Top Tech Jobs & Startup Jobs

The Claims Management Analyst III leads eBusiness initiatives, manages EDI trading partners, ensures compliance, and analyzes performance for continuous improvement.

The Clinical Psychologist provides oversight for Behavioral Health coverage, develops clinical policies, participates in quality improvement, and ensures compliance with regulations while working with providers, members, and state agencies.

The Clinical Psychologist provides behavioral health coverage determination, ensuring appropriate care in a cost-effective setting. Responsibilities include patient safety, developing clinical policies, participating in quality improvement, and serving as a clinical liaison.

The Community Marketing Representative II drives enrollment and retention strategies through community engagement, education, and collaboration with organizations to promote health plan offerings.

The Configuration Architect oversees the architecture for clinical system configurations, ensures alignment with business needs, evaluates solutions, and leads teams in implementing standards and guidelines while mentoring others in the department.

Design, develop, and deploy AI/ML solutions—especially generative and agentic AI—build LLM and RAG architectures, implement MLOps pipelines, prototype PoCs, and integrate models into production using cloud, containerization, and CI/CD practices while collaborating across teams.

The Provider Engagement Specialist oversees performance of delegated partnerships, manages data reports, collaborates with providers to enhance performance, and ensures regulatory compliance.

The Clinical Appeals Nurse processes clinical appeals and prepares for state hearings, ensuring compliance with regulatory standards while collaborating with medical staff and communicating with members and providers.

The Actuarial Analyst II conducts analyses and provides recommendations to support corporate initiatives. This involves profitability reporting, evaluating assumptions and government reimbursement, and participating in cross-functional teams.

The Applied AI Scientist III develops and applies advanced analytics using AI to enhance healthcare operations and patient care. This role involves evaluating technologies, leading projects, utilizing NLP and machine learning to extract insights from data, and collaborating with interdisciplinary teams.