Senior Specialist, Quality Program Management and Performance The Senior Specialist, Quality Program Management and Performance implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key quality program activities. Acts
Project Controls Specialist (Hybrid) Long Beach & Los Angeles, CA What We’re Looking For: Michael Baker International is seeking a Project Controls Specialist to support project delivery across our Long Beach and Los Angeles offices. This
Will consider Sign-on! This Jobot Job is hosted by: Natasha van der Griendt Are you a fit? Easy Apply now by clicking the Apply button and sending us your resume. Salary: $135,000 - $175,000 per year
Actuarial Analyst Provides entry level support for actuarial function activities including extracting, analyzing, and synthesizing data from various sources to identify risks. Estimates liabilities, establishes premium rates, and supports financial analysis and reporting. Essential Job Duties Supports
Job Description Provides senior level support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health plans and vendors to
Job Title Provides support and ownership for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities and improve financial performance. Essential Job Duties Extracts and compiles data and information
Claims Research Analyst Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate
Job Title Leads and directs team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and system
Job Title Job Description Job Summary Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and
AVP Of Maternal & Child Clinical Operations The AVP of Maternal & Child Clinical Operations provides strategic leadership and operational oversight for enterprise-wide maternal, newborn, and child health programs. This leader ensures high-quality, equitable, evidence-based care management
Job Title Leads and directs team responsible for government contracts activities. Essential Job Duties Leads and directs team responsible for management of regulatory and contractual requirements related to government programs including, but not limited to, Medicaid, Medicare,
Job Title Provides senior level support for health education activities. Job Summary Responsible for developing, implementing, and maintaining health plan health education programs. Assists in identifying health education program needs, researching and developing health education and disease management
Clinical Wellbeing Specialist Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting
Job Title Provides senior-level analytical support for medical economics initiatives, including extracting, analyzing, and synthesizing data from multiple sources. Identifies and quantifies cost-saving opportunities and communicates insights clearly in presentations to support broader understanding and adoption. Analyzes
Job Title Investigative Support for Special Investigation Unit (SIU) Activities Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting for the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to
Job Title Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers
Job Title Claims Adjudication Support Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. Essential Job Duties Responds to
Job Title Actuarial Analyst Job Description Job Summary Provides entry level support for actuarial function activities including extracting, analyzing, and synthesizing data from various sources to identify risks. Estimates liabilities, establishes premium rates, and supports financial analysis
Senior Level Analyst Support Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Essential Job Duties Analyzes claims,
Delegation Oversight Manager Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Collaborates closely with