• Quality Management Analyst 3

    University of Miami (Miami, FL)
    …& Immuno department has an exciting opportunity for a Quality Management Analyst 3 position. The incumbent conducts highly complex analysis while leading the ... state and federal programs, inclusive of the Centers for Medicare and Medicaid Services. Maintains fluency of provider workflows across UHealth that influence… more
    University of Miami (07/16/25)
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  • Senior Analyst , Special Investigative Unit

    CVS Health (Tallahassee, FL)
    …+ Pharmacy Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree in Criminal ... Justice or equivalent experience **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $112,200.00 This pay range represents the base hourly rate or base annual full-time salary for all… more
    CVS Health (08/24/25)
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  • Analyst , Business Quality (Remote)

    Molina Healthcare (Orlando, FL)
    …**PREFERRED EXPERIENCE:** + SQL expertise + Excel expertise + Medicare, Medicaid , Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally ... favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable… more
    Molina Healthcare (08/24/25)
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  • Senior Analyst , Quality Management

    CVS Health (Tallahassee, FL)
    …to multiple internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree ... or equivalent work experience in healthcare data **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $102,000.00 This pay range represents the base hourly rate or base annual full-time… more
    CVS Health (08/24/25)
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  • Special Investigation Unit Lead Review…

    CVS Health (Tallahassee, FL)
    …Care Anti-Fraud Association (AHFI), or have a minimum of three years Medicaid Fraud, Waste and Abuse investigatory experience. * Billing and Coding certifications ... such as CPC (AAPC)and/or CCS (AHIMA) * Knowledge of Behavioral Health policies and procedures is a plus * Experience working Behavioral Health fraud cases **Education** A Bachelor's degree, or an Associate's degree, with an additional three years (3 years… more
    CVS Health (08/20/25)
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  • Senior Analyst , Business Analytics

    CVS Health (Jacksonville, FL)
    …Qualifications** * QuickBase Expert or Pipelines Builder certification * 3+ Healthcare/ Medicaid experience * 3+ years provider data experience * Project Management ... experience **Education** Bachelors Degree or equivalent work experience **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $102,000.00 This pay range represents the base hourly rate or… more
    CVS Health (08/20/25)
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  • Lead Analyst , Claims/ Regulatory…

    Molina Healthcare (Jacksonville, FL)
    …on researching, presenting and documenting is required, + Experience with Medicare, Medicaid and Marketplace is required. + Medical coding experience is highly ... preferred. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination of education and experience **Required Experience** 7-9 years **Preferred Education** Graduate Degree or equivalent experience **Preferred Experience** 10+… more
    Molina Healthcare (06/18/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (FL)
    …coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** + ... At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization...experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects… more
    Molina Healthcare (08/14/25)
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  • Membership Accounting Advocate

    Convey Health Solutions (Fort Lauderdale, FL)
    Job Description The Membership Accounting Analyst is responsible for the timely and accurate resolution of discrepancies identified in the Enrollment, Billing and/or ... Reconciliation processes. The analyst will review documentation, work items in queues and...for correction and submission to Centers for Medicare & Medicaid Services (CMS) + Review and complete Late Enrollment… more
    Convey Health Solutions (08/20/25)
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  • Managed Care Specialist (Finance)

    Devereux Advanced Behavioral Health (Orlando, FL)
    …mission and culture? Then consider joining Devereux Florida as a Finance Analyst (Contracts / Managed Care)!_ Devereux provides mental and behavioral health services ... for new MDs and ARNPs joining MMA plans. + Apply for Florida Medicaid numbers for providers during onboarding. + Complete special projects within designated… more
    Devereux Advanced Behavioral Health (08/26/25)
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