• Senior Analyst , Special…

    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 ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
    CVS Health (08/24/25)
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  • Senior , Compliance Risk Adjustment…

    Centene Corporation (Tallahassee, FL)
    …with a focus on the auditing and monitoring functions. Collaborates with business areas to ensure effective prevention, detection, and correction of compliance ... landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: $68,700 -123,700 annual Centene offers a… more
    Centene Corporation (07/31/25)
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  • Risk Adjustment Audit Operations Analyst

    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
    Molina Healthcare (08/08/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Tallahassee, FL)
    …The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer ... as it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more
    Humana (08/14/25)
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  • Quality Management Analyst 2

    University of Miami (Miami, FL)
    …at the University of Miami has an exciting opportunity for a Quality Management Analyst 2. CORE JOB SUMMARYThe Quality Management Analyst 2 performs complex ... monitored and published by external regulatory agencies, ie, Centers for Medicare and Medicaid Services, Hospital Compare and Physician Compare. Collaborates closely… more
    University of Miami (07/25/25)
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  • Quality Management Analyst 3

    University of Miami (Miami, FL)
    …& Immuno department has an exciting opportunity for a Quality Management Analyst 3 position. The incumbent conducts highly complex analysis while leading the ... the mandates by state and federal programs, inclusive of the Centers for Medicare and Medicaid Services. Maintains fluency of provider workflows across UHealth that… more
    University of Miami (07/16/25)
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