The Risk Adjustment Consultant will manage provider engagement, analyze performance data, and collaborate on risk adjustment operations to enhance healthcare services.

The Actuarial Analyst I supports financial and actuarial functions with analysis, data management, and project management, working closely with various departments.

Manage cross-functional projects, ensuring goals are met on time and within budget, while coaching less experienced project managers and resolving project obstacles.

The Lead Compliance Program Manager manages compliance programs related to healthcare regulations, conducts risk assessments, oversees audits, and collaborates with internal and external stakeholders to ensure compliance and effective program implementation.

The Program Manager II oversees cross-functional projects, manages ongoing program operations, performs policy analysis, and recommends changes to improve efficiencies.

The Provider Audit Analyst audits claims for coding accuracy and contract interpretation, managing significant recoveries and coordinating findings with various departments.

The Senior Training Specialist delivers training programs, collaborates with SMEs, creates engaging learning environments, and mentors peers while handling complex training issues.

The Director of Payment Integrity will oversee strategies to optimize payment accuracy, manage vendor audits, and ensure compliance with regulations, while leading internal teams.

The Sr Analyst Workforce Planning Capacity analyzes workforce data to optimize resource allocation and improve service operations by developing forecasts and managing staffing models, while collaborating with leaders and IT.

The Cyber & Information Security Portfolio & Program Manager oversees C&IS initiatives, optimizing processes, managing vendors, and supporting executive engagement, ensuring alignment with organizational strategies and risk priorities.

The Procurement Category Manager manages vendor relationships, contract negotiations, and performance measurements across indirect categories, ensuring optimal value and risk management.

Manage ancillary specialties and provider contracts, negotiate and execute agreements, evaluate network needs, and mentor team members in contract management.

The Sr Administrative Assistant supports vice presidents and departments by managing complex calendars, answering calls, drafting documents, and maintaining databases while ensuring customer service.

The Sr. Compensation Analyst collaborates with HR and leaders to design compensation programs, perform job analyses, and manage compensation processes, ensuring equity and compliance.

The Revenue Specialist manages member eligibility and payment records, ensuring accuracy, and supports departmental objectives through data updates and process enhancements.

The Clinical Pharmacist manages pharmacy prior authorization requests, ensures timely coverage determinations, and collaborates with medical directors. They provide clinical support and address quality issues with pharmacy technicians.

The Senior Actuarial Analyst conducts financial and actuarial analysis, mentors junior staff, and drives project completion in healthcare-related functions.

The Manager of Commissions oversees broker compensation and internal sales commission functions, partnering with teams to optimize payment systems and manage processes efficiently.

The Clinical Reviewer conducts benefit coverage reviews and utilization management for behavioral health, ensuring compliance and supporting service goals, collaborating with operations and case management teams.

The Program Manager III oversees complex regulatory compliance projects, ensuring alignment with federal and state mandates while managing cross-departmental initiatives and training activities.