Responsible for application implementation, adoption, enhancement, and ongoing support including testing and documentation. Participates in team on-call rotations and provides remote or on-site support to end-users.
The Director leads the strategy, program design, and implementation for all LTSS/HCBS requirements within the Community HealthChoices program. They oversee strategic partnerships, ensure regulatory compliance, and manage budgets while collaborating with leadership to improve program effectiveness.
Develop and maintain scalable Databricks data models and PySpark/SQL pipelines that transform clinical and genomic data for research applications, including modernizing legacy SQL Server ETL processes for the cloud. Optimize and monitor data quality, performance, and reliability while contributing to architecture, code reviews, documentation, user support, and team mentoring.
The Medication Access Coordinator is responsible for obtaining prior authorizations and conducting benefit investigations for prescribed treatments. They also act as a liaison between patients, insurance companies, and care teams while managing enrollment in medication assistance programs.
Provides strategic and operational financial support to assigned business units, including forecasting, financial modeling, month-end reviews, variance analysis, capital investment analysis, and performance improvement. Leads projects and reporting initiatives, partners with operational and finance leaders, and mentors Finance Partners to support team development and achievement of department goals.
Reviews claims, authorizations, medical records, billing, and plan documents to assess coding accuracy, reimbursement, and compliance with contracts, policies, and regulations. Recommends recoveries and payment decisions, supports clinical and claims reviews, maintains department reports, and contributes to team discussions and onboarding.
The specialist will manage vendor relationships, oversee claim-edit validation, and ensure payment compliance using national coding standards. They will also lead internal committees, perform system testing, and mentor staff to support organizational payment integrity strategies.
The Application Developer Senior designs, develops, and maintains automation solutions using UiPath to improve business efficiency. They also collaborate with multidisciplinary teams to provide technical support, code reviews, and ensure compliance with security and healthcare regulations.
Develop, implement, and evaluate health and wellness programs for facility-based and community populations, including screenings, education, coaching, and outreach. Coordinate on-site activities and stakeholder communications, maintain program records and databases, and report participation and outcomes.
The supervisor is responsible for directing and planning the functions of the coding program, including staff management, training, and performance reporting. They ensure accurate billing practices and compliance with documentation standards and regulatory guidelines.
Coordinates and oversees accounting and financial analysis functions, including general ledger transactions and account reconciliations. Reviews, refines, and automates department procedures to improve workflow efficiency.
The Reimbursement Coordinator serves as a consultant to staff regarding reimbursement methodologies, coding compliance, and strategic savings initiatives. They are responsible for analyzing billing statistics, maintaining fee schedules, and providing actionable recommendations to leadership.
Conduct independent and collaborative research evaluating precision screening and prevention strategies using large healthcare datasets, statistical methods, machine learning, AI, and health economic analyses. Publish and present findings, contribute to grants and scientific reporting, and collaborate with multidisciplinary research partners.
The medical coder reviews and analyzes health records to translate diagnostic and procedural phrases into standardized numeric or alphanumeric codes. They also query physicians to clarify documentation and ensure accurate code assignment for reimbursement purposes.
The counselor assesses patient needs to develop and implement individualized treatment plans including psychotherapy and case management. They also collaborate with psychiatric and outpatient teams to provide crisis intervention and triage evaluations.
The role involves assessing patient needs, developing treatment plans, and providing individual, family, and group psychotherapy. Additionally, the therapist will collaborate with psychiatry teams to provide crisis intervention and case management services.
The Pharmacy Consulting Services Clinical Specialist leads clinical content and workflow for home infusion enablement engagements with partner health systems. They are responsible for business case development, implementation planning, and serving as the primary clinical point of contact.
The Associate BI Analyst assists in collecting, cleaning, and interpreting data sets to support business or clinical decision-making. They collaborate with internal partners to develop reporting solutions and provide analytic insights while managing projects under supervision.
The Patient Contact Specialist manages patient appointment scheduling, cancellations, and confirmations while ensuring accurate registration and insurance data collection. They also handle non-scheduling inquiries and route calls to provide one-call resolution for patients and physicians.
The role involves partnering with product managers to quantify AI opportunities, conduct exploratory data analysis, and build measurement frameworks for AI performance. You will also maintain feature datasets and translate complex analytical findings into clear narratives for leadership.
The Director of Pharmacy Value and Strategy provides comprehensive oversight of pharmacy services, including medication use processes and transitions of care. They are responsible for mentoring staff, managing financial performance, and collaborating with healthcare professionals to develop cost-effective, evidence-based medication therapies.
The Senior Project Manager supports Data Core leadership by managing projects across data infrastructure, software engineering, and health care data analytics. They are responsible for assembling project teams, defining project scope and objectives, managing budgets, and ensuring timely delivery of project milestones.
The Oncology Data Specialist is responsible for abstracting complex clinical data into the cancer registry and ensuring adherence to state and national reporting requirements. They also perform annual patient follow-ups and assist in maintaining accreditation standards for the Cancer Center.
Lead regional medical management of inpatient services and help develop and implement the Health Plan’s medical management plan. Guide medical appropriateness and level-of-care decisions, oversee appeals and related documentation, and collaborate on quality, claims, case management, and pharmacy activities.
The developer will design and build intuitive dashboards and reports to enable data-driven decision-making across the organization. They will also collaborate with stakeholders to gather requirements, perform data analysis, and troubleshoot data quality issues.
The Application Administrator Team Lead oversees quality assurance activities, manages testing resources, and ensures the delivery of high-quality, business-aligned software solutions. Additionally, the role involves managing the application administration team, developing performance metrics, and creating roadmaps for new software tools and platforms.
