- Capital One Bank (Plano, TX)
- Senior Manager of Software Engineering (DevOps)Do you love building and pioneering in the technology space? Do you enjoy solving complex business problems in a ... are seeking DevOps Engineers who are passionate about marrying data with emerging technologies to join our team. As...### or via email at ###@capitalone.com. All information you provide will be kept confidential and will be used… more
- CHRISTUS Health (Arp, TX)
- …with providers and plan members in case management medical activities to provide the most efficient and effective service .Identify targeted chronic diseases/high ... monitoring cases and claims, analyzing biometric and health risk assessment data , organizing disease management programs and proactively interacting with members,… more
- CVS Health (MI)
- …And we do it all with heart, each and every day. **Position Summary** The Provider Data Service Senior Coordinator is responsible for loading ... new and updated provider fee schedules into the ...system. Conducts thorough pre-load and post-load reviews to ensure data accuracy, policy compliance, and successful system updates. **Key… more
- CVS Health (Hartford, CT)
- …each and every day. **Position Summary** CVS Health has an opportunity for a full-time Provider Data Services Senior Coordinator. The Provider Data ... is responsible for supporting the loading of new and revised Medicaid participating provider data transactions into Aetna/CVS source systems. This role requires… more
- CVS Health (Workman, MN)
- …for automating and manually loading all new and revised participating provider data transactions. Manages and resolves third-party contracted reimbursement ... arrangements. + Communicates directly with providers and/or outside vendors to clarify data quality issues. Manages audits of provider information to escalate… more
- Humana (Detroit, MI)
- …to resolution. + Understanding of health insurance claims and ability to analyze data to resolve provider service issues. + Excellent written ... caring community and help us put health first** The Senior Provider Relations Professional is responsible for...to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The… more
- Point32Health (MA)
- …backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of ... Summary** Working under the direction of the Director or Senior Manager, the Senior Network Performance Analyst...of all of our colleagues, which helps us to provide service with empathy and better understand… more
- Geisinger (Danville, PA)
- …urgent enrollment items and escalations. + Ensure timely and accurate submission of provider data to all applicable payers, including Medicare, Medicaid, and ... with key stakeholders to set and monitor KPIs and service level expectations for provider readiness and...times. + Establish communication channels and reporting tools to provide visibility into provider enrollment status across… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …aspirations. Join Kite and help create more tomorrows. **Job Description** The ** Senior Director,** **US** ** Provider Access** **Strategy & Marketing** reports ... leads the development of scalable, future-focused initiatives that enhance provider readiness, optimize CAR-T service line economics,...and relevant discussions with assigned accounts and customers + Provide a provider POV for all relevant… more
- Humana (Richmond, VA)
- …part of our caring community and help us put health first** The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, ... Health contracts and agreements within the Virginia Medicaid space. The Senior Provider Contracting Professional work assignments involve moderately complex… more
- LogixHealth (Dania Beach, FL)
- …to providing expert revenue cycle services, we utilize proprietary software to provide valuable financial, clinical, and other data insights that directly ... and WV This Role: Supervise the day to day responsibilities for the Provider Enrollment Department workflow to ensure efficiency and accuracy of work. Supervise and… more
- Molina Healthcare (Syracuse, NY)
- … provider compensation methodologies, including but not limited to: fee-for- service , value-based care, and capitation * Strong working knowledge of quality ... **Job Description** **Job Summary** The Sr Specialist, Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, ... and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex… more
- Molina Healthcare (Dallas, TX)
- …and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the...JOCs on exception. Able to execute standardized fee for service and other core payment method contracts with predefined,… more
- Point32Health (Canton, MA)
- …backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of ... are at Point32Health (https://www.point32health.org/) . **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims...of all of our colleagues, which helps us to provide service with empathy and better understand… more
- Corewell Health (Grand Rapids, MI)
- Job Summary Drive provider network strategies and solutions to improve outcomes and decrease medical expense trends. Develop and implement network engagement ... groups. Essential Functions + Contributes to the development and execution of provider strategy and solutions for assigned Accountable Care Networks. + Executes the… more
- Siemens (Bellevue, WA)
- …about improving buildings; it's about creating perfect places that improve people's lives. ** Senior Field Service Engineers or Senior Electrical Services ... I&C on our power distribution equipment at our Hyper-Scale Data Center sites. Scope includes, but not limited to,...power monitoring, power quality, and protective relays. **As a Senior Field Service Engineer or a … more
- Amazon (Bellevue, WA)
- …will be performed. Kuiper Intelligence Data Services (KIDS) team is seeking a Senior Data Engineer who will help architect and build enterprise grade data ... program decisions. The role focuses on architecting and implementing data ingestion processes that provide crucial insights... systems. A day in the life As a Senior Data Engineer, you'll start your day… more
- IQVIA (Anaheim, CA)
- **Job Overview** + Independently manage end-to-end delivery of data management services for single/multi- service projects, ensuring quality deliverables on time ... and within budget, to customer satisfaction. Provide comprehensive data management expertise...multiple large studies or program of studies (possibly global) Provide leadership and senior support to DTLs… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Senior Data and Reporting Professional (Medicaid - Michigan) generates ad-hoc reports and ... queries and scripts supporting Humana's Michigan Medicaid plan network optimization. The Senior Data and Reporting Professional integrates data from… more
