• NC

Support sales and retention of ASO business by providing group financial analysis, consultation, pricing, and quoting. Coordinate and release new business and renewal proposals. Manage a book of business and initiate process and system changes for en..

• NC, AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MS, MO, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WY

Accurately assign codes to medical diagnoses and procedures, maintain up-to-date knowledge of medical coding standards, review medical records for coding purposes, serve as a resource to other coding staff.

• US National (Not hiring in CA, MA, NH, NJ, NY)

Establish and maintain relationships to support company response. Provide technical services for investigations and assist in drafting post-incident reports. Mentor junior engineers and provide guidance during crisis scenarios.

• Chattanooga, TN

Manage planning processes related to enterprise spend. Produce financial reports, support annual planning process, analyze financial information, oversee financial staff. Bachelor's degree in finance or related field and experience required.

• US National

Plan and produce financial reports, analyze trends, verify data, and communicate with corporate management. Develop and coordinate data and financial reports and analyze financial data to identify trends. Bachelor's degree and 5 years of experience.

• US National (Not hiring in CA, MA, NH, NJ, NY)

Manage financial management, control, analysis, and planning. Distribute tasks to junior staff. Provide financial planning, forecasting, budgeting, and control functions. Manage tax filing and governmental reporting activities.

• Reston, VA

Design and maintain stable and efficient information systems. Install, troubleshoot, and optimize computer systems, develop and implement system automation, and evaluate new systems. Bachelor's degree and software/hardware/systems engineer..

• Chattanooga, TN

Support clinical team and educate members on benefits and services. Conduct health needs assessments, assist with appointment scheduling, and manage member outreach. Assist with research and analysis of inquiries and complaints.

• US National

Applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for rating/pricing, valuation, healthcare economics and/or financial forecasting.

• Baltimore, MD

Oversee creation, maintenance, and decommissioning of testing environments. Schedule and coordinate resources for test environments. Communicate with project teams and stakeholders. Develop and implement test environment management processes.

• Owings Mills, MD

Coordinate and supervise analysts, develop actuarial analyses, ensure sound actuarial and financial methods are used. Requires a Bachelor's degree in Actuarial Science or related field and health actuarial experience with demonstrated lead..

• AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MS, MO, NC, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WY

Provide technical support for AI/ML applications. Troubleshoot issues related to data pipelines, model predictions, and system integrations. Assist in optimizing machine learning models for efficiency, accuracy, and scalability.

• Chattanooga, TN

Provides first line support and problem resolution for technology products or applications. Monitors calls and emails, maintains documentation, responds to inquiries, and provides remote technical support services.

• US National

To better serve our customers, were creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where...

• Oakland, CA, Long Beach, CA, El Dorado Hills, CA, Rancho Cordova, CA, Redding, CA, San Diego, CA, Woodland Hills, CA

Provide legal counsel on health law issues, develop policies, negotiate contracts with major health systems, engage with key regulators on filings and approvals, and work with executives to develop vision and strategy.

• Wall, NJ

Lead on-site audits of hospital billing and coding practices and desk audits. Identify billing discrepancies and error trends, compile audit information, and update audit processes. Train new staff on department procedures.

• Baltimore, MD

Provide safe patient care and clinical support. Maintain efficient patient flow, support patient safety and satisfaction, and demonstrate problem-solving skills. Prepares, administers, and documents medication and vaccines, collects laboratory specim..

• Baltimore, MD

Ensure vendor performance meets standards and requirements. Communicate vendor strategies and risks to stakeholders. Track vendor spend and collaborate with procurement for holistic sourcing. Report vendor performance and provide market intelligence.

• NJ, NY, PA, CT, DE

Responsible for member interface through comprehensive medication review for Medicare beneficiaries. Coordinates projects with activities performed by other clinical Pharmacists for the residents and students.

• NC, AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MS, MO, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WY

Define and extract data from multiple sources, integrate into a common data model, and integrate into a target database, application, or file. Document, test, and improve complex data systems. Deploy and maintain models in production-grade cloud systems.

• AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MS, MO, NC, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WY

Develop and implement AI/ML governance strategy, protocols, and ethical guidelines. Establish oversight processes for data collection and management. Serve as primary thought leader for policy/regulatory compliance. Lead training protocols for legal...

• NC, MS, SC, LA, TX

The Principal Logical Data Modeler providers leadership in designing, implementing, and documenting complex data architecture and data modeling solutions, which include the use of relational, dimensional, and NoSQL databases. These solutions support en...

