Handle inbound and outbound calls to resolve patient and physician inquiries regarding specialty pharmaceutical therapies. Process new applicants and coordinate with internal teams and external pharmacies to ensure patient access to care.
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Investigate allegations of healthcare fraud, waste, and abuse through claims audits and data analysis. Prepare detailed investigative reports for referral to state and federal agencies and coordinate resolutions with health plans.
Utilization Review RN - PT - Day - Utilization Resource Mgmt Pennington NJ 13 APPLICANTS
Capital Health (US)
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Full Time
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5 Weeks Ago
Capital Health (US)
Performs utilization and resource management activities to ensure cost-effective, quality patient care and optimized lengths of stay. Collaborates with healthcare teams and third-party payers to conduct clinical reviews and manage patient treatment plans.
Senior Manager, Enterprise Compliance Corrections
Centene Corporation
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Full Time
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5 Weeks Ago
Centene Corporation
Lead a team responsible for remediating and reporting non-compliance with Medicaid, Medicare, and Commercial regulatory requirements. Partner with internal leadership and product compliance teams to ensure timely resolution of identified issues and continuous program improvement.
Corporate Ethics & Compliance Investigator
Centene Corporation
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Full Time
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5 Weeks Ago
Centene Corporation
Lead and manage complex, high-impact internal investigations to ensure adherence to federal and state regulations and internal ethical standards. Act as a strategic advisor to senior leadership by analyzing records, conducting interviews, and recommending remedial actions to mitigate risk.
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Investigate allegations of healthcare fraud, waste, and abuse through claims audits and data analysis. Prepare detailed investigative reports for referral to state and federal agencies.
Manage and collect outstanding patient balances by reviewing accounts and communicating with patients via phone and email. Responsible for posting payments in eClinicalWorks and explaining insurance responsibilities to patients.
Lead high-impact tooling projects for precision-moulded medical components from concept through production. Coordinate with cross-functional teams and external vendors to ensure regulatory compliance, quality, and timely delivery.
Lead high-impact tooling projects for precision-moulded medical components from concept through production. Coordinate with cross-functional teams and external vendors to ensure regulatory compliance, quality, and timely delivery.
Senior Engineer - Workforce Tools & Integrations
College Board
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Full Time
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5 Weeks Ago
College Board
Design and implement scalable, secure cloud services and AI-powered integrations to modernize workforce tools. Collaborate across DevOps, Security, and Infrastructure teams to build event-driven automations and maintain high engineering standards.
Regional Business Manager - West IA and East NE
FMC Corporation
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Full Time
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5 Weeks Ago
FMC Corporation
The Regional Business Manager is responsible for driving regional sales performance, managing budgets, and implementing strategic plans in the Western Cornbelt Region. This includes leading and motivating a team of sales representatives while maintaining senior-level relationships with major strategic accounts.
Insurance Defense Trial Attorney - Dallas
Farmers Insurance Careers
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Full Time
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5 Weeks Ago
Farmers Insurance Careers
Represent clients in insurance defense practice by managing cases from intake through resolution. This includes preparing legal documents, attending hearings, and conducting trials for low to moderate complexity cases.
The Associate Program Manager maintains territory caseworker assignments and monitors protocol adherence and documentation for pharma commercialization services. They are responsible for client communications, reporting adverse events, and assisting with the hiring and training of new staff.
This role focuses on the creation, organization, and lifecycle management of HR knowledge content to ensure discoverability and accuracy. The consultant will collaborate with HR subject matter experts to develop user-friendly articles and multimedia assets within platforms like Workday Help.
Manage and maintain global vendor master data in SAP to ensure accuracy, integrity, and compliance. Collaborate with cross-functional teams to drive data cleansing initiatives and process improvements.
The Senior Test Coordinator oversees end-to-end quality engineering test management across all phases of the SDLC, including System Integration Testing, regression, User Acceptance Testing, and production readiness. This role also involves maintaining a centralized QE knowledge base to ensure best practices and continuous learning throughout the QE organization.
Sr. Manager, QE Domain Testing (ATL, LOU, or Remote)
Papa Johns
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Full Time
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5 Weeks Ago
Papa Johns
The Senior Manager, Quality Engineering oversees quality engineering initiatives across multiple teams, ensuring alignment with the technology roadmap and driving the adoption of quality standards. This role also involves managing capacity planning, knowledge management, and serving as a key decision-maker in release processes.
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Sr. Manager, QE Automation & Architecture (ATL, LOU, or Remote)
Papa Johns
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Full Time
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5 Weeks Ago
Papa Johns
Lead the development and optimization of test automation strategies and frameworks across all Quality Engineering teams. Integrate automated suites into CI/CD pipelines to achieve Elite DORA performance status and establish governance standards.
The Account Executive is responsible for selling and servicing eyewear products by managing existing accounts and developing new prospects. They will cultivate strong business relationships and apply innovative solutions to meet customer needs.
The Telco Cloud Architect will own the architecture, design, and successful delivery of large-scale telco cloud platforms built on OpenShift. They will lead consulting teams through successful customer pilot and production deployments while ensuring a world-class customer experience.
The Digital Project Manager II will manage a base of customers and successfully deploy data management software. They will also provide first-tier support to end-customers and collaborate with field resources for account planning and forecasting.
The Solutions Consultant will partner with Account Executives to engage prospective customers and understand their business and technical requirements. They will act as the technical point of contact, translating customer needs into aligned product capabilities and supporting pre-sales discussions.
The Associate Account Executive is responsible for selling a portfolio of software solutions to Global 1000 clients and ensuring customer satisfaction. They will work closely with marketing and sales teams to develop prospects and meet revenue targets.
The Solutions Consultant will partner with Account Executives to engage prospective customers and understand their business and technical requirements. They will act as the technical point of contact, translating customer needs into product capabilities and supporting pre-sales discussions.
Mass Tort & Environmental Specialty Operations Senior Manager
Allstate
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Full Time
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5 Weeks Ago
Allstate
The Mass Tort & Environmental Specialty Operations Senior Manager leads the Specialty Operations reinsurance claims function, overseeing complex environmental and latent injury exposures. This role is responsible for strategic leadership, operational excellence, financial oversight, and team development to ensure high-quality claim outcomes.
The Senior Key Account Manager will manage the sales cycle, guiding cross-functional teams and overseeing post-sale activities. They will develop relationships with key stakeholders to drive sales of high-value capital technologies.
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The Senior Data Scientist of Responsible AI leads the evaluation and validation of AI and GenAI systems, focusing on ensuring they are measurable, transparent, and aligned with Responsible AI principles. This role involves collaborating with various teams to operationalize Responsible AI practices and mentor junior data scientists.
The Senior Wind Technician – Travel is responsible for maintaining optimal function and output at wind sites by performing daily turbine operations and maintenance. This role includes troubleshooting mechanical, hydraulic, and electrical problems and ensuring compliance with safety and quality standards.
Retirement Plan Consultant - Indian River County, FL
Corebridge Financial
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Full Time
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5 Weeks Ago
Corebridge Financial
Provide objective guidance to plan sponsors and employees regarding retirement savings plans through individual and group presentations. Collaborate with relationship managers to conduct education campaigns and increase plan participation and deferral rates.
Interpret general emergency imaging, including STAT ER, urgent care, and inpatient cases. Perform 100% final reads remotely during designated swing shift hours.
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