- Molina Healthcare (Tampa, FL)
- …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...position will be a communicator to internal and external business partners and a problem solver/agent for change to… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...position will be a communicator to internal and external business partners and a problem solver/agent for change to… more
- Molina Healthcare (Tampa, FL)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (Tampa, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- Elevance Health (Tampa, FL)
- ** Business Information Analyst Sr. - Cost of Care** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates ... miles of one of Elevance's Pulse Point locations. **The Business Information Analyst Sr. - Cost of...outcomes such as return-on-investment (ROI) and payback periods using claims and authorization data. * Lead and/or actively participate… more
- Molina Healthcare (Tampa, FL)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Tampa, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- Molina Healthcare (Tampa, FL)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and related financial data like risk...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- The Cigna Group (Tampa, FL)
- …the office or visit Providers 3 days per week** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and reports ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- Molina Healthcare (Tampa, FL)
- **Job Description** **Job Summary** The Sr. Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Molina Healthcare (Tampa, FL)
- **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides ... as directed by the Enrollment team . Partners with the vendor to analyze business and vendor performance problems and issues using data from internal and external… more
- MUFG (Tampa, FL)
- …US compliance regulation checks/screening/data entry; and (h) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, ... Laws)/FEFTA /Red flags/vessels/shipping lines/ports/country violations relating to trade finance documents/ claims /transactions. **Transaction Processing in Trade 360 System** : Prepare… more
- MUFG (Tampa, FL)
- …US compliance regulation checks/screening/data entry; and (c) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, ... Laws) /Red flags/vessels/shipping lines/ports/country violations relating to trade finance documents/ claims /transactions. **Transaction Processing in Trade 360 System** : Prepare… more
- Molina Healthcare (Tampa, FL)
- …used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables ... departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods… more
- Molina Healthcare (Tampa, FL)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more