- Elevance Health (Miami, FL)
- **Proposal Development Analyst Sr ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... is granted as required by law._ The **Proposal Development Analyst Sr ** is responsible for providing technical...the business units' capabilities with respect to product design, managed care programs, financial strategies, etc. +… more
- Elevance Health (Lake Mary, FL)
- **Provider Contract Cost of Care Analyst Senior ** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... as required by law. The **Provider Contract Cost of Care Analyst Senior ** provides analytical...a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... Marketplace and Medicare/MMP + Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates + Assists… more
- CVS Health (Tallahassee, FL)
- …**Required Qualifications** - Candidate must reside in Florida (FL) - 5 years experience in managed care quality and/or 3 years in Medicaid managed care ... - National Committee for Quality Assurance (NCQA) accreditation experience - Medicaid managed care experience - Master's Degree **Education** Bachelor's Degree… more
- Prime Therapeutics (Tallahassee, FL)
- …projects simultaneously. + Strong analytical skills **Preferred Qualifications** + Pharmacy services, PBM, managed care or health care industry experience + ... purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven...the future of pharmacy with us. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description**… more
- Molina Healthcare (Miami, FL)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Proficiency with retrieving specified ... **JOB DESCRIPTION** **Job Summary** Provides senior level analyst support for medical...medical coding/billing (UB04/1500 form). * Demonstrated understanding of key managed care concepts and provider reimbursement principles… more
- Molina Healthcare (St. Petersburg, FL)
- …management experience maintaining databases, and/or analyst experience within a health care operations setting in a managed care organization supporting ... JOB DESCRIPTION Job Summary Provides senior level analyst support for configuration information management activities. Responsible for accurate and timely… more
- Molina Healthcare (Miami, FL)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...cleaning of data. + 5+ Years of experience in Managed Care Organization executing similar techno functional… more
- Highmark Health (Tallahassee, FL)
- …various complex potential claims with emphasis on controlling losses through effective managed care . This includes following a departmental claim checklist to ... **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information effectively. +… more
- Molina Healthcare (Miami, FL)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake...4 years of experience in previous roles in a managed care organization, health insurance or directly… more