Define and execute the enterprise AI and automation strategy to improve care quality and operational performance for Medicare Advantage business. Lead a multi-disciplinary engineering team to design and scale AI-powered systems while ensuring regulatory compliance.
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RN Case Management Coordinator - NICU/Maternity (W@H Anywhere)
BlueCross BlueShield of South Carolina
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Full Time
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6 Days Ago
BlueCross BlueShield of South Carolina
The RN Case Management Coordinator provides active care management, assesses service needs, and coordinates action plans to improve health outcomes and reduce care fragmentation. Responsibilities include performing medical reviews, providing telephonic support for high-risk members, and advocating for members within the healthcare delivery system.
Medicare Cost Report Auditor III
BlueCross BlueShield of South Carolina
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Full Time
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6 Days Ago
BlueCross BlueShield of South Carolina
Conduct comprehensive financial, compliance, and operational audits to evaluate internal controls and identify business risks. Prepare detailed audit reports and recommendations for executive management to improve corporate processes and ensure regulatory compliance.
Senior Member Advocacy Specialist
AAA Mountain West Group
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Full Time
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6 Days Ago
AAA Mountain West Group
Proactively contact at-risk members to prevent membership loss and negotiate payment plans for reinstatement. Promote and cross-sell AAA products and services while maintaining accurate records of all member interactions.
Responsible for the delivery and support of Curam projects, including facilitating requirements workshops and creating technical designs. The role involves developing and unit testing Curam extensions in a J2EE environment and configuring application servers.
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Strategic Account Operations Manager – Medical Prior Authorization
McKesson
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Full Time
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6 Days Ago
McKesson
Oversee complex customer relationships and strategic programs focused on medical benefit prior authorization and front-end access services. Act as a trusted operational advisor to ensure high-quality, scalable execution and adherence to contractual deliverables.
Drive the North America sales strategy for the Coatings, Adhesives, and Sealants business by building strategic customer relationships and optimizing distribution networks. Partner cross-functionally to deliver technical solutions and manage account growth against AOP targets.
Develop and maintain pricing tools and data pipelines using SQL and Python for Medicare Part D. Serve as a subject matter expert and assumption owner to support the bid cycle and forecasting activities.
Collaborate with cross-functional teams to design and deliver high-quality user experiences across desktop, mobile, and native app platforms. Translate complex cognitive challenges into elegant designs while communicating the vision and rationale to senior stakeholders.
Identify, map, and engage high-caliber executive talent across corporate functions using data-driven sourcing strategies. Partner with business leaders to build diverse talent pipelines and provide market intelligence to inform hiring decisions.
The Patient Financial Counselor educates patients on insurance coverage, deductibles, and out-of-pocket costs while managing payment arrangements. They also determine eligibility for financial assistance and document all account activity in medical record systems.
The Insurance AR Specialist manages monthly accounts receivables, follows up on outstanding balances, and handles claim re-files. They are responsible for researching and resolving insurance payment issues for oncology, radiology, and proton therapy services.
Lead the design and governance of enterprise-grade Playwright/TypeScript automation frameworks and AI-enabled quality engineering strategies. Provide technical oversight and mentorship to engineers while integrating AI tools for autonomous test maintenance and defect triage.
Lead the transformation of quality engineering by setting the vision for multiple platform portfolios and driving AI adoption in testing. Manage a diverse team of managers and engineers while establishing scalable QE standards and reporting quality metrics to leadership.
UHNW Operations Consultant (Remote)
Wealth Enhancement Group
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Full Time
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6 Days Ago
Wealth Enhancement Group
Provide operational leadership and advanced portfolio accounting for complex ultra-high-net-worth client relationships. Design and execute customized performance reporting solutions for multi-entity households, trusts, and alternative investments.
The role involves owning the end-to-end performance reporting framework and building BI dashboards to track business health for Media, Marketing, and Listings products. The manager will synthesize complex quantitative findings into executive narratives to drive strategic business decisions.
Acts as a liaison between Operations and Technical support to triage escalations and investigate system issues. Responsibilities include documenting cases, collaborating with development teams for fixes, and analyzing trends to prevent future issues.
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Channel Manager – Anchors & Fasteners - Remote Based
Stanley Black & Decker, Inc.
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Full Time
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6 Days Ago
Stanley Black & Decker, Inc.
Direct and coordinate strategic marketing activities to manage profitability, pricing, and product plans for Anchors and Fasteners within the C&I channel. Collaborate with cross-functional teams to execute market communication plans, analyze POS data, and support third-party sales agencies.
Lead technical initiatives and drive architectural decisions to build and support core value stream application components. Collaborate with product managers and stakeholders to translate business goals into scalable, resilient software systems.
Manage the end-to-end lifecycle of U.S. Government contracts, from solicitation and formation to administration and close-out. Partner with leadership to develop contracting strategies and mitigate business, performance, and compliance risks.
The Pre Approval Manager acts as a liaison between internal and external clients to guide borrowers through the best financial loan programs. Responsibilities include auditing income and assets, reviewing disclosure packages, and pre-underwriting loan files to ensure stability and approval.
Data Analysis and Informatics Specialist
State of North Carolina
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Full Time
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6 Days Ago
State of North Carolina
Leverage analytics and informatics to modernize public health data systems and inform evidence-based decision-making. Design data collection protocols, conduct statistical and epidemiological analyses, and develop interactive dashboards for stakeholders.
Own the end-to-end execution of retail marketing initiatives and product launches across major accounts like Target and Whole Foods. Coordinate between Brand, Sales, Ops, and Creative teams to ensure flawless in-store execution and operational alignment.
The Wholesale Operations Analyst manages daily order flow and serves as the primary contact between sales, logistics, and customers. They are responsible for maintaining system data integrity in SAP and Sweed while preparing sales and performance reports.
Territory Account Manager- Informatics Solutions, NA-East Region
Revvity
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Full Time
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6 Days Ago
Revvity
The role is responsible for identifying new opportunities and selling Informatics software and service solutions to the Life Sciences market. Key duties include managing the full sales cycle from prospecting and lead qualification to contract completion and forecasting.
Sr Director, Data Center Infrastructure Management, Intelligence & Controls
Flexential
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Full Time
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6 Days Ago
Flexential
Lead the systems, data, and controls for data center infrastructure, ensuring accuracy in capacity, power topology, and telemetry. Stabilize operational teams and harden data quality to support billing, capacity forecasting, and a future digital-twin state.
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Lead carrier operations performance through model governance, scorecard management, and the implementation of problem-solving strategies. Monitor performance metrics, conduct root cause analysis, and collaborate with leadership to drive operational improvements across markets.
Sr. Field Applications Specialist - South Dakota
Danaher Corporation
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Full Time
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6 Days Ago
Danaher Corporation
Responsible for the validation of new Chemistry and Immunoassay instrument installations to ensure they meet customer and company requirements. Provides onsite and remote support for assay and QC questions while training customers on proper instrumentation operation.
Senior Director of Workforce Programs
University of Washington
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Full Time
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6 Days Ago
University of Washington
Lead the delivery and scaling of workforce-aligned education and credentials to increase employment in high-demand sectors across Washington. Manage statewide partnerships, oversee the workforce program portfolio, and provide strategic leadership to staff.
Manage a high-performing operations team to deliver complex fiber infrastructure projects from engineering through final service delivery. Act as a strategic technical lead and primary operational partner for key accounts, ensuring vendor accountability and process scalability.
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