- Molina Healthcare (Miami, FL)
- …Operations teams + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...Molina. Identifies the root cause of processing errors through research and analysis, coordinates and engages with appropriate departments,… more
- Elevance Health (Miami, FL)
- **Title: Grievance/Appeals Analyst I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... and ensures essential face-to-face onboarding and skill development. The **Grievance/Appeals Analyst I** is an entry level position in the Enterprise Grievance… more
- University of Miami (Miami, FL)
- …Department of SCCC has an exciting opportunity for a Full Time Remote Regulatory Analyst 1. CORE JOB SUMMARY: The SCCC department is seeking a Regulatory Analyst ... and testing the revised treatment matrix which will identify possible cancers from claims data. The RA1 will facilitate the process of preparing required regulatory… more
- University of Miami (Miami, FL)
- …of Miami/UHealth Department of SCCC has an exciting opportunity for a Full Time Regulatory Analyst 1 to work remotely. CORE JOB SUMMARY The Regulatory Analyst 1 ... tests the revised treatment matrix to identify possible cancers from claims data. CORE JOB FUNCTIONS Analyzes regulatory requirements, identifies potential… more
- University of Miami (Miami, FL)
- …System, "UHealth", IT Department has an exciting opportunity for a Full-time Epic Sr. Analyst - Quality and Population Health. The Epic Sr. Analyst - Quality ... and procedures and safeguards University assets. Department Specific Functions: As an Epic Analyst - Quality and Population Health, you will: + Build and maintain… more
- University of Miami (Miami, FL)
- …System IT Department has an opportunity for a full-time Epic Senior Analyst - Resolute Professional Billing. The Epic Senior Analyst , Resolute Professional ... Epic Analysts and Epic Analysts on the team. The Epic Senior Analyst , Resolute Professional Billing initiates the implementation, builds, and modifies of the… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Actuarial Services Analyst - Service Fund is responsible for managing and tracking the risk positions ... process improvement, solution assessment, etc. + Analyzes and validates payer claims data, funding data, underlying capitations, settlement terms, and contractual… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL… more