- Prime Therapeutics (Tallahassee, FL)
- …drives every decision we make. **Job Posting Title** Specialty & Home Delivery Program Claims Analyst - Remote **Job Description** The Specialty & Home Delivery ... Program Claims Analyst is responsible for serving as...Pharmacy Match product which may include implementations, projects, claims & performance guarantee monitoring, and testing. This position… more
- TEKsystems (Orlando, FL)
- Senior Medical Claims Analyst (Remote) Contract Duration: Through January 2026 (with potential for extension) Location: Remote (US based) Schedule: Flexible ... the Role We're seeking a detail-oriented and analytical Senior Claims Analyst to join our team. This...adjudication platform. Key Responsibilities + Perform manual calculations on pharmacy claims and coupon submissions. + Use… more
- Baylor Scott & White Health (Tallahassee, FL)
- …, MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with Healthcare claims , enrollment and pharmacy data is preferred + Knowledge of ACA, ... TPA business requirements preferred.Experience with healthcare encounters, enrollment and pharmacy data preferred. **BENEFITS** Our competitive benefits package… more
- CVS Health (Tallahassee, FL)
- …Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...You will work with a collaborative, close-knit team on pharmacy and member specific claims data… more
- CVS Health (Miami, FL)
- …available benefits and services. + **Reporting & Analytics:** Review and interpret data related to claims , utilization, and service issues. Communicate insights ... do it all with heart, each and every day. **Position Summary** As the Benefits Analyst , Account Manager at CVS Health, you will play a critical role in supporting… more
- Prime Therapeutics (Tallahassee, FL)
- …related work experience; HS diploma or GED is required + 2 years of experience within Claims Processing, Audit, Quality or Pharmacy + Must be eligible to work in ... our passion and drives every decision we make. **Job Posting Title** QA Analyst PBM Implementation - Remote **Job Description** The Quality Assurance (QA) Analyst… more
- Evolent (Tallahassee, FL)
- …fosters expertise and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding health plan cost ... **What You'll Be Doing:** **Who You'll Be Working With:** The Senior Analyst Performance Suite Analytics utilizes and develops project management tools to solve… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current… more
- Molina Healthcare (Tampa, FL)
- …for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy , Lab and HEDIS rates. + ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...users on how to use reports. + Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics along… more
- Molina Healthcare (FL)
- …Marketplace and Medicare/MMP * Develops custom health plan reports related to managed care data like Medical Claims , Pharmacy , Lab and HEDIS rates * ... **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will...develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for rate tracking… more