• Senior Analyst, Medical Economics - REMOTE

    Molina Healthcare (Miami, FL)
    …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... clinical performance is achieving desired results. * Keeps abreast of Medicaid and Medicare reforms and impact on the Molina business. * Supports scoreable action… more
    Molina Healthcare (01/11/26)
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  • Claims Processing Representative

    CenterWell (Miramar, FL)
    …Knowledge of HIPAA 837 and 835 electronic claims transactions + Knowledge of Medicare Risk Adjustment and/or Medicaid processes **Additional Information** + ... knowledge of medical claims processes + Knowledge of CPT, ICD-10, and HCPCS coding + Medical terminology + Ability to manage multiple or competing priorities, work… more
    CenterWell (01/17/26)
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  • VP, Medical Economics

    Molina Healthcare (Jacksonville, FL)
    …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced analytical work… more
    Molina Healthcare (12/23/25)
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  • Lead Data Engineer

    Convey Health Solutions (Fort Lauderdale, FL)
    …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... is at the level needed for our solutions + Follow best practices and coding standards to create custom scripts to clean/map/align client data to the expected inputs… more
    Convey Health Solutions (01/15/26)
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