- Molina Healthcare (FL)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... scrubbing, scrapping, and cleaning of data. + 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing… more
- Molina Healthcare (Tampa, FL)
- …scrubbing, scrapping, and cleaning of data. * 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing ... **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will...Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting… more
- Molina Healthcare (Miami, FL)
- …Experience** + 2-5 years of experience in business analysis, preferably in a managed care or CMS environment + Familiarity with Agile methodologies and ... **Job Summary** Molina Healthcare is seeking a seasoned Business Analyst to support cross-functional initiatives across all lines of business. This role… more
- Molina Healthcare (FL)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation...4 years of experience in previous roles in a managed care organization, health insurance or directly… more
- Evolent (Tallahassee, FL)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... teams in developing the strategic approach for innovative and in-demand value-based care pursuits. + Support the development of capitated risk partnerships,… more
- Centene Corporation (Tallahassee, FL)
- …process, gathering requirements) experience in healthcare industry or 3+ years of managed care encounters experience. Experience with encounters or claims ... business analysis experience in healthcare, preferably managed care or Medicaid. Knowledge of Amisys or other claims system, HIPAA transactions (ie 837, 999,… more
- CVS Health (Sun City Center, FL)
- …changing environment - Effective communication skills, both verbal and written - Managed Care experience - Computer proficiency in Microsoft Word, Excel, ... in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care … more
- American Red Cross (FL)
- …life's work with an ongoing mission that's bigger than all of us. As you care for others, you're cared for with competitive compensation and benefits. You join a ... data sets, industry benchmarks, and market trends to identify patterns, support feasibility assessments, and recommend innovative sourcing and category strategies. +… more
- Highmark Health (Tallahassee, FL)
- …auditing, investigations, regulatory accreditation, process improvement, project management and/or managed care operations **Knowledge, Skills and Abilities** + ... governmental, contractual, and/or corporate entities. Provide consultation and analytic support to assigned functional areas. Continuously monitors regulatory changes,… more
- Elevance Health (FL)
- …range of experience with autism services and treatment required. + Prior managed care experience required. **Preferred Skills, Capabilities and Experiences:** + ... use disorder management, a comprehensive employee assistance program, work/life support , specialty programs for autism and depression, and insightful analytics… more