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
Who We Are: Since 1906, New Balance has empowered people through sport and craftsmanship to create positive change in communities around the world. We innovate fearlessly, guided by our core values and driven by the belief
About Pair Team At Pair Team, were an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social -
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
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
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
Job Description Provides analyst support for financial analysis activities including data/text mining, analysis, modeling, and predicting to understand business issues, develop solutions and enable informed business decisions. Essential Job Duties Extracts and compiles information from large
Job Title Provides support 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 within the Molina network.
Job Title Investigative Support For Special Investigation Unit Job Description Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care
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.
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 Description Provides senior level support for all aspects of taxation including compliance, planning, forecasting, merger and acquisition (M&A) evaluation, expense, liability and asset recordation, securities and exchange (SEC) and statutory reporting disclosure, Sarbanes-Oxley (SOX) compliance,
Job Description Provides senior level support for Molina Protection Services Operations Center (PSOC) enterprise applications. Responsible for executing and managing the applications that support physical security operations, business continuity management, crisis management, emergency response, and health
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
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
Job Title Leads and directs a team responsible for financial analysis activities across designated business areas - focusing on operational performance and strategic partnerships. Facilitates analysis, modeling, and forecasting to uncover business insights, develop data-driven solutions,
Job Title Provides analyst support for financial analysis activities including data/text mining, analysis, modeling, and predicting to understand business issues, develop solutions and enable informed business decisions. Essential Job Duties Extracts and compiles information from large