The Lead BI Analyst serves as a subject matter expert for Medicare 5-star methodology, partnering with stakeholders to provide data-driven insights and strategic vision. They are responsible for leading complex analytic studies, mentoring junior developers, and ensuring high-quality reporting to support organizational decision-making.
The Digital Marketing Specialist will develop and execute email marketing campaigns while managing workflows within CRM and marketing platforms. They will also contribute to multi-channel marketing strategies, including SEO and web content, while analyzing campaign performance to optimize the customer experience.
The Sourcing Specialist III identifies and implements supply chain expense opportunities while collaborating with clinical and operational leadership to optimize product selection. They conduct advanced analytics, manage vendor negotiations, and ensure contract compliance to deliver value-based decisions for the organization.
The consultant supports the development of performance and business plans to optimize home infusion pharmacy services for partner health systems. They are responsible for project management, data analysis, and the creation of financial models and executive-level presentations.
Directs the activities of an IT team to support organizational segments and develops IT strategy in collaboration with leadership. Manages vendor relationships, departmental budgets, and oversees staff recruitment, development, and performance.
The radiologist will provide 100% remote emergency, trauma, and acute-care imaging services for hospitals across Pennsylvania. Responsibilities include interpreting various imaging modalities and collaborating with subspecialty radiologists and emergency departments.
The coder reviews and analyzes medical records to translate diagnostic and procedural phrases into accurate numeric codes for reimbursement. They also perform quality audits, query physicians for documentation clarification, and provide training on coding guidelines and practices.
Supports pre-award and post-award processes for sponsored projects, including managing funding opportunities and restricted external funding. Facilitates internal approvals, maintains award records, and develops educational materials for project teams.
Draft, review, and negotiate various research-related contracts while collaborating with legal and research teams. Perform clinical study coverage analysis, budget development, and ensure regulatory compliance across all research documentation.
Responsible for the development, implementation, and evaluation of provider and member communication plans, including direct mail, digital assets, and collateral. Coordinates projects with internal departments and external vendors to ensure accurate data delivery and adherence to marketing goals.
Define and drive the product vision and roadmap for a portfolio of AI initiatives across clinical, operational, and pharmacy domains. Lead these initiatives through the full lifecycle from discovery and validation to deployment and continuous improvement.
The Credentialing Coordinator II plans, coordinates, and oversees the Provider Credentialing Program to ensure compliance with regulatory requirements. They conduct background investigations, analyze physician applications, and maintain accurate provider databases for committee review.
Develop and lead the implementation of comprehensive marketing, communications, and digital engagement strategies to achieve organizational business objectives. Lead cross-functional teams to co-create tactical plans while monitoring performance metrics and maintaining strong client relationships.
Collaborate on the design of clinical research studies and develop biostatistical analysis plans for research proposals and grants. Manage, analyze, and interpret study data while educating research team members on statistical methods.
This role supports IT Demand Management and Due Diligence by collaborating with stakeholders to assess new technology and strategic initiatives. The position facilitates the intake, analysis, and documentation of IT requests to ensure alignment with organizational priorities.
Collaborate with clinical investigators to design research studies, develop analysis plans, and manage and interpret study data. Provide statistical consultations, prepare publication-quality graphics, and educate research staff on statistical methods.
Cultivate new sales of Medicare Advantage and supplemental plans through group and home presentations. Build collaborative relationships with community-based organizations and strategic partners to develop prospects in the assigned region.
Perform remote neuroradiology interpretations for adult and pediatric patients, focusing on brain, head, neck, and spine imaging. Utilize advanced imaging tools and collaborate with a dedicated 3D radiology lab to process cases.
Interpret a full range of imaging modalities, including Body and Neuro, for Level I and II trauma centers. Provide overnight coverage on a 7-on/14-off schedule working independently with subspecialty support.
The Director serves as the enterprise strategy lead for a business unit, translating high-level enterprise direction into actionable multi-year plans. They are responsible for shaping strategic choices, managing investment theses, and ensuring alignment between business unit execution and enterprise priorities.
Provides leadership and technical oversight for an assigned IT segment, focusing on policy creation and system reliability. Manages vendor contracts, departmental budgets, and operational KPIs to ensure efficient service delivery.
The Senior BI Analyst partners with AI Evaluation & Monitoring teams to collect, clean, and interpret data to drive data-driven decisions. They are responsible for executing validation studies, monitoring production AI performance, and mentoring junior developers.
The Tech Lead Data Scientist will define and oversee the technical methodology for evaluating, monitoring, and optimizing AI systems in production. They will provide hands-on guidance to program teams and mentor a team of data analysts to ensure rigorous validation and performance measurement.
The Senior Data Scientist leads the end-to-end lifecycle of AI and machine learning initiatives to improve healthcare outcomes and operational efficiency. They also mentor junior staff and translate complex technical findings into actionable insights for stakeholders.
The Patient Contact Specialist schedules medical appointments for patients, ensuring alignment with their preferences and physician guidelines. They also handle non-scheduling inquiries and maintain accurate patient information related to registration and insurance.
The Care Connector serves as the primary contact for the Special Needs Unit, assisting in resolving patient/member concerns and providing education and support. They manage crisis situations and advocate for patients/members who are unable to communicate effectively with service delivery systems.
The RN Nurse Navigator Triage provides nursing triage services and health advice for patients over the phone and in person. Responsibilities include assessing patients' acuity levels, providing education related to diagnostic testing, and coordinating care across departments.
