Provider Engagement Administrator II
1 day 21 hours ago
Provider Engagement Administrator II','1223188','!*!Position Purpose: The Provider Engagement Administrator II is the internal and external liaison for the Provider Network Management Department who maintains positive working relationships with participating physicians,..
Provider Data Management Analyst I
1 day 21 hours ago
Provider Data Management Analyst I','1223204','!*!Position Purpose: Perform provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of..
Pediatric Program Specialist II - Social Work
1 day 21 hours ago
Pediatric Program Specialist II - Social Work','1221040','!*!Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s..
Project Manager III (Finance)
1 day 21 hours ago
Project Manager III (Finance)','1222414','!*!Position Purpose: Plans, organizes, monitors, and oversees complex company wide health plan projects working closely with corporate health plan operation groups and subsidiary health plans to deliver..
Medical Management Auditor (Children's)
1 day 21 hours ago
Medical Management Auditor (Children's)','1223138','!*!Position Purpose: Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes Develop and maintain the audit process..
Provider Claim Resolution Analyst
1 day 21 hours ago
Provider Claim Resolution Analyst','1223195','!*!Position Purpose: Oversee the reimbursement strategies and overpayment recoveries. Responsible for providing claims coding, and pricing expertise to initiatives and act as key contact for third party..
Prior Authorization Nurse I
1 day 21 hours ago
Prior Authorization Nurse I','1222973','!*!Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests...
Program Coordinator I
1 day 21 hours ago
Program Coordinator I','1221828','!*!Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with..
Provider Engagement Administrator I
1 day 21 hours ago
Provider Engagement Administrator I','1223190','!*!Position Purpose: The Provider Engagement Administrator I is the internal and external liaison for the Provider Network Department who maintains positive working relationships with participating physicians, participating..
Project Coordinator II
1 day 21 hours ago
Project Coordinator II','1222574','!*!Position Purpose: Plans, coordinates, and monitors project scheduling, logistics, and administrative tasks. Participate in identification and proposal of departmental initiatives, including defining requirements and implementing projects. Track and..
Medical Management Auditor
1 day 21 hours ago
Medical Management Auditor','1223134','!*!Position Purpose: Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes Develop and maintain the audit process and..
Provider Engagement Administrator I(Children's)
1 day 21 hours ago
Provider Engagement Administrator I(Children's)','1223191','!*!Position Purpose: The Provider Engagement Administrator I is the internal and external liaison for the Provider Network Department who maintains positive working relationships with participating physicians, participating..
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