Top Tech Jobs & Startup Jobs

The AVP, Network and Contracting oversees provider contracting and network strategy, ensuring compliance and optimizing member access while leading a high-performing team.

The Revenue Cycle Coordinator III ensures timely resolution of member complaints related to eligibility and billing, leads teams, and develops training for compliance with regulatory standards.

The Operations Specialist III provides analytical support for claims projects, leads initiatives, reviews claims, and develops policies for claims processing.

The Operations Specialist II provides analytical support for Claims projects, assists in training staff, resolves provider issues, and analyzes claims data.

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 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.