The Population Health RN is responsible for coordinating care and managing cases for members at risk for health deterioration to improve outcomes. They will assess member needs, implement comprehensive care plans, and collaborate with providers and community resources to ensure cost-effective, quality healthcare.
This role is responsible for auditing medical providers to ensure accurate coding and billing practices while enforcing reimbursement compliance. The incumbent will also research and resolve coding appeals and identify patterns of over-utilization to support provider contracting efforts.
The Medical Review Nurse is responsible for coordinating, processing, and managing medical claims to ensure compliance with contractual limitations and medical necessity. They also prepare documentation, conduct research, and collaborate with medical directors to determine benefit eligibility.
The BCaBA Utilization Reviewer evaluates the medical necessity and clinical appropriateness of ABA services for members. This role also oversees unlicensed clinical staff and collaborates with providers to ensure compliance with payer guidelines.
Design, develop, test, and maintain software systems and applications while serving as a technical expert on development projects. Collaborate with stakeholders to analyze requirements, document technical specifications, and provide ongoing support for enterprise solutions.
The Senior GRC Analyst leads the validation, assessment, and authorization processes to ensure IT systems meet cybersecurity and risk requirements. They collaborate with technical teams to develop governance documentation, manage risk assessments, and oversee security control monitoring.
Design, implement, and optimize enterprise voice and contact center communication solutions across cloud and hybrid environments. Lead technical troubleshooting, automation development, and provide senior-level support for mission-critical communication services.
The intern will support the Corporate Strategy Office by conducting research, analyzing market trends, and tracking key performance indicators for the organization's strategic plan. They will also assist in creating executive-ready presentations and managing internal communications and strategy-related web content.
The Senior Software Quality Assurance Engineer delivers automated testing solutions and coordinates testing activities to ensure successful project deployment. They also identify bugs, collaborate with cross-functional teams, and provide training to the test team to improve quality processes.
The intern will support risk-based audit activities, including research, documentation, and data analysis to assist with project work. They will also maintain vendor and SOC report inventories while developing training guides and process documentation.
The intern will assist in developing statistical, predictive, and machine learning models to improve patient outcomes and provider performance. They will also contribute to generative AI initiatives and collaborate with cross-functional teams to translate analytical findings into actionable insights.
The intern will support the administration and analysis of value-based healthcare programs, including payment reconciliation and performance monitoring. They will work alongside analysts to assist with operational projects and data reporting to support business decisions.
The Lead Domain Architect guides the technical roadmap for specific domains to support business and IT projects while ensuring sustainable and economically viable designs. They act as a subject matter expert for the Architecture Review Board and collaborate with stakeholders to transform business requirements into effective technical solutions.
