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: 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 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: 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...
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: The Data Engineer will be responsible for expanding, optimizing and monitoring our data and data pipeline architecture, as well as optimizing data flow and collection across organizational teams. The Data Engineer will suppor...
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 Azure Administrator is responsible for the day-to-day administration, security, and reliability of the Microsoft Azure cloud environment, including Azure infrastructure and identity and access management. The Azure Admini...
JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, ...
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...