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,
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
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 departments,
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
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.
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
Job Title Claims Recovery Specialist Job Description Job Summary 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.
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 Manages team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Collaborates with health plans identify and track savings opportunities.
Member Engagement & Interventions Senior Specialist The Member Engagement & Interventions (MEI) Senior Specialist is responsible for managing, and executing member engagement programs that drive behavior change, improve health outcomes, and support overall plan performance. This
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
Job Title Lead Healthcare Data Strategist Job Summary Leads the design, development, and standardization of healthcare data assets supporting Medical Economics, Finance, Actuarial, and operational business functions. This role is responsible for driving scalable data frameworks,