The analyst creates data-driven insights to improve healthcare outcomes, costs, and patient experiences. They serve as a consultative expert, interpreting complex clinical and financial data to provide actionable recommendations to stakeholders.
The Business Systems Analyst supports the application product life cycle by gathering requirements, creating business cases, and translating business needs into detailed technical specifications. They collaborate with cross-functional teams to ensure quality delivery, perform testing, and resolve defects throughout the software development lifecycle.
Design and operate real-time and analytical data pipelines using Azure Data Explorer to support enterprise reporting and decision-making. Collaborate with cross-functional teams to develop data models, ensure data quality, and create business-ready visualizations.
The Lead Financial Analyst performs financial research, prepares forecasts, and analyzes trends to support management decision-making. They also serve as a project lead for special financial studies, ensuring projects are documented and completed within established timeframes.
The Community Health Worker acts as a liaison between members, providers, and community organizations to improve health outcomes and close care gaps. They conduct outreach, provide health education, and assist members in navigating the healthcare system and addressing social determinants of health.
The Medical Director conducts electronic reviews of escalated cases against medical policy criteria to determine medical necessity and appropriateness. They also participate as a physician member of a multidisciplinary team to advise on high-risk cases and contribute to protocol development.
The Category Manager creates and executes strategic business plans for contract categories while negotiating high-value contracts with suppliers. They also provide guidance to sourcing staff and present business cases to senior leadership to ensure organizational compliance and cost-effectiveness.
The Medical Director conducts utilization reviews of escalated cases to ensure medical necessity and compliance with clinical standards and regulations. They also participate in multidisciplinary teams to provide physician expertise for case and disease management.
The clinician provides comprehensive psychiatric evaluations and delivers individual, group, and family therapy to acute patients. They are also responsible for maintaining accurate clinical documentation and attending departmental meetings.
The coder is responsible for reviewing and interpreting medical records to assign accurate ICD-10 CM and CPT codes for diagnoses and procedures. They also abstract data elements for statistical reporting and ensure efficient management of medical information to support cash flow.
The role involves resolving standard and non-routine customer inquiries through various communication channels while maintaining high efficiency and quality standards. Employees are expected to provide tailored recommendations and de-escalate challenging situations using in-depth product knowledge.
The Case Manager is responsible for assessing member needs, developing individualized care plans, and coordinating services to ensure quality and cost-effective health outcomes. They act as an advocate and liaison for members while monitoring progress and ensuring compliance with regulatory and accreditation standards.
The manager oversees the pre-payment high dollar claims review process, ensuring accuracy and identifying system defects to generate recoveries. They also lead staff, manage departmental operations, and represent the company in association-level claims processes.
The Senior Business Process Analyst identifies process gaps, recommends improvements, and manages complex cross-functional projects to align technology with business strategies. They are responsible for gathering operational objectives, creating process maps, and providing guidance to less experienced team members.
The Product Manager will define and execute the strategic vision and roadmap for Provider Data Products to ensure data accuracy and regulatory compliance. They will act as a bridge between business strategy and technical execution, overseeing the end-to-end delivery of products in partnership with engineering teams.
The HRIS Consultant serves as the functional architect for the Workday ecosystem, leading enterprise implementations and defining scalable design standards. They provide technical mentorship to HRIS analysts and partner with cross-functional stakeholders to align HR technology with business strategy.
The Senior Enterprise Solution Architect will lead the design and implementation of scalable, robust solutions that align with enterprise architectural standards and strategic business goals. This role involves providing technical leadership, facilitating complex business process development, and ensuring that functional and non-functional requirements are met throughout the solution lifecycle.
The incumbent evaluates clinical information and physician requests against medical policy to make medication coverage determinations. They also update system records to ensure accurate claims processing and conduct research to support coverage decisions.
The incumbent delivers high-quality, patient-centered care through in-home, virtual, and telephonic clinical assessments for patients with chronic or life-limiting conditions. Responsibilities include diagnostic interpretation, symptom management, advance care planning, and maintaining accurate clinical documentation for risk adjustment.
The Lead Data Solutions Analyst collaborates with customers and cross-functional teams to translate business needs into detailed data requirements and analytical deliverables. They provide subject matter expertise, lead complex projects, and ensure quality delivery while managing risks and defects throughout the product lifecycle.
The incumbent will support solution strategy and analysis by designing business models, processes, and systems to optimize Living Health solutions. They will collaborate with stakeholders to identify root causes of business issues and develop actionable recommendations through analytical frameworks.
