- Molina Healthcare (St. Petersburg, FL)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- CVS Health (Tallahassee, FL)
- …has an exciting opportunity to join our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health strives ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...team is highly collaborative. You will report to the Senior Reporting Manager within the PBM Finance Data, Analytics,… more
- MetLife (Tampa, FL)
- …for meetings How You'll Help Us Build a Confident Future (Key Responsibilities): The STD Senior Quality Analyst is responsible for: * Working with senior ... functions meet quality and performance standards. * Evaluating and improving business and associate performance by effectively conducting quality evaluations of… more
- Molina Healthcare (St. Petersburg, FL)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives ... by translating healthcare business needs into technical solutions. This role works closely...queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and… more
- Prime Therapeutics (Tallahassee, FL)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization + ... drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy...define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business… more
- CVS Health (Tallahassee, FL)
- …be willing to work EST time zone hours.** **Position Summary** We are hiring a Senior Analyst to support the Complaint, Grievances and Appeals (CG&A) team. This ... and answering ad-hoc requests + Work closely with analysts and other business partners to gather requirements and understand the reporting needs for ad-hoc… more
- CVS Health (Tallahassee, FL)
- …each and every day. **Position Summary** CVS Health is looking for an experienced Business Analyst , QA and Technical SME with focus on balancing high-impact ... business management solutions with small project speed to market...+ Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims , Rebates, Network contracting, Sales, Call Center Ops and… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... healthcare business needs into technical solutions. This role works closely...queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain… more
- CVS Health (Tallahassee, FL)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more