- USAA (Tampa, FL)
- …candidate selected for this position will be joining the Service Team within the Claims Actuary and Analytic community, which is part of P&C Data Science. They be ... responsible for delivering insights to the Claims organization related to all things Service to better...The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (eg, attributes,… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen....operations + Must have strong understanding of QNXT claims processes + Must be able to identify and… more
- The Cigna Group (Sunrise, FL)
- …work in the office or visit Providers 3 days per week The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and ... reports to the Contracting Manager or Market Lead . This role assists and supports the day to...communication with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical… more
- Elevance Health (Miami, FL)
- **Title: Grievance/Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The **Grievance/Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Highmark Health (Tallahassee, FL)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations , Customer Service, Regulatory Affairs, IT, Legal and other departments, ... federal, and industry regulatory changes and assess their potential impact on Claims Operations , Customer Service and other operational areas processes and… more
- University of Miami (Miami, FL)
- …System, "UHealth", IT Department has an exciting opportunity for a Full-time Epic Sr. Analyst - Quality and Population Health. The Epic Sr. Analyst - Quality ... and access. The incumbent supports junior staff members in day-to-day operations and resolving application issues. Core Responsibilities: + Collaborates with key… more
- Sedgwick (Tampa, FL)
- …Fortune Best Workplaces in Financial Services & Insurance IT Systems Analyst Specialist Job Description Join us in delivering cutting-edge technology solutions ... THE ROLE** : To review, analyze and document software requirements and to lead the business analysis phase for projects. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** +… more
- Molina Healthcare (Jacksonville, FL)
- … operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- CVS Health (Tallahassee, FL)
- …to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to continuously innovate ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Prime Therapeutics (Tallahassee, FL)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs, may lead some initiatives within their designated areas, and partners with key internal… more