- Molina Healthcare (St. Petersburg, FL)
- …strategic investment decisions + Research and develop reports and analyses for senior management and effectively and concisely communicate results and key ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment… more
- Bank of America (Miami, FL)
- …coaching + Self-motivated and results-oriented with excellent organizational skills **Skills:** + Claims Management + Controls Management + Monitoring, ... Treasury - Senior Quality Analyst (Bilingual - English...Surveillance, and Testing + Policies, Procedures, and Guidelines Management + Quality Assurance + Attention to Detail +… 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 ... Short Term Disability (STD), State Plans, PFML, and concurrent Absence Management Solutions (AMS) claims to ensure we meet or exceed customer expectations. Will… more
- Molina Healthcare (Miami, FL)
- …easy to understand. + Research and develop reports and analysis for senior management and effectively communicate results. **JOB QUALIFICATIONS** **Required ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk...analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue,… 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
- 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 ... into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver… more
- CVS Health (Tallahassee, FL)
- …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 efficiency....+ 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 ... into technical solutions. This role works closely with clinicians, care management teams, and business stakeholders to gather requirements and deliver actionable… 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