- CenterWell (Boston, MA)
- …first** The Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- Highmark Health (Pittsburgh, PA)
- …a plus (eg, RBE models), especially CM delegation + Familiarity with major health care data sources ( claims , clinical) and advanced analytics **Preferred:** + ... leading, optimizing, and transforming all operational aspects of member facing health engagement team activities through case management, disease management, and… more
- Herc Rentals (Philadelphia, PA)
- …as a field-based clinical resource, supporting employees and management regarding health -related incidents, claims , and injury management. + Assess work-related ... America as of September 30, 2025. **Job Purpose** The Herc Rentals Occupational Health Nurse strengthens our field medical support and employee health … more
- General Dynamics Information Technology (Fairfax, VA)
- …Education and Experience** + BA/BS or equivalent experience + 8+ years' experience in health care claims analysis + 8+ years' experience in fraud, waste, and ... Obtain:** None **Public Trust/Other Required:** None **Job Family:** Ancillary Health **Skills:** Healthcare Fraud (Inactive),Insurance Fraud Investigations,Insurance Regulations,Medical Billing… more
- R1 RCM (Austin, TX)
- …in the health insurance industry (Commercial Insurances, Medicare, Medicaid); health claims billing and/or Third-Party contracts, minimum of two years ... solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines… more
- Mount Sinai Health System (New York, NY)
- …**Responsibilities** The ideal candidate will have had some experience working with health administrative/insurance claims data and other large datasets. Prior ... **Job Description** The Department of Population Health Science and Policy at the Icahn School...applications for a Postdoctoral Research Scientist with interest in health economics, health services research, and … more
- LA Care Health Plan (Los Angeles, CA)
- …stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other ... (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by...additional service needs according to specific program guidelines. Uses claims processing and care management software to look up… more
- Insight Global (Santa Barbara, CA)
- …accurate ledger entries. The ideal candidate will have hands-on experience with health plan financials, claims systems, and advanced data analysis tools. ... Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements Health Plan Experience - deep understanding of claims… more
- Sutter Health (Sacramento, CA)
- …Directs the strategic advancement and upkeep of the risk financing portfolio for Sutter Health , manages all claims and litigation, and serves as an advisor to ... We are so glad you are interested in joining Sutter Health ! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** Develops,… more
- Baylor Scott & White Health (Dallas, TX)
- …+ Collect and analyze data from a variety of sources, including electronic health records, and claims data (50%). + Provide observations and recommendations ... + VBC Analytics is an independent organization covering BSW Health Plan (Payer) and BSW Quality Alliance (ACO Provider)...benefits package includes the following + Immediate eligibility for health and welfare benefits + 401(k) savings plan with… more