- Molina Healthcare (Jacksonville, FL)
- …to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, ... and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and performs audits… more
- AdventHealth (Maitland, FL)
- …Onsite) **Job Location** : Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving ... multiple sources of data to support executive decision-making regarding contract violations. The Senior Compliance Analyst will have expertise in Commercial… more
- Centene Corporation (Tallahassee, FL)
- …in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the auditing and monitoring ... with business areas to ensure effective prevention, detection, and correction of compliance issues. Facilitates and leads external audits related to Risk Adjustment… more
- CVS Health (Tallahassee, FL)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... Federal regulations and internal policies and procedures. Contributes to compliance reporting and documentation, highlighting findings, recommendations, and areas of… more
- Prime Therapeutics (Tallahassee, FL)
- … Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's ... with business partners across the enterprise. **Responsibilities** + Executes compliance procedures and enforces policy governance across the organization to… 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
- 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
- BayCare Health System (Clearwater, FL)
- …FL (Hybrid) | Full-Time | Exempt | Reimbursement Department **About the Role:** The Senior Revenue Management Analyst plays a key role in BayCare's Reimbursement ... supports accurate net revenue analysis, financial forecasting, and regulatory compliance . The ideal candidate brings strong healthcare finance knowledge, sharp… more
- Banner Health (FL)
- …with regard to interpretation of coding guidelines prior to referral to senior manager, educator or Coding Quality Analyst . MINIMUM QUALIFICATIONS High ... treatment information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code… more