The Claims Specialist III is responsible for capturing, resolving/facilitating resolution, and reporting on claim adjustment requests.
The Member Health Assessor engages with the member to establish an effective, professional relationship with primary responsibility to conduct their health risk
The Manager, Service Center is responsible to guide Team Leaders and staff relative to daily operational issues. Manage staffing and scheduling functions.
The Media Relations Specialist III is responsible for maximizing earned media opportunities in both traditional news and across a variety of platforms, tracking
The Team Lead, Provider Data Integrity performs supervision and support of the Provider Data Integrity (PDI) team. Critical listening and thinking skills.
The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects.
The Clinical Operations Analyst II works with Decision Support Informatics to develop on-going reporting that will support root cause analysis.
The Clinical Appeals Nurse is responsible for the completion of clinical appeals and state hearings from all states. Critical listening and thinking skills.
The Community Based Care Coordinator I BH/SUD is the member concierge and is the single point of contact for assessment, person centered planning, service
The Application Developer III is responsible for the designing, coding, testing, and analyzing software programs and applications including research, design,
The Healthcare Analyst III is responsible for presenting analytical findings and recommendations regarding utilization to management and being proficient in
The Talent Acquisition Partner II is responsible for developing relationships with internal leaders to maintain up-to-date on critical initiatives, organization
The Content Strategist II is responsible for developing, producing, and maintaining plain language content for member or provider materials and collateral.
Full time 40 hours per week. Must be available to work during queue hours. The Member Health Assessor engages with the member to establish an effective,
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