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The Internal Auditor II will execute risk-based audits to evaluate controls, processes, and risk mitigation strategies across health plan operations. They will also communicate audit findings and recommendations to management while supporting emerging AI-related audit initiatives.
The role involves performing financial analysis, pricing, and risk assessment to support Value-Based Care initiatives. You will develop financial models, analyze healthcare datasets, and collaborate with stakeholders to track vendor performance and financial outcomes.
The clinician performs utilization reviews of Applied Behavioral Analysis (ABA) services to ensure medical appropriateness and clinical effectiveness. They also analyze behavioral health data and interact with healthcare providers to improve the quality of care for members.
The Certified Professional Coder will perform comprehensive medical record reviews to ensure billing compliance and identify potential fraud, abuse, or billing errors. They will also articulate findings to various stakeholders, including investigators, law enforcement, and medical directors.
The National Sales Executive is responsible for driving new sales, growth, and implementation of extended warranty products within a defined North American territory. They will engage dealership enterprises, meet sales targets, and provide training to dealer staff to maximize insurance product performance.
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The Clinical Specialist manages member and provider appeals and grievances by investigating clinical cases and ensuring compliance with regulatory standards. They are responsible for case development, preparing documentation for medical reviews, and resolving issues related to service authorizations.
Performs clinical evaluations on medical claims to ensure documentation substantiates the need for employee absence. Acts as a clinical resource for claims examiners to provide guidance on medical management and claim decisions.
Supervise multiple teams of examiners and technical staff to ensure efficient liability claims adjudication and process improvement. Monitor claim workloads, provide technical direction, and maintain high standards of quality and client service.
The Payments & eCommerce Lead is responsible for the strategy, governance, and operational oversight of the organization's incoming and outgoing payment ecosystem. This role manages vendor relationships, financial performance, and cross-functional initiatives to ensure efficient and compliant payment operations.
The Senior Compliance Analyst assists in maintaining the corporate compliance program by performing regulatory reporting, auditing, and risk assessments. They also lead special projects and serve as a liaison for regulatory agencies to ensure organizational adherence to state and federal mandates.
The Senior Group Sales Manager is responsible for exceeding group room and catering revenue goals by identifying, qualifying, and soliciting new business within an assigned territory. They must also manage complex incoming opportunities, develop sales strategies, and maintain strong relationships with key travel partners and clients.
The Attorney Auditor reviews legal and non-legal invoices for insurance carriers, corporate legal departments, and government entities to ensure compliance with billing guidelines. They also communicate with law firms regarding billing requirements and manage invoice workflows to meet production objectives.
The AMISYS Developer will design, develop, and implement complex healthcare payer solutions while collaborating with business and IT stakeholders. Responsibilities include analyzing business requirements, creating technical specifications, performing root-cause analysis, and managing vendor solution delivery.
The QNXT Developer will design, develop, test, and implement complex healthcare payer technology solutions. They will collaborate with business and IT partners to resolve system issues and ensure high-quality delivery of technical specifications.
The Account Director is responsible for driving revenue growth by actively prospecting and selling communications infrastructure solutions to financial services and banking enterprises. They must manage the full sales cycle, from presenting proposals to maintaining long-term customer relationships and ensuring high customer satisfaction.
The Senior Director owns the enterprise strategy, governance, and delivery of cybersecurity across the full transaction lifecycle, including due diligence and integration. They lead a global team and serve as the primary security advisor to Corporate Development, Finance, and Legal regarding transaction-related cyber risk.
The Associate Sales Representative supports the growth of the surgical glaucoma portfolio by providing operating room case support and clinical education to surgeons. They partner with sales managers to drive product adoption, maintain accounts, and execute regional growth initiatives.
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The Claims Examiner is responsible for analyzing and processing complex bodily injury auto and commercial transportation claims by investigating liability and evaluating damages. They also manage the litigation process, coordinate vendor management, and ensure claim files are properly documented and resolved within service expectations.
The Patient Care Coordinator supports pharmacy liaison workflows by managing patient inquiries, documenting requests, and coordinating follow-ups with providers and payers. They also maintain accurate case records and collaborate with internal teams to ensure timely service delivery and issue resolution.
Analyze and process low to mid-level auto commercial trucking and transportation claims. Develop action plans to ensure contract deadlines are met and pursue subrogation opportunities.
You will design and build scalable web applications and APIs while partnering with product managers and designers to deliver thoughtful technical solutions. Additionally, you will contribute to architectural decisions, mentor junior engineers, and leverage AI-assisted tools to improve development velocity.
The BESS Engineer III is responsible for the design, development, implementation, and optimization of battery energy storage system projects. This role provides strategic technical direction, engineering oversight, and project management to ensure the successful delivery of BESS solutions.
The Principal RASSU Specialist supports regulatory study start-up activities by managing compliance assessments, IRB/IEC submissions, and site documentation quality. They also oversee site budgets and contracts while mentoring junior staff and representing the regulatory department in project meetings.
The Recruitment Specialist will manage the end-to-end recruitment process, including requisition management, candidate pipeline development, and interview coordination. They will also utilize digital tools like Workday and GenAI to improve recruitment efficiency, reporting, and candidate experience.
The Title Examiner reviews property records and legal documents to determine ownership status and identify potential title defects. They collaborate with internal teams and external partners to ensure accurate title reports and compliance with regulatory standards.
The Claims Team Lead supervises multiple teams of examiners to ensure efficient liability claims adjudication and process improvement. They are responsible for monitoring workloads, providing technical direction, and maintaining professional relationships with clients.
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The Senior Commissioning Manager leads the commissioning project management function and provides portfolio-level oversight for testing and commissioning delivery across utility-scale projects. This role is responsible for integrated planning, milestone visibility, cross-functional coordination, and resource balancing from early engagement through project closeout.
Manage a team of Vocational Rehabilitation Specialists to provide return-to-work services and ensure performance targets are met through data-driven insights. Lead team initiatives, coach staff, and serve as a business partner while leveraging AI tools to improve productivity.
The Senior Director will build and execute the company's LTSS market position to drive revenue growth and new business opportunities. They will oversee proposal development, manage new business implementations, and cultivate relationships with key providers, regulators, and community leaders.
Oversee prepay waste, abuse, and fraud reviews through coding, editing, and audit programs while ensuring adherence to state and federal regulations. Develop and implement internal payment integrity policies, interpret audit results for senior management, and lead compliance teams to streamline operational processes.
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