Provide first and second-level technical support for Microsoft 365, Azure, and networking functions to ensure system stability. Manage user onboarding, offboarding, and system maintenance while documenting incidents and escalating complex issues.
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The Associate Actuary provides support for rate advocacy, manages financial forecast models, and analyzes medical and pharmacy cost drivers. They are responsible for developing actuarial models and communicating results to various stakeholders while adhering to professional standards.
MDM / ERDM Business Systems Analyst Senior
Amerihealth Caritas
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Full Time
·
5 Weeks Ago
Amerihealth Caritas
The role serves as a Subject Matter Expert providing business analysis support for Member and Provider MDM and ERDM initiatives. Responsibilities include leading requirements management, performing hands-on data analysis using SQL and Databricks, and acting as a liaison between business and technical teams.
Manage the full sales cycle from discovery calls to signed agreements, focusing on identifying business problems and recommending hiring solutions. Maintain a clean pipeline in HubSpot and coordinate with internal teams to ensure a seamless handoff to recruiting.
Drive net-new business for CloudLabs by managing the full sales cycle from qualification to closing. Build a clean pipeline in HubSpot and execute seamless handoffs of won accounts to the Account Management team.
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REMOTE HVAC/Mechanical Estimator (Permanent Dayshift, WFH-Philippines)
Scale-X Solutions
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Full Time
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5 Weeks Ago
Scale-X Solutions
The Estimator is responsible for leading tender preparations, creating Bills of Quantities, and preparing accurate cost estimates for HVAC and mechanical projects. They will collaborate with Project Managers and subcontractors to clarify design issues and ensure compliance with client requirements.
Family Medicine Medical Director Utilization Management
Amerihealth Caritas
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Full Time
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5 Weeks Ago
Amerihealth Caritas
Lead operational areas of the Utilization Management program, including prospective, concurrent, and retrospective reviews to ensure medically appropriate patient care. Collaborate with multidisciplinary teams to develop medical policies and analyze utilization trends to improve clinical effectiveness.
Vice President Provider Network Management
Amerihealth Caritas
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Full Time
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5 Weeks Ago
Amerihealth Caritas
The Vice President leads enterprise-wide provider contracting and network management strategy to ensure high-performing, compliant networks. This role oversees the Indiana provider network strategy and collaborates across business functions to align network growth with organizational goals.
The role focuses on growing revenue and awareness of Abcam's product range in West Japan through direct customer engagement and collaboration with sub-dealers. Key duties include developing strategic account plans, managing project pipelines, and building long-term relationships with senior decision-makers in Biotech and Pharma.
Lead the launch, growth, and overall operational performance of the Indiana health plan. Serve as the primary market-facing leader to build relationships with state agencies, providers, and community partners.
Automations and AI Integration Expert (Permanent AU Dayshift, Remote/WFH - Philippines - AU Legal industry)
Scale-X Solutions
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Full Time
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5 Weeks Ago
Scale-X Solutions
Design and deploy scalable automation and AI systems to reduce manual workloads and improve operational efficiency. Build internal tools, integrate core business systems, and establish governance for the safe use of AI within a legal professional services environment.
Accounts Assistant - Xero & Smokeball (Permanent AU Dayshift, WFH-Philippines - AU Law Firm)
Scale-X Solutions
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Full Time
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5 Weeks Ago
Scale-X Solutions
Maintain accurate financial records, process invoices, and perform bank reconciliations using Xero for an Australian law firm. Provide administrative support for payroll, debt recovery, and financial reporting while ensuring strict confidentiality.
Senior Operations and Compliance Manager
Naijatutors Konnect
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Full Time
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5 Weeks Ago
Naijatutors Konnect
Lead global platform operations by unifying Finance, Client Support, and Session Monitoring under a single governance framework. Ensure strict compliance through systematic audits, SLA enforcement, and the optimization of data-driven staffing models.
Diplom-Jurist / Volljurist für IT- und Datenschutzrecht (m/w/d)
actago GmbH
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Full Time
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5 Weeks Ago
actago GmbH
Support the implementation of data protection and information security legal requirements in close cooperation with designated officers. Handle customer inquiries and draft or review relevant documents such as AV contracts and TOMs.
The role involves managing executive calendars, travel, and communications while acting as a primary point of contact for stakeholders. It also requires utilizing digital and AI tools to streamline administrative workflows and improve executive productivity.
Provide high-level administrative and executive support, including calendar and client coordination. Assist with bookkeeping, financial record organization, and basic social media content updates.
Research and collect verified contact information for evangelical megachurches and their leadership across the United States. Maintain a structured database in Excel or CRM platforms while ensuring data accuracy and consistency.
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Network Contractor Provider Network Management
Amerihealth Caritas
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Full Time
·
5 Weeks Ago
Amerihealth Caritas
The Network Contractor is responsible for recruiting, contracting, and re-contracting healthcare providers to ensure a compliant and marketable network. This includes negotiating rates, managing provider satisfaction, and aligning contracts with federal and state regulations.
Appeals & Grievance Case Resolution Specialist
Amerihealth Caritas
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Full Time
·
5 Weeks Ago
Amerihealth Caritas
Manage the full life cycle of member and provider appeals and grievance cases through intake, investigation, and documentation. Act as a liaison between internal departments and external stakeholders to ensure timely resolution compliant with federal and state standards.
Manage the end-to-end print and postage process, including mail merges, PDF conversions, and quality control of letter output. Coordinate print projects to meet client SLAs and identify opportunities for production efficiency.
Develop large reporting layers, executive decks, and metrics to support the Total Cost of Care revenue and expense review process. Collaborate with operational partners to identify high-value opportunities for savings and revenue growth.
Coordinate long-term services and supports for Medicaid participants through face-to-face assessments and participant-centered planning. Manage the delivery of physical, behavioral, and social health services while ensuring participants are informed of their rights and options.
The Director of Customer Value Delivery is responsible for the end-to-end execution and governance of complex insurance software programs to ensure timely value realization. This role manages program milestones, risks, and commercial outcomes like NRR and ARR while leading cross-functional delivery teams.
The Director of Customer Value Delivery is responsible for the end-to-end execution and governance of complex insurance software programs to ensure timely value realization. This role manages program milestones, risks, and commercial outcomes while leading cross-functional teams and maintaining C-suite customer relationships.
Act as the first point of contact for patients calling with health-related concerns to obtain demographics and register them for virtual care. Coordinate patient flow by directing callers to clinicians and monitoring biometric alerts for follow-up.
Lead a team of technical leads and architects to oversee critical enterprise integration and API platforms. Drive the modernization of platforms using cloud-native practices, API-first strategies, and AI-driven automation.
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Draft and refine narrative sections for state Medicaid managed care bids, translating technical information into compliant and compelling prose. Collaborate with subject matter experts and utilize AI-enabled tools to produce high-quality, evaluable proposal responses.
Lead the daily operations of the proposal writing team, managing assignments and timelines for state Medicaid managed care bids. Coach writers and personally draft high-visibility sections to ensure compliant, persuasive, and evaluable responses.
Lead the development of complex, scenario-based narratives and high-visibility sections for state Medicaid managed care bids. Collaborate with subject matter experts and leadership to translate technical operational details into compelling, compliant, and evaluable prose.
Develop and maintain strong relationships with healthcare providers to drive performance and satisfaction. Support network management strategies, resolve provider disputes, and conduct educational orientation sessions.
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