The Account Manager is responsible for managing a book of business, renewing existing accounts, and selling new products to current clients. They act as a strategic consultant, representing the organization at meetings and coordinating with internal teams to provide policyholder solutions.
Lead enterprise-wide strategic planning, transformation programs, funding processes, and long-range organizational goals, aligning strategy and execution across business units. Manage strategic governance and portfolio performance, oversee executive reporting, and resolve project risks, resource issues, and escalations.
Lead complex, end-to-end strategic projects and data-driven analyses to improve healthcare program efficiency, care quality, and performance. Turn findings into actionable recommendations and impact models, advise cross-functional leaders, monitor implemented initiatives, mentor analysts, and present insights to executives.
The coder is responsible for reviewing and interpreting medical records to assign accurate ICD-10 and CPT codes for diagnoses and procedures. They also abstract data elements for statistical reporting and ensure efficient management of medical information to support cash flow.
The Strategy Partner leads and supports key strategic initiatives across the enterprise, playing a central role in development, execution, and project management. They are responsible for identifying complex issues, performing data analysis, and ensuring alignment across various business units.
The Senior Product Manager owns the end-to-end financial front door for members, defining the product strategy and vision for cost transparency and coverage experiences. They are responsible for managing the product backlog, setting roadmaps, and coaching junior team members in a player-coach model.
The incumbent will design and interpret clinical and population health analyses to identify actionable opportunities for improving healthcare outcomes and costs. They will serve as a strategic business partner, providing consultative expertise and leading matrixed teams to achieve organizational goals.
The incumbent serves as a senior consultant to prioritize data requirements and deliver financial, utilization, and performance analytics to support business decision-making. They are responsible for leading the implementation of complex analytical solutions and mentoring less experienced colleagues.
Lead the Network’s cost accounting operations, including staff management, consistent cost definitions and allocation methods, and the production of accurate patient-care cost information. Use analytics and decision-support tools to inform clinical and financial decisions, support reimbursement discussions and capital planning, and collaborate with leaders and departments to explain and maintain credible cost data.
Provides nursing assessments and clinical triage by phone, prioritizes patient needs, and coordinates appointments and access to clinical and supportive services. Supports callers and non-clinical staff, identifies at-risk patients, and collaborates with multidisciplinary teams and physician offices to coordinate care.
The incumbent will design and develop scalable software applications while participating in all agile scrum ceremonies. They are responsible for technical execution, code reviews, and mentoring associate and intermediate software engineers.
The accountant performs professional-level financial tasks including the maintenance, reconciliation, and analysis of financial records. They also provide guidance to lower-level staff and ensure all transactions comply with GAAP and company policies.
The role involves administering Planview portfolios, configuring workflows, and managing project intake processes to support business capability enablement. It also requires acting as a subject matter expert to resolve complex integration issues and provide data-driven insights for process improvements.
The specialist is responsible for requesting and obtaining medical records from healthcare providers to ensure accurate documentation and risk-adjusted revenue. They must coordinate retrieval methods, maintain secure repositories, and adhere strictly to HIPAA regulations.
The Senior Sales Executive is responsible for prospecting and securing new group business for core and supplemental health products within an assigned territory. They will manage the entire sales cycle, including high-stakes meetings, pipeline management, and maintaining relationships with brokers and consultants.
The manager serves as the technical and strategic leader for the enterprise data protection program, overseeing data security, loss prevention, and encryption initiatives. They are responsible for managing a multidisciplinary team, establishing security roadmaps, and ensuring compliance with corporate policies and regulatory standards.
The Lead AI Architect will design the end-to-end ecosystem for AI solutions, ensuring scalability, security, and seamless integration with enterprise infrastructure. They will lead cross-functional teams to align AI roadmaps with business goals while establishing best practices for MLOps and AI safety.
Design and architect secure data solutions across cloud and on-premises environments while ensuring compliance with regulatory standards. Partner with cross-functional teams to develop scalable data platforms and provide technical leadership and mentoring to staff.
The Credentialing Representative processes provider applications, maintains the provider database, and coordinates credentialing verifications. They also support network implementations, generate reports, and act as a subject matter expert for internal and external stakeholders.
The Claims Adjuster reviews and adjusts Blue Card claims while ensuring accuracy and adherence to corporate procedures. They also identify potential fraudulent cases and resolve customer issues through process improvements.
