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.
Online Jobs (206,163)
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
Capital Health (US)
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Full Time
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2 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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2 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.
Senior Compliance Analyst - External Audit
Centene Corporation
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Full Time
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2 Weeks Ago
Centene Corporation
Lead the coordination of external audits and regulatory examinations, serving as the primary point of contact for auditors and regulators. Manage the end-to-end audit process, including evidence collection, submission, and the development of responses to audit reports.
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Corporate Ethics & Compliance Investigator
Centene Corporation
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Full Time
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2 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.
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.
Investigate allegations of healthcare fraud, waste, and abuse through claims audits and data mining. Prepare detailed investigative reports for referral to state and federal agencies.
The role involves contacting clients to collect outstanding payments and reconciling remittances with the cash application team. Responsibilities include monitoring accounts, processing credit card payments, and reporting on accounts receivable status in NetSuite.
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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2 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.
Senior Functional Business Analyst
Curriculum Associates
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Full Time
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2 Weeks Ago
Curriculum Associates
The Senior Functional Business Analyst translates complex business needs into actionable requirements for Revenue and Sales Operations. They lead stakeholder discovery, manage UAT, and mentor junior BAs to improve the overall BA practice.
Software Engineer II - Merchandising
DICK'S Sporting Goods
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Full Time
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2 Weeks Ago
DICK'S Sporting Goods
Develop and maintain next-generation merchandising tools and custom software for the Inventory 360 initiative. Collaborate with product management and architecture teams to optimize inventory planning and purchasing processes.
Regional Business Manager - West IA and East NE
FMC Corporation
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Full Time
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2 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.
Lead the global execution and rollout of the Microsoft Modern Commerce platform across the Americas, APJ, and Europe. Collaborate with senior leaders to define cloud platform strategy and manage program governance, risks, and performance metrics.
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Lead workflow planning, scheduling, and resource allocation across Tax and Client Accounting Services teams to improve efficiency. Partner with leadership to monitor utilization, solve capacity challenges, and identify operational bottlenecks.
Insurance Defense Trial Attorney - Dallas
Farmers Insurance Careers
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Full Time
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2 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.
Inbound Business Development Representative, English speaker
Trimble Inc.
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Full Time
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2 Weeks Ago
Trimble Inc.
Triage and respond to inbound inquiries to uncover business needs and convert qualified leads into opportunities for account executives. Collaborate with Marketing to follow up on campaigns and maintain accurate data within corporate CRM systems.
Credit Processor
Medical University of South Carolina
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Full Time
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2 Weeks Ago
Medical University of South Carolina
The Credit Processor researches and resolves undistributed and credit transactions within the Epic system through transfers, postings, and refunds. They are responsible for verifying insurance and guarantor information and maintaining productivity and accuracy audits.
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.
Plan and execute the management of business requirements and rules through various elicitation techniques. Guide team members on software requirements and support internal validations and business manager approvals.
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.
HR Systems and Support Administrator
World Insurance Associates, LLC.
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Full Time
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2 Weeks Ago
World Insurance Associates, LLC.
The role focuses on the administration and configuration of HR systems, specifically UKG Pro and Dimensions, to ensure data accuracy and stability. It involves managing cyclical HR processes such as compensation and performance cycles while providing Tier 2-3 technical support.
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Client Relationship & Marketing Operations Manager
World Insurance Associates, LLC.
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Full Time
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2 Weeks Ago
World Insurance Associates, LLC.
Manage client onboarding, account transitions, and administrative support for advisors while ensuring compliance and accurate documentation. Execute marketing operations including social media management, email campaigns, and digital content updates to drive business development.
Clinical Research Coordinator 1 (A) Full Time Bascom Palmer Eye Institute Miami, FL
University of Miami
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Full Time
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2 Weeks Ago
University of Miami
The coordinator manages entry-level clinical research activities, including participant screening, data collection, and the implementation of research protocols. They are responsible for maintaining regulatory binders, reporting adverse events, and coordinating study timelines and visits.
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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2 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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