
- …to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, ... and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and performs audits and oversight functions involving business-critical… more
- Molina Healthcare (Jacksonville, FL)
- …in SQL for large dataset analysis and transformation, specifically in processing healthcare claims data and supporting managed care reporting needs + Experience ... solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data , including claims , authorization, pharmacy, and lab datasets. * Build… more
- University of Miami (Miami, FL)
- …MU + Familiarity with health plan concepts and workflows + Familiarity with outside claims data ingestion. + Ability to communicate effectively in both oral and ... System, "UHealth", IT Department has an exciting opportunity for a Full-time Epic Sr. Analyst - Quality and Population Health. The Epic Sr. Analyst - Quality… more
- Molina Healthcare (St. Petersburg, FL)
- …in data analysis. Performs research and deep-dive analysis of complex healthcare claims data , CMS return files, and financial cost, revenue, and vendor ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk...and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision… more
- Highmark Health (Tallahassee, FL)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- ChenMed (Miami, FL)
- …business planning, process improvement, solution assessment, etc. + Analyzesand validatespayer claims data .Assistsmarkets to identify factors driving claims ... great people to join our team. The Actuarial Services Analyst is responsible for managing and tracking the risk...of revenue, reserves and/or cash flow projections. + Identifies data patterns and trends, and provides insights to enhance… more
- ICW Group (Orlando, FL)
- …makes recommendations to management for new, more efficient, processes. + Analyzes claims data focusing on outcomes and vendor performance. **SUPERVISORY ... of this job is to provide quantitative and qualitative data analysis and report trends, insights, and make recommendations...with external vendors and serves as liaison between the claims department and vendors. + Acts as a gatekeeper… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and ... existing lines of business and expansion into new states. The Lead Analyst , Reimbursement will be primarily responsible for implementation, maintenance, and support… 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 ... actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current… more