- CVS Health (Tallahassee, FL)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more
- Prime Therapeutics (Tallahassee, FL)
- …our passion and drives every decision we make. **Job Posting Title** Senior Data Scientist **Job Description** The Data Scientist designs and develops processes ... to support clinical program using eligibility, medical, and pharmacy administrative claims . This position is responsible for performing work that includes study… more
- USAA (Tampa, FL)
- …special and impactful. **The Opportunity** As a dedicated, Business Process Owner Senior you will plan, direct, and coordinate activities for complex processes, ... OFAC, NACHA, PCI). + Familiar with core insurance systems (eg, Guidewire) and claims workflows. + Proven ability to influence decision making through data supported… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient… more
- Molina Healthcare (Jacksonville, FL)
- …any identified finding; Supports management with presenting results and recommendations to Senior Leadership and department staff. * Recommends new or updated job ... experience working in Medicare + Must have experience analyzing claims . **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree and/or equivalent… more
- Centene Corporation (Tallahassee, FL)
- …Monday - Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and handles ... calls with members and provider offices to provide resolution to claims (ie: additional information requests and medication determination updates) + Thoroughly… more
- Jacobs (Miami, FL)
- …innovation meets impact. Jacobs is seeking a seasoned and collaborative Senior Project/Construction Manager to lead water and wastewater infrastructure projects in ... guidance across all phases of construction management: contract administration, claims resolution, cost/time control, safety, quality assurance, and project… more
- Deloitte (Tampa, FL)
- …this role ends on May 31 st 2026. Work you'll do As a Tax Senior within Deloitte's National Tax Controversy Services Interest Analyzer practice, you will be part of ... Revenue Service ("IRS") and litigation settlement, interest reviews, and IRS refund claims . + Assist clients and Deloitte engagement teams with federal interest and… more
- Molina Healthcare (FL)
- …skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data. ... to understand. + Research and develop reports and analysis for senior management and effectively communicate results. **JOB QUALIFICATIONS** **Required Education**… more
- Mass Markets (FL)
- …trusted partner in the industry. We are seeking a seasoned and dynamic Senior Capture Manager with demonstrated expertise in managing large-scale capture efforts and ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more