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Save Education High School Diploma or GED Skills Excel Managed Care Medical Coding Certification Certified Internal Auditor Serve as a liaison between the plan, claims, providers and various departments to..
Save Education High School Diploma or GED Skills Multilingual Customer Service Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner. Respond to telephone or..
HourlyPosition Purpose: To distribute incoming and outgoing correspondence Open, sort and prepare incoming correspondence Scan incoming correspondence Record specified incoming documents Appropriately file imaged claims, appeals, adjustments and inferior quality..
Care Manager InUSA-North Carolina-Rocky Mount, USA-North Carolina-RaleighnPosition Purpose: Perform care management duties to assess, plan andncoordinate all aspects of medical and supporting services across thencontinuum of care for select members..
Save Education Bachelor's Degree Skills Data Mining Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and..
Description:rrPosition Purpose\: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial..
Director, Utilization Management (RN)nnPosition Purpose: Oversee operations of the referral management, telephonic utilization review, prior authorization functions, and case management programs. Ensure compliance government and contractual guidelines and the mission,..
Finance Analyst IVnUSA-California-Rancho CordovanPosition Purpose: Compile and analyze financial information for thencompany. Lead various financial projects. Cost effectively manage thenutilization of services and develop measures to track, trend andnforecast related..
Product OwnernnPosition Purpose:nnGather feedback from operations teams and research industry trends to improve business systems processesnWrite and capture user stories and acceptance criteria to communicate clear product objectives and requirementsnManage..
Senior Product Manager Senior Product Manager (1144619) Position Purpose: Capture market needs and define requirements, including concept, use cases, feature functions acceptance criteria and growth opportunities Responsible for strategic and..
Quality Improvement Coordinator II (Behavioral Health)nnPosition Purpose: Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related..
System Engineer (Storage)nnPosition Purpose:nnResponsible for Day to day support of the Storage environment supporting end users, application teams, infrastructure teams and project teams. Support of NetApp (FAS, StorageGRID) and EMC..
Sales Representative (Specialty Pharmacy)nUSA-New YorknPosition Purpose: Develop new prospects and interact with existingncustomers to gain additional accounts within assigned area.nPerform sales related activities on company s specialist pharmacynprograms for designated..
Save Education Bachelor's Degree Master's Degree Skills CPA Accounting GAAP Assist with the management of the financial affairs for all health plans. Assist with the preparation of monthly financial analyses..
Position Purpose: Define and direct the marketing and community outreach functions in accordance with the mission, philosophy, and objectives of the company. Establish a brand and presence in the community...
Save Education Bachelor's Degree Master's Degree Skills SQL Software Development Teradata Hadoop Apache Lead streaming best practices and set standards for stream architecture Oversee the implementation of core infrastructure monitoring,..
Manager, Risk AdjustmentnUSA-Wisconsin-WauwatosanPosition Purpose: Manage the business processes related to risknadjustment and quality improvement across Centene s for assignednproducts and plans.n* Develop and implement action plans, across all departmentsnaffecting assigned..
Save Education Bachelor's Degree Skills VoIP Visio LAN Description: Position Purpose: Troubleshoot, resolve, and document Tier III support calls as related to the LAN and WAN. Will be working on..
Full Stack Developer - Agile Technical CoachnnPosition Purpose:n- Responsible for hands on training of teams to deliver modern cloud products using DevOps best practices.n-nnLead technical coaching in an immersive learning..
System Administrator (Wintel)nnPosition Purpose: Provide operational and technical support to ensure the ongoing stability to the server environments. Assist in the IT infrastructure design and implementations.nn- Assist in the technical..
Save Education Bachelor's Degree Skills Managed Care Supervising Experience Project Management Position Purpose: Ensure regulatory compliance with federal and state legal and regulatory requirements as it relates to Medicare compliance..
Save Education High School Diploma or GED Skills Data Management CPT Coding Accept or reject coding recommendations based on provider documentation, administrative policies, regulatory codes, legislative directives, precedent or other..
System Administrator (Security)nnPosition Purpose:nnAssist in the technical support of the IT Security environment as well as the applications residing on these serversnCoordinate and provide assistance with end-user support, trouble ticket..