- 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
- Highmark Health (Tallahassee, FL)
- …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **LICENSES or CERTIFICATIONS** **Required** + None… 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 ... decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job...project team and various levels of management. With consistent Senior Leadership visibility, the IT BSA Sr is also… more
- AdventHealth (Maitland, FL)
- …FL hybrid (Monday, Wednesday, Thursday) on-site **The role you will contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating ... care contracts and proposals, analyze fee schedules, and determine contract compliance. The Senior Medical Economics analyst must have attention to detail and… more
- AdventHealth (Altamonte Springs, FL)
- …providing actionable data to the Population Health team. The Health Plan Data Analyst engages clients (finance team, senior leaders, leaders, health plans, ... the most critical gaps in lowering the cost of care. The Analyst uses healthcare data ( claims , labs, EHR data) analytics to gain insights into provider ordering,… more
- Prime Therapeutics (Tallahassee, FL)
- …Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value generated by Prime's ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Humana (Tallahassee, FL)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more
- Norstella (Tallahassee, FL)
- …therapies to market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. ... Sr. Medical Analyst Company: MMIT Location: Remote, United States Date...extract meaningful insights from real-world data (RWD) sources, including claims , laboratory results, billing codes, and electronic health records… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and… more
- Sedgwick (Jacksonville, FL)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Data Analyst Manager **PRIMARY PURPOSE OF THE ROLE:** To manage a staff of data ... data reports and provides analysis for forecasting and/or benchmarking used by senior management. + Reports directly to senior management and communicates… more