Job Summary: The LTSS & Dual Eligible Report Engineer IV will play a crucial role in utilizing data analytics to drive informed decision-making and optimize business processes within the healthcare environment. This senior-level position is responsible for
Job Summary: The Team Lead, Program Integrity drives and encourages innovative investigative processes and workflows to reduce turnaround time and produce positive investigative outcomes. Essential Functions: Direct the day-to-day activities and leadership of investigative staff to ensure
Job Summary: Vice President, Actuarial - Product is responsible for driving company strategy and managing actuarial expertise in coordination with other leaders on all aspects of CareSource’s rate levels to ensure actuarial soundness, and to use
Requisition Number: 29268 Required Travel: 0 - 10% Employment Type: Full Time/Salaried/Exempt Anticipated Salary Range: $58,877.00 - $85,000.00 Security Clearance: None Level of Experience: Mid This opportunity resides with Warfare Systems (WS), a business group within
Manage all assigned technology components, including setting vision, direction and execution. Develop strategy and high-level implementation plans for the delivery of new technology and validate business proposition of this technology. Evaluate currently deployed services and develop
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 Processes. Essential
Job Summary: The Business Analyst IV is a senior-level position responsible for driving strategic initiatives and leading cross-functional teams to deliver innovative solutions that address complex business challenges. This role bridges the gap between business needs
Job Summary: The Manager, Pharmacy Benefit Management is responsible for managing a team and overseeing the day-to-day operations associated with regulatory activity, PBM oversight, performance and monitoring, pharmacy audit activity, pharmacy compliance business owner tasks as
Job Summary: The Quality Consumer Experience (Cx) Project Manager is responsible for managing variably complex high-priority, cross-functional projects within the Consumer Experience organization, executing within the project management framework. Essential Functions: Ensure project milestone deliverables are