Responsible for the design, development, implementation, and support of the Archer GRC platform and related technologies. Collaborates with stakeholders to define business processes and deliver scalable, secure GRC technology solutions.
The Director of Enterprise Transformation Strategy identifies, develops, and directs a portfolio of projects to improve performance metrics and drive strategic value. They are responsible for project execution, financial outcomes, and influencing senior leadership within a matrixed organization.
The Senior Security Engineer will lead the integration of security controls into the software development lifecycle, focusing on shift-left strategies and AI-assisted development. They will also manage vulnerability risk reduction, automate security toolchains, and provide expert guidance to engineering teams.
The Senior Case Manager is responsible for providing comprehensive case management services to members, including assessing needs, developing care plans, and coordinating services to ensure quality and cost-effective outcomes. They also act as a liaison between members and healthcare providers while providing mentorship to lower-level staff.
The Community Health Worker acts as a liaison between members, providers, and community organizations to improve health outcomes and close care gaps. They conduct outreach, provide health education, and assist members in navigating the healthcare system and addressing social determinants of health.
The Account Executive is responsible for driving sales revenue and growing market share by acquiring new clients within the national print and mail manufacturing footprint. They will manage the full sales cycle, including prospecting, needs assessments, contract negotiations, and ongoing client retention.
The Senior Investigator conducts investigations into potential fraud, waste, and abuse involving providers, members, and employees while managing anti-fraud programs. They also provide subject matter expertise, mentor team members, and coordinate with law enforcement and regulatory agencies to ensure compliance and financial recovery.
The Registered Nurse is responsible for assessing, planning, and implementing nursing care for patients in a home infusion setting. This includes administering infusion therapy, coordinating with interdisciplinary teams, and ensuring accurate documentation and patient education.
The Product Owner is responsible for managing the product backlog, translating business strategy into agile execution, and serving as the primary point of contact for cross-functional teams. They oversee product requirements, release planning, and stakeholder alignment to ensure the delivery of high-value business outcomes.
The auditor will ensure claims are processed according to internal procedures and plan documents while monitoring audit workflows for timely turnaround. They will also provide coaching to the claims team, conduct specialized audits, and assist with system upgrade testing.
The Grants and Contracts Officer manages the pre-award process by facilitating grant proposals, budget preparation, and financial planning for research projects. They also act as a liaison between investigators and external organizations while ensuring compliance with legal and institutional policies.
The Product Manager will define and deliver data products leveraging conversational AI and omnichannel interaction data to improve member experience and operational efficiency. They are responsible for managing the product backlog, setting strategic roadmaps, and ensuring data governance and regulatory compliance.
The incumbent analyzes clinical data to identify trends and cost drivers while preparing reporting metrics for healthcare clients. They collaborate with internal teams to develop clinical management strategies and support the RFP/RFI process.
The lead is responsible for managing the Finance technology product roadmap and portfolio, ensuring alignment with strategic business objectives. They act as the primary liaison between Finance stakeholders and technology teams to oversee the end-to-end demand lifecycle and project delivery.
The senior auditor leads complex clinical, documentation, and billing compliance reviews while providing guidance to the audit team. They are responsible for implementing orientation programs, conducting investigations, and managing corrective action plans to ensure adherence to federal and state regulations.
The Coding Coordinator assists management in overseeing coding and charging activities, including managing Epic work queues and communicating with vendors. They also serve as an Epic super-user, coordinating appeals and denials while ensuring timely billing through cross-departmental collaboration.
The incumbent manages post-award financial activities for grants, contracts, and clinical trials, including award set-up, compliance review, and financial reporting. They are responsible for analyzing financial results, ensuring accurate invoicing, and facilitating project close-out while adhering to institutional and sponsor policies.
The Senior Case Manager is responsible for providing comprehensive case management services to members with complex health needs to ensure quality and cost-effective care. They will develop and implement individualized care plans while collaborating with physicians and healthcare providers to monitor member progress.
The Provider Relations Liaison is responsible for recruiting, training, and managing dental networks within an assigned territory to ensure contractual compliance and network growth. They act as the primary intermediary between the organization and dental providers, facilitating contract negotiations, financial performance monitoring, and quality improvement initiatives.
The Community Health Worker acts as a liaison between members and healthcare providers to improve health outcomes and close care gaps. They conduct face-to-face outreach, provide health literacy education, and assist members in navigating the healthcare system and accessing community resources.
