- RELX INC (Boca Raton, FL)
- …driving evidence-based solutions to help our clients make more informed decisions and help mitigate risk . About the Role: The Fraud Data Analyst works as part of ... About the Business: LexisNexis(R) Risk Solutions provides customers with solutions and decision...a disability or other need that requires accommodation or adjustment , please let us know by completing our Applicant… more
- CVS Health (Tallahassee, FL)
- …the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required.… more
- 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), ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key… more
- The Cigna Group (Lake Mary, FL)
- …trends, variances, and key issues and provides recommendations for adjustment . Responsible for conducting moderately complex financial analysis projects and/or ... system applications for processing and reporting financial information. May administer risk management and loss prevention programs to maintain maximum protection of… more
- Molina Healthcare (Orlando, FL)
- …directly with **clinicians, nurses, or case management teams** + Familiarity with risk adjustment , value-based care models, or healthcare performance metrics + ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating… more
- Datavant (Tallahassee, FL)
- …reports directly to the Director of Strategic Operations. As a trusted partner to the Risk Adjustment COO and broader leadership team, you'll play a key role in ... for delivering results **Bonus Points If:** + You have experience in risk adjustment coding applications and technology \#LI-BC1 We are committed to building a… more
- Centene Corporation (Tallahassee, FL)
- …evaluation. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. Pay ... Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with… more
- Citigroup (Tampa, FL)
- …President - Hybrid The Business Execution Lead (Data Governance Foundation Senior Lead Analyst - C14) is responsible for leading activities that contribute to the ... definition of the Enterprise and Wholesale Loans Data Governance Strategy, Data Risk and Control Framework, and plays a critical role in leading activities to… more
- CenterWell (Tallahassee, FL)
- …specific to cardiology, nephrology, orthopedics, and oncology + Familiarity with risk adjustment methodologies and population health analytics. + Experience ... programs, specialty provider network development, and financial performance. The Senior Analyst will work closely with market leadership, executive stakeholders, and… more