Job Summary: The Information Security GRC Analyst III managed day to day, short and long term information security risks and ensures activities are within risk tolerance and in compliance with approved risk management policies, procedures and
Job Summary: The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects. Essential Functions: Represent claims on cross-functional project work teams Submit, monitor and prioritize IT tickets for
Job Summary: The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects. Essential Functions: Represent claims on cross-functional project work teams Submit, monitor and prioritize IT tickets for
Job Summary: The Behavioral Health Medical Director is responsible for the overall safety of patients with a BH diagnosis, with a special focus on safe prescribing. Essential Functions: Assume responsibility for the overall safety of patients
Job Summary: The Vendor Medical Coding Analyst is responsible for guiding the overall efficiency and accuracy of the vendor payment process through analyzing medical records and supplemental data to ensure diagnostic and procedural codes accurately reflect
Job Summary: The AVP, Finance is responsible for providing financial oversight, leadership and support to the market/corporate and ensures the department proactively collaborates with and provides support for analyses being conducted by areas outside the Finance
Job Summary: The Claims Specialist III is responsible for capturing, resolving/facilitating resolution, and reporting on claim adjustment requests. Essential Functions: Resolve complex COB issues through member information updates and adjustment of claims Maintain accountability for daily
Job Summary: The Applied AI Scientist III is responsible for the development and application of cutting-edge advanced analytics solutions using emerging Artificial Intelligence (AI) technologies such as Agentic AI, Retrieval Augmented Generation (RAG), Large Language Models
Job Summary: Payment Cycle Analyst III is responsible for conducting both systemic and targeted analysis to identify reimbursement errors and to determine root cause. As well as collaborating with Configuration, Configuration UAT, Enterprise UAT, IT Claims,
Job Summary: The Program Integrity Medical Coding Reviewer III supports most complex medical record audit programs, dispute management, escalation management and generates concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid
Job Summary: The Clinical Psychologist provides Behavioral Health coverage determination for utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting. Essential Functions: Assume responsibility for the overall safety of
Job Summary: The Information Security Engineer III is responsible for designing and developing technologies and processes to monitor operation of IT systems to detect suspicious activity that could indicate an attempted or actual intrusion into the
Job Summary: The Health Plan Data Analyst III is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. Additional responsibilities include analyzing data operations to support building new solutions
Job Summary: The Manager, Rapid Response & Incident Management Operations provides leadership and direction to the Rapid Response Team and Incident Management Team to ensure the goals and standards of the department and CareSource are met.
Job Summary: The Employee Relations Partner III serves as a strategic advisor on employee relations, partnering with business leaders, HR Business Partners, and CoEs to strengthen organizational practices and advance enterprise initiatives. This role helps shape
About Concept Plus Concept Plus is a mission-focused technology solutions provider that transforms IT concepts into impactful solutions for federal agencies. Headquartered in Fairfax, VA, we bring the agility, responsiveness, and customer intimacy of a small