- Molina Healthcare (Jacksonville, 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
- Elevance Health (Miami, FL)
- …non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...regulatory standards and requirements. + As such, the analyst will strictly follow department guidelines and tools to… more
- Prime Therapeutics (Tallahassee, FL)
- …passion and drives every decision we make. **Job Posting Title** Sr. Market Pricing Analyst - REMOTE **Job Description** The Senior Market Pricing Analyst serves ... of new or enhanced financial pricing strategies. This position will also lead complex financial pricing analyses and provide consultation and analytic insight to… more
- Prime Therapeutics (Tallahassee, FL)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides ... programs that align with Prime's strategic imperatives and will lead high-complexity analysis and special projects as required. **Responsibilities** +… more
- Cognizant (Tallahassee, FL)
- …modern technologies to transform a variety of business operations. The **Encounters Analyst ** plays a critical role in ensuring the accurate and timely submission ... of healthcare encounter data to regulatory agencies. This **fully remote, US-based** position is responsible...scorecards and process-related MIS. **Continuous Improvement & Collaboration** + Lead and participate in Lean and Kaizen projects to… more
- Highmark Health (Tallahassee, FL)
- …or more of the following: + Perform research on projects and manage and lead projects to successfully meet business objectives. May manage all size projects (small, ... corporate guidelines, regulations, and policies and procedures. Continuously monitor regulatory changes, legislative efforts, industry trends, and/or contract changes.… more