• VA, ID, NE, GA, OR, IA, MO, NC, NH, MD, TX, OH, AR, TN, SC, MI, PA, ME, MN, FL, IN, IL, Washington, DC

Senior leader to advance legislative and regulatory policy solutions in Medicare, Medicaid, Duals, and CHIP. Develop consensus positions, lead advocacy efforts, and manage a team to deliver strong results.

• MD

Manages proposal development team to create high-quality proposals. Provides guidance on response strategy and development. Facilitates interdisciplinary task forces for process improvement. Manages budget and evaluates staff.

• Baltimore, MD

Identify members with acute/complex medical and/or behavioral health conditions. Develop comprehensive plans of care and collaborate with interdisciplinary care team. Monitor and update plans of care over time.

• Baltimore, MD

Manage transition from inpatient care to home or other levels of care. Analyze clinical information, determine appropriateness and authorization of inpatient clinical services. Collaborate with medical directors and participate in internal case round...

• Knoxville, TN

Perform assessments, planning, and monitoring of service provision and member well-being. Identify needed supports and collaborate with colleagues to meet member needs for health, employment, and independent living.

• TN

Collaborate with care/support coordinators and external partners to ensure continuity of care. Utilize clinical knowledge to manage LTSS requests, referrals, screenings, and hospital admissions. Submit completed requests and documents to appropriate ..

• Trenton, TN

Manage member care and progress for cases with multiple levels of risk. Serve as a liaison between members, providers and internal/external customers. Oversee complex cases and perform essential activities of case management.

• Memphis, TN

Manages member care and progress for cases with multiple levels of risk. Supports utilization management functions, serves as a liaison between members, providers, and internal/external customers, and oversees complex cases to ensure effective implem..

• Chattanooga, TN

Manage member care and progress for cases with multiple levels of risk. Serve as a liaison between members, providers, and internal/external customers. Oversee highly complex cases identified through various mechanisms to ensure effective implementat..

• Baltimore, MD

Develop policies and procedures for behavioral health services. Collaborate with physicians to ensure service expectations are met. Direct the strategic and day-to-day activities of the department, including coaching and guiding individuals and teams.

• Baltimore, MD

Provide virtual primary care services, optimize care delivery strategy and best practices, oversee care team members, and collaborate with the CloseKnit team to improve provider processes. Medical degree and 2 years of post-residency and primary care..

• Baltimore, MD

Conduct independent analysis for complicated regulatory inquiries, interpret regulations, provide recommendations, track implementation of solutions, review and analyze data, maintain database, provide training and mentoring.

• Owings Mills, MD

Leads the entire product management life cycle, defines the product roadmap, facilitates go-to market strategy and launches for new products, and works with finance to ensure competitiveness in the market.

• Baltimore, MD

Act as a liaison to ensure members are connected with appropriate care channels. Outreach and follow-up with patients to promote a seamless healthcare experience. Collect and relay information to the Care Coordination team.

• Baltimore, MD

Support government programs division by bridging member, clinical, and administrative staff. Assist members, families, and caregivers in accessing healthcare system through outreach, education, coordination, and resources. Participate in community ev..

• Chattanooga, TN

Support customer service activities for multiple products/clients. Resolve inquiries through various channels, document communication, educate callers, and work flexible schedules. Requires 1 year experience, MS Office proficiency, time management, a..

• Chattanooga, TN

Support customer service activities and initiatives for various products or clients. Handle customer inquiries and resolve issues through various channels. Ensure clear documentation of customer communication.

• US National

Translate business/functional requirements into system level functional solutions. Develop functional designs for new, customized, or enhanced systems. Ensure traceability from business/functional requirements through development of the solution.

• AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MS, MO, NC, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WY

Support the development and implementation of enterprise's Data and Analytics Governance strategy. Act as a data steward, identify approaches for defining, improving and executing best practices and performance measures for foundational and strategic..

• NC, AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MS, MO, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WY

Lead data stewardship in Membership domain to improve data quality, governance, access/security, and management/ownership. Partner with Membership business to drive data improvement, mitigate risks, and build data fluency. Execute Trusted Access Plat...

• Chattanooga, TN

Provide financial services to the organization including planning, record keeping, reporting, and identifying trends. Develop financial modeling, reports, and presentations for management. Filing tax forms and other government reports required by the..

• NC, AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, MD, MI, MO, OH, OK, PA, SC, SD, TN, UT, VA, WI, WY

Perform actuarial research, calculations, and statistical analyses using Excel, SQL, and SAS. Calculate premiums, risk scores, and reserves for insurance plans. Provide support to senior analysts or actuaries. Retrieve and validate data for actuarial..

• Durham, NC

Manage the payroll, tax compliance, accounting and financial reporting for multiple companies with employees in 28 states. Supervise and mentor payroll and accounting staff. Identify and implement process improvements to enhance efficiency and accuracy.