Top Tech Jobs & Startup Jobs

Manage and lead healthcare fraud and internal investigations, supervise investigators and certified coders, design and optimize pre-payment review processes, coordinate with legal, compliance, provider services and law enforcement, utilize claims data and predictive analytics to detect fraud, and monitor program effectiveness and regulatory compliance.

Lead business analysis and coordinate complex, cross-divisional strategic projects from inception to completion. Oversee project teams, resources, budgets, and timelines; engage senior management, prioritize transformational activities, and track progress to goals.

Design and develop end-to-end data integration and analytics engineering pipelines across RDBMS, MPP, Hadoop, and Azure Databricks. Lead projects, provide technical guidance, build Enterprise BI data marts and semantic layers, and collaborate with stakeholders to deliver data products and insights.

Develop, maintain, and test desktop automation tools for Customer Service using C#, VB.NET, SQL, Access, and Excel. Gather requirements, analyze processes, design automated solutions, lead stakeholder meetings, and manage multiple projects to deliver measurable efficiency improvements.

Sell a portfolio of managed health insurance and ancillary products to meet sales targets, directly or via brokers. Build broker relationships, analyze data and prepare reports, create and deliver presentations, provide customer service, mentor others, and travel regionally (including overnight) as needed. Obtain required General Agent State Insurance License within 90 days.

Manage development, implementation, maintenance, and review of actuarial models for pricing, underwriting, reserving, forecasting, and statistics. Build complex models, train others, produce presentations for decision-making, and lead complex cross-functional projects. Require deep knowledge across multiple actuarial areas and at least one business segment.

Researches and applies premium and provider refunds, processes miscellaneous payments, analyzes incoming payments and claims data, creates allocation spreadsheets and reports, troubleshoots system errors, and responds to internal and external inquiries. Performs reconciliations and supports daily payment management.

Lead full-cycle recruiting for technology and IT roles (Infrastructure, Cloud, Cybersecurity, Software Engineering, Data & Analytics, Enterprise Applications). Serve as strategic talent advisor to hiring leaders, develop sourcing strategies, assess candidates, consult on compensation and workforce planning, manage ATS/HRIS processes, and collaborate with HR and hiring managers in a fast-paced environment.

Lead analytics and consulting engagements for large commercial health plan clients. Use SQL, R/Python, and Tableau/Power BI to analyze claims and population health data, present findings to C-suite, design data layers and coding standards, and drive scalable, high-impact solutions across stakeholders.

The Staff Actuary evaluates financial theories and statistics to inform company decisions, focusing on pricing, underwriting, and forecasting. Requires strong communication and technical skills.