- Molina Healthcare (Jacksonville, FL)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Molina Healthcare (Orlando, FL)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Molina Healthcare (Miami, FL)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Molina Healthcare (Orlando, FL)
- …Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data , and ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst, Healthcare Analytics role will be responsible...I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + Data… more
- AdventHealth (Maitland, FL)
- …sources using knowledge of healthcare managed care contracts and healthcare administrative claims data + Employs existing complex models and implements them ... to the team:** + Research and analyzes managed care data from the various financial systems and...provider types + Applies detailed understanding of medical coding systems affecting the adjudication of claims to… more
- Sedgwick (Tampa, FL)
- …+ Assists with ad hoc analysis and communicates results and recommendations to senior management. + Maintains various systems and updates as appropriate; may ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . FP&A Analyst/ Hybrid **PRIMARY PURPOSE** **:** To partner with and support the… more
- Medtronic (Miami, FL)
- …for these individuals. We are hiring a passionate, fast-paced, and strategic ** Sr . Group Market Development Manager** to manage the healthcare professional (HCP) ... and provides strategic support to reimbursement, clinical, and sales teams. The Sr . Group Market Development Manager will focus on increasing healthcare professional… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **Responsibilities:** + The Managed Care Financial Analyst Sr . performs financial analyses of patient data for BayCare ... reports for health system management. + Models contracts performance in adjudication systems and Excel during the contract negotiation process. + Serves as Primary… more
- Molina Healthcare (Orlando, FL)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr . Analyst, Network Strategy, Pricing & Analytics guides...(including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future… more
- Molina Healthcare (FL)
- … systems to support executive decision-making + Mine and manage information from large data sources + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...reports, and improvement opportunities based on analyses + Provide data driven analytics to Clinical COE, Finance, Claims… more