• Special Investigation Unit Lead Review Analyst…

    CVS Health (Tallahassee, FL)
    …**Required Qualifications** + 3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and ... healthcare coding. + Must be able to travel to provide testimony if needed. + Experience with Excel. **Preferred Qualifications** + Certified Professional Coder + Knowledge of CVS/Aetna's policies and procedures + Excellent verbal and written communication… more
    CVS Health (11/19/25)
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  • Risk Management Coordinator

    HCA Healthcare (Aventura, FL)
    …Risk Management Coordinator? At HCA Florida Aventura Hospital, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible ... on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more
    HCA Healthcare (10/24/25)
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  • Facets Healthcare Developer

    Cognizant (Tallahassee, FL)
    **Facets Healthcare Developer** **Work Model: Remote** **Employment Type: Full-Time** **Job ID: 00065752001** **About the role** As a **Senior Developer** , you will ... make an impact by designing, developing, and deploying robust solutions for healthcare platforms. You will be a valued member of the delivery team and work… more
    Cognizant (11/12/25)
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  • RN Infection Prevention and Employee Health

    HCA Healthcare (Niceville, FL)
    …HCA Florida Twin Cities Hospital our nurses set us apart from any other healthcare provider. We are seeking a(an) RN Infection Prevention and Employee Health to join ... our healthcare family. **Benefits** HCA Florida Twin Cities Hospital, offers...inservices. Ensures the timely processing of employee workers' compensation claims ; evaluates occurrence reports to determine accuracy and completeness.… more
    HCA Healthcare (11/10/25)
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  • Admissions Rep Registrar

    HCA Healthcare (Gainesville, FL)
    …Admissions Rep Registrar? At North Florida Surgical Pavilion, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...and insurance information to ensure accurate coding, billing and claims submission. What you will do: + You will… more
    HCA Healthcare (11/14/25)
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  • Lead Investigator, Special Investigative…

    Molina Healthcare (Tampa, FL)
    …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to organize,… more
    Molina Healthcare (11/21/25)
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  • Payment Integrity Intern (Analytics) - REMOTE

    Molina Healthcare (St. Petersburg, FL)
    **JOB DESCRIPTION** **Job Summary** The Molina Healthcare Internship Program shares an objective to create a stepping stone for students who aim to be professionals ... and future leaders in the healthcare business profession. Interns are assigned special projects and...learning and rule-based logic to detect potentially incorrectly paid claims .​ + Contribute to improve data quality, perform data… more
    Molina Healthcare (11/21/25)
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  • Medical Director

    Molina Healthcare (Tampa, FL)
    …medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements in efficiency and ... focused reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.… more
    Molina Healthcare (10/17/25)
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  • Senior Analyst, Quality Analytics & Performance…

    Molina Healthcare (St. Petersburg, FL)
    …Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS ... + 3+ Years of experience with predictive modeling in healthcare quality data. + 3+ Years of experience in...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
    Molina Healthcare (11/27/25)
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  • Associate Specialist, Corporate Credentialing…

    Molina Healthcare (FL)
    …DESCRIPTION** **Job Summary** Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
    Molina Healthcare (11/27/25)
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