- Humana (Tallahassee, FL)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Evolent (Tallahassee, FL)
- …team at Evolent. This individual will be primarily focused on performing medical economics analysis in support of complex risk-based contract development and will ... into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- The Cigna Group (Sunrise, FL)
- …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, ... Providers 3 days per week The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider...Cigna's competitive position. + Supports initiatives that improve total medical cost and quality. + Drives change with external… more
- Mass Markets (FL)
- …partner in the industry. We are looking for a proactive and detail-oriented Real-Time Analyst to join our workforce management team. This role is crucial in ensuring ... sometimes even cars! + Health Benefits:Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of employment, and all… more
- CVS Health (Tallahassee, FL)
- …day. **Position Summary** CVS Health is looking for an experienced Business Analyst , QA and Technical SME with focus on balancing high-impact business management ... our various enterprise operations teams using a variety of platforms. We service medical , pharmacy, sales, product and call center support models across the CVS… more
- NextEra Energy (North Palm Beach, FL)
- **Compliance Analyst ** **Date:** Aug 22, 2025 **Location(s):** North Palm Beach, FL, US, 33408 **Company:** NextEra Energy At PALMS Insurance, a NextEra Energy ... state regulations and requirements + Assists with managing producer, broker, and claims adjuster licenses and renewals and database management + Periodically meets… more
- CVS Health (Tallahassee, FL)
- …setup, essential for online viewing and processing, related to customer service, claims , enrollment, billing, and reporting, in support of internal and external ... client advocacy, and/or account management, including a demonstrated knowledge of medical terminology. + Ability to work Monday-Friday from 8am-5pm, with the… more
- CVS Health (Tallahassee, FL)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
- CVS Health (Tallahassee, FL)
- …in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
- Polk County Public Schools (Bartow, FL)
- …TPA regarding claims management. * Serves as a backup to Analyst and management at legal proceedings including workers' compensation and liability mediation ... and risk management administration. This position gathers information, reviews claims , communicates and coordinates information to third-party administrators (TPA),… more