The Senior Architect leads the design, development, and optimization of complex architecture strategies, specifically focusing on the Digital Chat Platform. They provide strategic consultation to business customers and mentor team members to ensure high-quality, scalable application development.
The Mainframe Storage Administrator will assist in researching, designing, and implementing mainframe infrastructure systems while ensuring compliance with organizational standards. They will also provide production monitoring, support, and collaborate with cross-functional teams to deliver technical solutions.
This leadership role oversees underwriting operations, managing team performance and strategic initiatives to support customer acquisition and retention. The incumbent collaborates with sales leadership to develop book management strategies and ensures adherence to internal and governmental regulations.
The supervisor manages the Medicare Fee-for-Service appeals unit, delegating assignments and ensuring compliance with CMS thresholds and internal standards. They provide direct oversight to staff, handle high-profile provider issues, and monitor departmental performance against budget and quality goals.
The incumbent will support, maintain, and optimize cloud technologies through engineering and automation builds. They will collaborate with cross-functional teams to design, test, and implement technical solutions that meet organizational goals.
The investigator is responsible for developing anti-fraud programs and conducting investigations into alleged fraud, waste, and abuse by providers and members. They must also prepare cases for legal referral, testify in court, and coordinate the recovery of misappropriated funds.
The Identity & Access Management Security Engineer participates in the development, testing, implementation, and integration of IAM systems and solutions. This role focuses on supporting identity solutions, troubleshooting access issues, and ensuring the security of information resources.
The Senior Oracle Cloud EPM Analyst will administer, maintain, and enhance Oracle Cloud EPM applications, with a primary focus on Planning and EPBCS. They will also partner with Finance, Accounting, and IT teams to translate business requirements into scalable technical solutions and provide production support.
The consultant manages a block of stop loss business, overseeing new business and renewal pricing, risk analysis, and financial performance. They collaborate with sales, clinical, and underwriting teams to develop creative solutions and provide leadership and training to staff.
The manager provides leadership oversight to a group of project managers, ensuring delivery processes are followed and obstacles are removed. They are responsible for staff development, budget management, and resolving cross-domain scheduling conflicts.
The Principal Information Security Architect leads the design and advancement of enterprise data security architectures to protect sensitive information across its lifecycle. They collaborate with cross-functional teams to establish secure solutions for modern data platforms, analytics environments, and cloud infrastructure.
The Lead Enterprise Architect will drive technology strategy and innovation by designing comprehensive architecture roadmaps and leading AI solution strategies. This role involves providing strategic consultation to business customers and mentoring team members to ensure cohesive, scalable, and cost-effective enterprise solutions.
Lead the full project lifecycle from concept to delivery for mid-to-large initiatives, ensuring they are completed on time and within budget. Manage resources, mitigate risks, and maintain strong communication with stakeholders through detailed reporting and documentation.
Lead the full project lifecycle for large to extra-large initiatives, ensuring delivery on time, within budget, and to quality standards. Manage resources, mitigate risks, and maintain strong communication with stakeholders through detailed reporting and documentation.
The role is responsible for the performance and capacity management of the IBM zEnterprise mainframe environment to ensure system efficiency and cost-effectiveness. Key duties include capacity forecasting, performance tuning of middleware, and cross-functional collaboration with DevOps teams.
The role involves designing and developing research databases and analytic solutions to address clinical and financial healthcare challenges. The informaticist serves as a liaison between physicians and research staff to translate data needs into actionable insights.
Drive change within Utilization Management and Medical Policy operations by bridging clinical decision-making and operational finance. Develop robust financial and operational data models to quantify the impact of medical policies and track administrative costs.
Manage Information Security and Risk Management services, overseeing personnel, budgets, and the implementation of security technology products. Lead strategic planning, ensure corporate policy compliance, and develop security awareness training programs.
The role involves analyzing industry data and financial conditions to assess risk for small and mid-sized clients. The underwriter collaborates with sales teams to deliver quotes and provide strategic risk management recommendations.
Develops and executes strategic business plans for contract categories and manages high-dollar bids and GPO operational activities. Builds strategic relationships with supplier partners and presents business cases to senior leadership.
Responsible for the retention, growth, and profitability of medium to large customer accounts through strategic renewal negotiations and contract management. The role involves collaborating with internal teams to deliver product solutions and managing client issues to resolution.
