The analyst will support medical policy development by conducting research, monitoring regulatory changes, and leveraging AI-enabled solutions to improve operational efficiency. They will also translate clinical and business needs into actionable requirements while collaborating with cross-functional teams to optimize workflows.
The role involves providing technical leadership for cloud software deployment and automating infrastructure to support enterprise value. You will design cloud services, manage operational tasks, and collaborate with teams to migrate and optimize workloads.
Lead the design, development, and productionalization of sophisticated AI solutions and platform capabilities for healthcare payer applications. Partner with stakeholders to translate business workflows into scalable AI-enabled systems while mentoring junior engineers.
The trainee will handle customer inquiries via telephone, chat, email, and TEAMS to provide timely and accurate resolutions. They are responsible for documenting all communications and educating callers to ensure issues are resolved on the first contact.
The AI Workflow Engineer will partner with business leaders to identify, design, and implement AI-driven automation solutions within Treasury and Internal Audit divisions. They are responsible for integrating AI components with internal systems while ensuring compliance with healthcare regulations and data governance standards.
The Care Coordinator will partner with members and families to identify support needs and facilitate access to health and community services. They are responsible for conducting objective face-to-face assessments to determine the physical, behavioral, and social needs of members.
The Underwriter is responsible for performing risk appraisals, classifying group health risks, and determining appropriate coverage and pricing. They also maintain underwriting guidelines and collaborate with sales, account managers, and actuarial teams to support group health insurance products.
The RN Case Manager will provide comprehensive, member-centered care for individuals with complex health needs by coordinating services and reducing barriers to improve outcomes. They will also support utilization management functions and serve as a liaison between members, providers, and internal teams.
The Clinical Pharmacy Specialist supports coverage review activities by managing cases and ensuring timely access to pharmacy benefits. Responsibilities include entering authorizations, handling provider and member inquiries, and monitoring pharmacy reports to ensure accurate claims processing.
You will lead the modernization of internal claims applications by designing and maintaining enterprise-grade browser-based solutions using Vue.js and TypeScript. Additionally, you will serve as a front-end subject matter expert, mentoring team members and driving technical best practices across the development lifecycle.
The Care Coordinator partners with members and families to identify support needs and direct services to meet personal health and independent living goals. They conduct objective face-to-face assessments and collaborate with a clinical team to ensure member needs are met through authorized home and community-based services.
The supervisor will lead, mentor, and support a team of Care Coordinators to manage the complex needs of CHOICES members while ensuring regulatory compliance and quality standards. They will oversee daily operations, provide clinical guidance, and occasionally manage a member caseload during staffing transitions.
The RPA Team Lead manages daily operations, system maintenance, and development for the automation team while supervising staff performance and professional growth. They also track project details, serve as a technical subject matter expert, and ensure adherence to organizational policies and budgets.
You will design, build, and maintain customer-facing enterprise mobile applications across iOS and Android platforms using React Native. Additionally, you will troubleshoot complex system issues, integrate APIs, and contribute to engineering best practices through code reviews.
The Support Coordinator will empower individuals with intellectual and developmental disabilities by managing their health, social, and employment needs through person-centered planning. This role involves conducting face-to-face assessments, authorizing community-based services, and collaborating with clinical teams to ensure member goals are met.
The Care Coordinator partners with members and families to identify support needs and direct services to achieve health and independent living goals. They conduct objective face-to-face assessments and collaborate with clinical and social support teams to manage member care.
The Enterprise Architect II will lead the strategy and implementation of scalable AI solutions, including defining architectural standards and governance for the Microsoft AI ecosystem. They will act as a technical product owner to drive GenAI maturity and ensure alignment between emerging technologies and enterprise business objectives.
The Care Coordinator partners with members and families to identify support needs and facilitate access to health, employment, and community living services. They conduct objective face-to-face assessments to determine the physical, behavioral, and psycho-social status of members while authorizing appropriate home-based care.
The Team Lead will manage day-to-day operations, oversee system maintenance, and guide a team of engineers in modernizing member portal platforms. They are responsible for mentoring staff, ensuring project delivery predictability, and collaborating with cross-functional stakeholders.
Lead a team of engineers in designing, building, and scaling enterprise authentication and federation solutions. Manage day-to-day operations, staff development, and technical direction to ensure secure and resilient identity services.
Lead the design, development, and delivery of enterprise-grade applications while ensuring compliance with quality standards. Manage vendors and contracts, and mentor developers to inspire high performance and teamwork.
