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AWS Audit/Risk Analyst
1 week ago
Saxon Global Doral, United StatesPosition: AWS Audit/Risk Analyst · Location: Ideally onsite in Miami or Boston, but open to remote talen · Duration: 6+ Months · Overview: · Our client's IT Audit team is searching for a contract role to support the analysis of Amazon Web Services public cloud environments. The ...
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Senior Analyst, Technology Internal Audit
2 weeks ago
Circle Doral, United StatesCircle is a financial technology company at the epicenter of the emerging internet of money, where value can finally travel like other digital data - globally, nearly instantly and less expensively than legacy settlement systems. This ground-breaking new internet layer opens up p ...
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Data Analyst
2 weeks ago
Global Human Capital Group Miami, United States Full timeRequirements · Bachelor Degree or Equivalent.Minimum of 5 years of relevant experience.Data analysis experience, with exposure to data analytics software, Excel or other visualisation tools.Experience of applying data analytics to audit situations and/or to the monitoring of bus ...
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Digital Growth Strategist
2 weeks ago
Kforce Miami, United States ContractDescription · Kforce has a client that is seeking Financial Reporting Production Analysts in Boston, MA.Duties Include: · Financial Reporting Production Analysts will collect, analyze, and arrange financial information to create yearly audited financial statements, such as the ba ...
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Inventory Control Analyst
1 week ago
Ascendo Resources Miami, United StatesPosition Title: Inventory Control Analyst · Location: Miami, FL · Company: Our Reputable Client · Overview: Our reputable client is seeking an experienced and analytical Inventory Control Analyst to join their team in Miami. This role is critical in ensuring accurate inventory ma ...
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Senior Insights Manager, Social Media
1 week ago
1000heads Miami, Florida, United States PermanentWe are looking for a talented Senior Insights Manager to join our Insights team. · The Insight team at 1000heads are a dynamic data-driven force, tasked with exploring what makes online consumers tick, understanding how brands are perceived by their communities and are responsib ...
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Relationship Manager
4 weeks ago
Ascensus Miami, United States Full timeJob Functions · , Essential Duties and Responsibilities Nurtures long standing relationships with clients by delivering high quality and responsive service that exceeds their expectations · Leads efforts to onboard new accounts, gather relevant information and coordinate account ...
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Compensation Analyst
2 weeks ago
ChenMed Miami, United States Full timeWe're unique. You should be, too. · We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? · We're different than ...
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Small Business Administration Credit Analyst
4 days ago
City National Bank of Florida Miami, United StatesOverview · The Small Business Administration (SBA) Credit Analyst is primarily responsible for the underwriting, processing, closing, and servicing of all SBA loan products currently offered by the Bank. As needed, will be responsible for the ongoing administration of a loan por ...
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Security Analyst
1 week ago
Apex Systems, Inc. Miami, United States Part timeJob#: · Job Description: · Apex Systems, a World-Class Technology Solutions Provider, is seeking applicants for the below position on behalf of our client. Please apply if interested and qualified. Please note that only qualified candidates will be contacted. · Position: Securit ...
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Accounting Manager
4 weeks ago
Costa Farms Miami, United States Full timeJob Details · Description · Company Overview · Who is Costa Farms? We're one of the world's largest horticultural growers—but without an ego to match our acreage. Our headquarters are in Miami, Florida, where we were founded in 1961. Costa Farms started on just 30 acres, and o ...
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Lateral Analyst
2 weeks ago
Clyde & Co Miami, United StatesJob Title Lateral Analyst Job Location Miami Job Type Business Services Country/Territory United States Region The Americas Description Overview · You will primarily be responsible for assisting Clyde & Co with the highly confidential conflicts and compliance checks of potenti ...
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Global Sourcing Specialist
2 weeks ago
Costa Farms Miami, United States Full timeJob Details · Description · Company Overview · Who is Costa Farms? We're one of the world's largest horticultural growers—but without an ego to match our acreage. Our headquarters are in Miami, Florida, where we were founded in 1961. Costa Farms started on just 30 acres, and o ...
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Manager, Clinical Documentation Improvement
2 weeks ago
University of Miami Miami, United States Full timeCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review th ...
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BI System Analyst III
3 weeks ago
Nicklaus Children's Hospital Coconut Grove, United StatesJob Summary · Responsible for conducting highly complex analysis while leading the design, planning, and production of reports and analysis related to quality performance metrics and outcomes measures for Nicklaus Children's Health System that are defined by internal parameters t ...
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Audit Manager
2 weeks ago
Spartan Placements, LLC Miami, United StatesJob Description · Job DescriptionJob OverviewWe are looking for an Audit Manager for our organization to lead the auditing process. · As a Senior Auditor, you should possess a strong knowledge of auditing principles and procedures with excellent analytical and organizational skil ...
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Deposit Operations Analyst
4 weeks ago
Pacifica Continental Miami, United StatesJob Description · Job DescriptionDeposit Operations Analyst · In Pacifica Continental we are looking for an Account Management Client Support Analyst to join an important bank in Miami. · Primary Responsibilities: · ● Process all maintenance for new/existing clients such as pers ...
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Deposit Operations Analyst
4 weeks ago
Pacifica Continental Miami, United StatesJob Description · Job DescriptionDeposit Operations Analyst · In Pacifica Continental we are looking for a Deposit Operations Analyst to join an important bank in Miami. · Primary Responsibilities: The function has as objective to provide support to and execute the demands from t ...
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Senior Tax Accountant
1 week ago
Randstad USA Miami Beach, United States Full timejob summary: · An excellent company seeking a Senior Tax Analyst to join their team · location: Miami Beach, Florida · job type: Permanent · salary: $115, ,000 per year · work hours: 9 to 5 · education: Bachelor's degree · experience: 3 Years · responsibilities:Experience in prep ...
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Field Sales Analyst
5 days ago
ExtendMyTeam Miami, United StatesJob Description · Job DescriptionWe are looking for a Field Sales Analyst to join our Sales team to uphold the company's mission and vision by optimizing both long-term and short-term objectives. The ideal candidate will be a dynamic team player who can maintain high-level custom ...
Pharmacy Benefit Audit Analyst - Miami, United States - Secure Eclaims LLC
Description
Job Description
Job DescriptionSpecific job functions include:
· Review and understand PBM contracts for all relevant pricing terms
· Review and understand plan design documents provided by PBM or client
· Utilize company's proprietary Compliance Model
· Calculate client contractual financial guarantees, admin fees, rebates and other terms as required by client contract
· Assemble audit reports and summarize findings
· Document all potential issues and track decisions
· Collaborate with account management and pharmacy consultants to discuss results with clients and vendors
· Provide documentation during follow-up negotiations and discussions
· Work with IT to further develop Compliance Model logic and capabilities
· Assist in other financial projects as needed
Requirements:
· Bachelor's degree in Business, Finance, or other health related field
· At least 3 years of either a) pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms
· Working knowledge of the PBM industry and pharmacy benefit claims
Desired Skills:
· Proficient in Microsoft Office, with extensive experience working with Excel
· Basic SQL query building
· Strong verbal and written communication skills
· Detail-oriented
· Solid, independent worker (this position will likely be based in the applicant's home)
· Pharmacy Technician Certification (preferred)
Company DescriptionLeading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down.We are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.
Company Description
Leading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down.\r\r
We are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.
