- AdventHealth (Maitland, FL)
- …sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new ... Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 CPT, CPT, HCPCS II, DRG and revenue codes… more
- CVS Health (Tallahassee, FL)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... etc. **Preferred Qualifications** + Experience overseeing or defending product liability claims and litigation. + Familiarity or experience with insurance and… more
- Prime Therapeutics (Tallahassee, FL)
- …team, broader project team and various levels of management. With consistent Senior Leadership visibility, the IT BSA Sr is also responsible for partnering ... to elicit, define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT… more
- The Walt Disney Company (Celebration, FL)
- **Job Summary** Under the oversight of the Senior Manager of Marine and Technical Projects, oversees the warranty claim coordination between key project teams, ... the warranty claim + Review, assess, and submit warranty claims , as specified in the agreed warranty guidelines by...and key OEM subcontractors regarding the status of their claims and provide updates + Maintain accurate and detailed… more
- L3Harris (Melbourne, FL)
- …centralized Global Labor & Employment practice group, reporting to the Senior Director, Managing Counsel - Labor, Employment, Benefits, and Immigration. Essential ... Functions: + Investigate, negotiate and resolve pre-litigation claims and administrative charges to drive results consistent with the company's labor and employment … more
- Prime Therapeutics (Tallahassee, FL)
- …- Remote **Job Description** **Calling all Solution Strategists!!** **We are looking for 2 Senior Solution Strategists to be a part of our JUDI Team.** **The first ... role will be focused on Claims Compare - analyzing data to identify key points....second role will focus on interfacing with clients and Senior Leadership, while utilizing project management skills.** The … more
- Norstella (Tallahassee, FL)
- …and India. **Job Description :** We are seeking a dynamic and visionary Senior Director of RWD (Real-World Data) Analytics and Innovation to lead real-world data ... integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health (SDoH) data, to drive… more
- MyFlorida (Tallahassee, FL)
- …Antitrust litigation + Experience in Complex litigation + Experience in False Claims Act litigation + Experience with E-discovery + Undergraduate degree in Economics ... in this class. This position works under the direct supervision of a senior level attorney. I. INVESTIGATION OF ANTITRUST VIOLATION: Assists the Lead Attorney in… more
- Molina Healthcare (St. Petersburg, FL)
- …you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners ... gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior individual contributor with the charter to build a focused CTM… more
- Prime Therapeutics (Tallahassee, FL)
- …Sr. Functional Bus Consultant (Compliance) - Remote **Job Description** The Senior Functional Business Consultant The Functional Business Consultant serves as a ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to… more