- MyFlorida (Tallahassee, FL)
- …Plan Management Operations (PMO). PMO is responsible for the primary oversight of Medicaid's managed care programs, with a focus on the Statewide Medicaid ... 68022205 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Jul 31, 2025...Managed Care (SMMC) program. The bureau's primary responsibility is ensuring that… more
- MyFlorida (Tallahassee, FL)
- …does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive ... 68064376 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: Jul 24,...responsibility: Fraud and Abuse Detection, Prevention, Overpayment Recovery, and Managed Care oversight. MPI operates with dynamic… more
- AdventHealth (Altamonte Springs, FL)
- …are being spent to close the most critical gaps in lowering the cost of care . The Analyst uses healthcare data (claims, labs, EHR data) analytics to gain ... **Health Plan Data Analyst ** **AdventHealth PHSO Resources** **All the benefits and...focused on lowering the cost of healthcare for our managed populations by providing actionable data to the Population… more
- Intermountain Health (Tallahassee, FL)
- …pathology, radiology, picture archiving and communications (PACS), cardiovascular, pharmacy, home care , long term care , population health, consumer and patient ... scheduling, time and attendance, customer relationship management) The Principal analyst is responsible for providing overseeing technical support, configuration,… more
- MyFlorida (Miami, FL)
- …Certified Public Accountants (AICPA). Auditing and analyzing complex financials of the managed care provider including their provider network. Analyze and ... AUDIT EVALUATION & REVIEW ANALYST - 41000827 Date: Jul 21, 2025 The...interpret managed care encounter data. Communicating the results...interpret managed care encounter data. Communicating the results of your analysis… more
- MyFlorida (Tallahassee, FL)
- GOVERNMENT ANALYST II - 64081770 1 Date: Jul 24, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 857453 Agency: Department of Health Working Title: GOVERNMENT ANALYST II - 64081770 1 Pay Plan: Career Service Position Number: 64081770… more
- Evolent (Tallahassee, FL)
- …analytics or utilization management within a payer, provider, clinical vendor, managed care , or healthcare consulting environment. + Strong understanding ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...for the culture. **What You'll Be Doing:** **Senior Scope Analyst , Scope Management** The Specialty Scope Management team is… more
- Molina Healthcare (Jacksonville, FL)
- …facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (FL)
- …Target/Ranking Engine for all line of businesses. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and related financial ... **Job Description** **Job Summary** The Analyst , Risk Adjustment-Predictive Analytics role will support Molina's...cleaning of data. + 1-3 Years of experience in Managed Care Organization executing similar techno functional… more
- Molina Healthcare (FL)
- …for Medicaid, Marketplace and Medicare/MMP + Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates ... **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's...cleaning of data + 3-5 years of experience in Managed Care Organization executing similar techno functional… more