Overview: The Medical Assistant (MA) – Multi-Specialty position presents an exciting opportunity for Medical Assistants to expand their knowledge and skill set in a Multi-Specialty Clinic environment. Under direction of licensed medical a...
JOB SUMMARY: Responsible for processing advanced enrollment and membership transactions, such as report review, transaction reconciliation, renewal and PCP routes, new group audits, system updates, correspondence, notices, prior coverage re...
JOB SUMMARY: The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and intermediate level...
JOB SUMMARY: The Senior Claims Examiner is responsible for reviewing and examining claims that require additional analysis prior to adjudication. Using established resources, technical knowledge, and sound judgment, the Senior Claims Exam...
JOB SUMMARY: The Population Health Clinical Assistant provides administrative and care coordination support to PHM nurses, the clinical pharmacist, social worker, and nurse case managers. This role organizes referrals, schedules member as...
JOB SUMMARY: The Senior Solution Architect is responsible for owning the enterprise AI architecture and providing technical leadership across AI initiatives by defining target architectures, standards, solution patterns, governance practi...
JOB SUMMARY: Responsible for supervising and coordinating daily workflow and leadership of staff. Activities include developing operating procedures and managing personnel and resources. KEY RESPONSIBILITIES: Serves as a resource to t...
JOB SUMMARY: The Director Utilization Management provides strategic and operational leadership for the health plan's Physical Health Utilization Management department and reports to the Chief Medical Officer. The Director leads supervis...
JOB SUMMARY: The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying issues related to and/or participates in various projects aimed at identifying areas of non-compliance and/or potential f...
JOB SUMMARY: Support revenue cycle through accurate billing, payment processing, and customer account maintenance. Plans include Medicare, Marketplace, Group coverage and EAP. Collaborates closely with internal teams and external customer...