The role involves processing customer complaints and inquiries, documenting responses, investigating issues, and collaborating with stakeholders to ensure regulatory compliance and improve processes.

Lead the development and operationalization of data pipelines, ensuring data quality and reliability while developing real-time processing applications. Oversee data engineers and manage large-scale data structures for analytics.

The Strategic Sourcing Specialist II leads supplier negotiations, develops RFI and RFPs, and collaborates with stakeholders to support contract negotiations and sourcing strategies.

Responsible for managing technology projects, ensuring timely and budget-compliant delivery, and maintaining stakeholder relationships. Evaluates risks and ensures project closure.

The Senior Business Systems Analyst collaborates with stakeholders to translate requirements into technical specifications, manages project requirements, and improves processes for health care solutions.

Lead the technical approach for cloud infrastructure management, automation, upgrades, and monitoring. Collaborate with teams to deploy secure cloud applications and ensure capacity planning. Serve as a technical advisor and mentor for cloud engineering teams.

The Project Manager IV plans and oversees complex telephony projects, ensuring delivery meets strategic goals. Responsibilities include project life cycle management, cross-functional team coordination, and stakeholder communication, along with travel requirements of approximately 10%.

Perform comprehensive audits of claims, analyze errors, document audit observations, and facilitate corrective plans. Monitor state websites for changes affecting claims.

Administers and configures cloud software and infrastructure, manages deployments, ensures security, and collaborates with teams to enhance cloud infrastructure.

The Appeals Specialist II supports the processing of appeals and disputes according to regulations, prepares documentation, conducts research, and tracks outcomes to ensure timely decisions.

The Project Manager will oversee Telephony implementations, manage project life cycles, ensure quality standards, and coordinate cross-functional teams.

Develop strategic partnerships between health plans and providers, focusing on performance improvement, patient care, and data analytics to enhance care delivery.

Oversee finance department activities, ensure integrity in financial systems, prepare reports, and communicate strategic and operating budgets. Direct financial planning and program effectiveness evaluations.

Manage network performance analytics, develop reporting tools, oversee financial impact analysis, and support health plans with data-driven insights.

The Community Resource Coordinator connects members to community resources, supports care teams with education, conducts assessments, and assists with member inquiries.

The Sr. Actuarial Analyst will support the health plan's value-based contracts, perform financial analyses, and assess risk outcomes while developing related reports.

The Program Manager IV leads large scale projects, manages cross-functional teams, and ensures alignment with strategic objectives through comprehensive planning, execution, and stakeholder communication.

Lead the development and implementation of a comprehensive business continuity and disaster recovery program, conducting risk assessments, collaborating with stakeholders, and ensuring compliance with industry standards.

Design and lead a vendor management program focused on business continuity. Conduct audits, ensure compliance, and foster vendor relationships to enhance resilience.

Develop strategic partnerships with provider networks, fostering relationships to enhance patient care and optimal provider performance through analytics and data. Educate providers, resolve issues, and perform ongoing evaluations while managing contracts and performance metrics.