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53 fresh jobs found

Senior Manager, Member Services
Remote

Mitigation Strategies Periscope KPI Models Business Insights Lean Six Sigma Technology Platform Team Development Six Sigma +25

Senior Full Time

USD 92K+

Senior Claims Quality Control Analyst
Remote

Database languages Total quality management Healthcare Claims Models Business Insights Healthcare operations Lean Six Sigma Workflow Management Technology Platform +32

Senior Full Time

USD 65K+

Senior Manager, Data Analytics
Remote

Network performance KPI KPI Frameworks Quality care Contracting Strategies Models Data Storytelling Healthcare Analytics Technology Platform +34

Senior Full Time

USD 129K+

Technical Implementation Associate
Remote

Client Data Management Models Data Pipeline Technical Implementation Campaign Development Technology Platform Solution Design Scalability Health Insurance +15

USD 98K+

Director, BPO Strategy & Governance
Remote

BPO Strategy Operational improvement Technology Platform Cross-functional Leadership Transformation Six Sigma Lean Root Cause Analysis Health Insurance +20

Exec Senior Full Time

USD 156K+

Compliance Project Coordinator
Remote

Meeting organization Administrative assistance Presentation preparation Calendar Management Technology Platform Administrative Support Health Insurance Regulatory Regulatory Compliance +7

Entry Full Time

USD 82K+

Manager, Pharmacy Policy
Remote

Pharmacy Policy Quality care Clinical Policy Clinical evidence MCG Medical Writing Technology Platform Prior authorization Quality improvement +23

USD 131K+

Utilization Review Processor
Remote

Ticket management Utilization Review Knowledge Management Technology Platform Reporting tools Health Insurance Customer Support C CRM +8

Entry Mid Full Time

USD 38K+

Data Scientist I, Decision Science
Remote

KPI Frameworks Utilization Trends Models Healthcare Analytics Technology Platform Financial Performance Pandas Claims Advanced Analytics +25

Entry Mid Full Time

USD 119K+

Senior Director, Insurance Financial Management
Remote

Financial strategy Strategic Analysis Management Reporting Technology Platform Financial Performance Efficiency Contracting Financial Management Managed Care +23

Senior Full Time

USD 172K+

Senior Analyst, Medical Economics
Remote

Utilization Trends KPI Frameworks Healthcare economics Cost analysis Technology Platform Financial Performance Pandas Analytical tools Google Sheets +25

Senior Mid Full Time

USD 72K+

Data Scientist I, Payment Integrity
Remote

Models Risk Adjustment Technology Platform Data Validation Advanced Analytics Data integrity Data Pipelines Reliability Health Insurance +11

Entry Mid Full Time

USD 119K+

Analyst, Gov/Reg Affairs
Remote

Rosco Legislative tracking Westlaw Appeals Appian Technology Platform Google Workspace Regulatory Affairs Claims +8

USD 71K+

Project Lead, Learning and Training
Remote

Operational improvement Remote team management Lean Six Sigma Project Management Software Technology Platform Learning and development PMP Lean Six Sigma +16

Senior Mid Full Time

USD 65K+

Senior Director, Pharmacy & Behavioral Health Program Operations
Remote

Technology Platform Cost Management Controls Transformation Efficiency Pharmacy Regulatory requirements Health Insurance Regulatory +22

Senior Full Time

USD 172K+

Community Health Worker
Remote

Resource provision Quality care Navigation Technology Platform Care Coordination Health Insurance Spanish Outreach Behavioral health +8

Entry Mid Full Time

USD 48K+

Claims Quality Senior Analyst
Remote

Healthcare Claims Healthcare operations Lean Six Sigma Workflow Management Technology Platform Process improvements Stakeholder Collaboration Data Mining Claims processing +22

Senior Mid Full Time

USD 65K+

Senior Sales Executive
Remote

Broker management Technology Platform Healthcare industry Health Insurance Spanish Market Research Bilingual Relationship building C +9

Senior Full Time

USD 88K+

Senior Software Engineer I
Remote

CS concepts Modular code Fault-tolerant systems Scalable software Technology Platform Technical Design Health Insurance Application Development Equity +10

Senior Full Time

USD 158K+

Senior Quality Data Analyst, Claims
Remote

Insurance experience Data Quality Assurance Technology Platform Healthcare Data Efficiency Operations Management Google Sheets Data integrity Data Pipelines +22

Senior Full Time

USD 84K+

Senior Director, Strategic Finance & Corporate Development
Remote

Qualitative evaluation Quantitative evaluation Financial targets Corporate Development Capital modeling Strategic Insights Insight Generation Corporate strategy Mergers and acquisitions +24

Senior Full Time

USD 172K+

Senior Counsel
Remote

Complex litigation management Health insurance regulatory requirements Payer-provider disputes Litigation strategy Analytical abilities Contract drafting EDiscovery Technology Platform Legal research +14

Senior Full Time

USD 172K+

IT Internal Audit Associate Director
Remote

Technology risk management System Development Life Cycle IT Audit Electronic Health Records Technology Platform Internal Audit Cyber Security Health Insurance Data privacy +13

Entry Senior Full Time

USD 142K+

Appeals Review Nurse
Remote

NCCN Medical decision support tools Level of care reviews Medical necessity reviews Milliman care guidelines Evidence-Based Guidelines InterQual MCG Clinical Guidelines +16

