Develop and maintain actuarial models for risk-sharing, provider performance, and employer pricing strategies. Manage stop-loss and reinsurance strategies while collaborating across clinical, financial, and commercial teams to drive scalable risk capabilities.
The engineer will design, implement, and secure hybrid cloud environments while leading cybersecurity operations and incident response. They are also responsible for supporting SOC 2 Type II audits and maintaining compliance across the organization's infrastructure.
The Healthcare Support Advocate serves as a primary point of contact for members and providers, managing inquiries via phone, email, and chat. They are responsible for resolving claims, benefits, and eligibility issues while collaborating cross-functionally to ensure high-quality service delivery.
Define and own the product vision and strategy for the claims processing platform while serving as the primary liaison between business stakeholders and the engineering team. Manage the product roadmap, draft detailed business requirements, and ensure the platform meets operational, regulatory, and technical standards.
The role involves designing and maintaining scalable full-stack applications for a healthcare insurance platform using .Net, Angular, and GraphQL. Key duties include implementing serverless architectures on AWS and mentoring junior developers to ensure technical excellence.
This role serves as a primary point of contact for members and providers while managing claims processing, research, and adjudication. The specialist handles omni-channel inquiries and collaborates cross-functionally to resolve complex healthcare operational issues.