Drive the adoption of innovative health products by partnering with sales and marketing to deliver consultative client presentations. Manage a book of business and develop client-specific marketing plans to meet the needs of large key accounts.
Lead the development of actuarial studies and analyses focusing on insurance pricing, claim trends, and profitability. Provide technical guidance to junior staff and represent the department's needs in cross-disciplinary settings.
Lead the design, implementation, and maintenance of critical mainframe systems including z/OS, DB2, and CICS. The role involves driving platform improvements, troubleshooting critical issues, and mentoring junior engineers in a geographically dispersed environment.
The role focuses on adopting, maintaining, and optimizing cloud technologies and automation builds across the organization. Responsibilities include designing and implementing technical solutions, collaborating with stakeholders, and mentoring junior engineers.
Lead the advancement and integration of the marketing technology stack and AI to scale marketing efforts. Manage vendor relationships, operational strategies, and the delivery of platform roadmaps in collaboration with IT and other stakeholders.
Lead the development of actuarial studies and analyses to inform management decisions across various insurance functions. Guide and mentor junior staff while implementing efficient processes for pricing, claim trends, and profitability analysis.
The role involves applying actuarial techniques and statistical analysis to functions such as pricing, claim trends, and profitability. The analyst is responsible for developing data queries, creating studies for decision-makers, and participating in the Actuarial Executive Development Program.
Provides clinical consultation and utilization management reviews for behavioral health and addiction services within Medicaid and Medicare programs. Collaborates with leadership to develop strategic directions, ensure compliance with medical standards, and manage provider networks.
Perform financial and business research, including the preparation of forecasts, trend analysis, and financial reports. Lead special projects by gathering data, documenting findings, and presenting results to management to improve business outcomes.
The Manager of IT Data Governance provides operational leadership for the data governance team to support IT projects and enterprise data standards. They are responsible for managing data owners, facilitating governance councils, and ensuring continuous process improvement across the organization.
The Registered Nurse is responsible for assessing patient needs, planning and implementing nursing care, and administering infusion therapy in home settings. They must maintain accurate medical records, coordinate with interdisciplinary teams, and ensure adherence to safety and quality standards.
The Senior Cyber Incident Responder leads complex cyber investigations and coordinates incident response efforts within the Cyber Fusion Center. They are responsible for analyzing threat data, performing forensic collections, and providing expert technical guidance to ensure enterprise-wide security.
This role involves instructing, directing, and checking the work of other analysts and programmers while formulating complex system scope and objectives for assigned projects. Responsibilities include providing complex architecture and technical designs, managing the entire application life cycle, and ensuring adherence to project schedules.
Physicians will provide a full range of diagnostic neuroradiology services across various AHN facilities, including trauma centers and stroke centers, utilizing state-of-the-art imaging technologies. Involvement in clinical and didactic teaching for residents and medical students, along with active participation in multidisciplinary conferences, is also expected.
The Imaging Institute is expanding services and locations, recruiting radiologists for musculoskeletal imaging roles. Positions are available as part-time or full-time, with options for onsite, hybrid, or remote work arrangements.
The role involves reading chest imaging exclusively or a combination of chest and cardiac imaging, with options for body imaging interpretation available. Responsibilities include providing diagnostic services across plain film, various CT modalities (including cardiac CT), and MR imaging (including cardiac MRI).
The Registered Nurse assesses human responses and plans, implements, and evaluates nursing care for individuals or families, assuring safe delivery of nursing services in alternative care settings like home infusion visits to administer therapy. Responsibilities include active participation in interdisciplinary communication, directing ancillary care, accurate documentation, and timely implementation and evaluation of physician orders.
The Mainframe Systems Programmer will install, upgrade, and manage CICS/MQ environments, ensuring the health and stability of the mainframe system. They will also participate in disaster recovery exercises and troubleshoot issues to determine root causes.
The coder performs thorough medical record reviews to abstract medical and demographic data and applies appropriate ICD codes for diagnoses and procedures. They also ensure efficient management of medical information and assist in decreasing average accounts receivable days.
The Sales Executive actively prospects for new clients and manages relationships with existing accounts to ensure retention and growth. They are responsible for selling core and supplemental products while acting as a strategic consultant for clients.
The Medical Director ensures that utilization management responsibilities are performed according to clinical standards by reviewing escalated cases and determining medical necessity. They also participate in multidisciplinary teams for case and disease management, advising on high-risk cases and managing special projects.