Entry Mid Full Time

USD 70K+

Nurse Manager, Quality of Care
Remote

Evidence-based resources Clinical performance Milliman care guidelines Quality Auditing Quality of care Operational performance Appian Ticketing Systems Triage +34

USD 108K+

Program Manager, Complex Issue Resolution
Remote

Claims resolution Healthcare Claims Program strategy Metrics Development Operational Improvements Technology Platform Controls Risk Analysis Efficiency +22

USD 92K+

Director, Market Management
Remote

Market economics Healthcare Contracting Workflow improvement Financial Performance Technology Platform Contracting Healthcare industry Health Insurance Equity +12

Exec Senior Full Time

USD 156K+

Program Associate, Complex Issue Resolution
Remote

Tools development Healthcare Claims Operational Improvements Technology Platform Controls Efficiency PMP Six Sigma Operational Efficiency +16

USD 84K+

Prior Authorization Pharmacist
Remote

Clinical audits Peer-to-peer calls Pharmacy Practice Prior authorizations Clinical Criteria Clinical Review Technology Platform Prior authorization Pharmaceuticals +11

USD 108K+

Regulatory Manager
Remote

Legal studies Legislative tracking Westlaw Healthcare Regulations Policy analysis Technology Platform Public Policy Google Workspace Managed Care +13

USD 97K+

Senior Manager of Capacity Planning
Remote

Clearview IEX NICE Verint Five9 Production planning Operational planning Workforce management Lean Six Sigma +23

Senior Full Time

USD 107K+

Associate, Provider Success
Remote

Workflow Design Lean Six Sigma Technology Platform Project Planning Six Sigma Lean Health Insurance Communications Consulting +17

USD 84K+

Compensation Program Manager
Remote

Compensation planning Pay equity studies Headcount planning Plan Design Pay equity SOX compliance Technology Platform Advanced Excel Health Insurance +17

USD 102K+

Utilization Management Liaison Lead
Remote

Insurance experience Workflow improvement Clinical Review Performance Indicators Lean Six Sigma Technology Platform Administrative Tasks KPIs Utilization management +24

Senior Mid Full Time

USD 48K+

Utilization Review Nurse
Remote

Level of care reviews Medical necessity reviews Evidence-Based Guidelines Clinical Guidelines Acute care RN licensure Clinical Practice Clinical Review Utilization Review +11

USD 70K+

Team Lead, Claims Production
Remote

Quality of care Google office suite Operational Improvements Technology Platform Claims processing Health Insurance Performance Metrics Scheduling Metrics +13

Senior Mid Full Time

USD 51K+

Senior Analyst, Regulatory
Remote

Legal studies Arbitration Dispute resolution Legal counsel Technology Platform Public Policy Regulatory Affairs Health Insurance Regulatory +11

Senior Mid Full Time

USD 69K+

Program Lead, Payor Connections
Remote

Data file transfers SFTP Healthcare Consulting Operational strategy Risk Adjustment Technology Platform Health Insurance API Consulting +12

Senior Mid Full Time

USD 88K+

Senior Analyst, Process Improvement
Remote

Lean Methodologies Healthcare Contracting Healthcare operations Workflow Design Network management Technology Platform Lean Six Sigma Dashboard Development Project Coordination +26

Senior Mid Full Time

USD 65K+

Clinical Operations Analytics Associate
Remote

Quality of care Risk Adjustment Contract negotiations Technology Platform Dashboard Development Analytical tools Clinical operations Google Sheets Health Insurance +24

USD 88K+

Social Worker
Remote

Bilingual Spanish and English Community Resources Patient advocacy Technology Platform Crisis Intervention Care Coordination Social Work Health Insurance Spanish +12

USD 71K+

Care Navigation Guide
Remote

Chromebook Healthcare navigation Technology Platform Care Coordination Google Workspace Lean Health Insurance Spanish Clinical +9

Entry Mid Full Time

USD 38K+

Manager, Treasury
Remote

Asset liability management Investment Management Technology Platform Portfolio Management Health Insurance Financial modeling Metrics Critical thinking Risk Management +14

USD 97K+

Site Reliability Engineer II
Remote

Fault tolerance Code Quality Infrastructure Management Technology Platform Technical Design Site Reliability Engineering Reliability Scalability Health Insurance +14

USD 144K+

Manager, Knowledge Management
Remote

Workflow Design Lean Six Sigma Program development Technology Platform Six Sigma Lean Operational Excellence Health Insurance Data integrity +21

USD 92K+

Senior Actuarial Analyst
Remote

Analytical Modeling Health insurance concepts Actuarial Analysis Pricing strategies Technology Platform Benchmarking Stakeholder communication Data-driven decision making Health Insurance +11

Senior Mid Full Time

USD 82K+

Senior Engineer II
Remote

OAuth2 SCIM Identity Governance OIDC Flask Technology Platform SAML Identity Management Authentication +22

Senior Full Time

USD 174K+

Associate, Affordability
Remote

Healthcare Consulting Clinical Review Technology Platform Utilization management Six Sigma Lean Health Insurance Risk mitigation Professional Development +19

USD 88K+

Director, SIU
Remote

Financial targets Investigative strategies Audit Processes Provider Contracting Fraud Prevention Operational Management Technology Platform KPIs KPI development +24

Exec Senior Full Time

USD 118K+

Director, Corporate Compliance & Privacy/Ethics
Remote

Compliance Analytics Records Management Healthcare Compliance Ethics Technology Platform Controls Health Insurance Regulatory Audit +17

Exec Senior Full Time

USD 142K+

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