- 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
- Bank of America (Miami, FL)
- Treasury - Senior Quality Analyst (Bilingual - English / Spanish (Portuguese a plus) Miami, Florida **To proceed with your application, you must be at least 18 ... be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Miami/Treasury Senior -Quality- Analyst --Bilingual English Spanish--Portuguese-a-plus-\_25030676-2) **Job Description:** At Bank… more
- CVS Health (Tallahassee, FL)
- …has an exciting opportunity to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to ... 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 Compliance Pharmacy Payments team.… 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 ... Disability (STD), State Plans, PFML, and concurrent Absence Management Solutions (AMS) claims to ensure we meet or exceed customer expectations. Will engage business… more
- Molina Healthcare (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
- Highmark Health (Tallahassee, FL)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… 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 ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient… more
- MetLife (Tampa, FL)
- …Responsibilities: * Conducts quality reviews of Americans with Disabilities Act (ADA) claims . * Identifies trends, root causes, and quality gaps from the analysis ... the training and procedures team. * Presents findings to Senior Level Management and other key stakeholders. * Coach...supported. Required: * 3+ years of experience managing ADA claims . * Experience managing absence claims for… 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 ... Qualifications** + Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims , Rebates, Network contracting, Sales, Call Center Ops and Pharmacy… 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 ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines… more