• Lead Analyst , Claims…

    Molina Healthcare (Orlando, FL)
    …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
    Molina Healthcare (06/18/25)
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  • Lead Analyst , Configuration…

    Molina Healthcare (Orlando, FL)
    **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
    Molina Healthcare (07/24/25)
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  • Lead Analyst , Payment Integrity

    Molina Healthcare (Orlando, FL)
    …**Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
    Molina Healthcare (08/20/25)
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  • Lead Analyst , Healthcare Analytics-…

    Molina Healthcare (Orlando, FL)
    …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
    Molina Healthcare (09/11/25)
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  • Payer Manager

    AdventHealth (Maitland, FL)
    …component data into designated contract management system being mindful of regulatory changes that impact estimated reimbursement. Ensures thorough research and ... validation of non-contracted and government payer information * including regulatory and interim rate updates in relevant programs for Midwest, Southeast, Southwest,… more
    AdventHealth (09/09/25)
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