- The Cigna Group (Bloomfield, CT)
- …recommendations based on performance results. + Collaborate cross-functionally with clinical , product, network, and finance partners to influence decision-making and ... drive performance improvement. + Support and maintain savings scorecards, ensuring emerging risks and opportunities are identified, quantified, and communicated effectively. + Translate ambiguity into structured plans, actionable insights, and measurable… more
- Charles River Laboratories (Wilmington, MA)
- …provides a suite of products and services to support our clients' clinical laboratory testing needs and manufacturing activities. Utilizing this broad portfolio of ... products and services enables our clients to create a more flexible drug development model, which reduces their costs, enhances their productivity and effectiveness to increase speed to market. With over 20,000 employees within 110 facilities in over 20… more
- Insight Global (Nottingham, MD)
- …focuses on resolving underpayments, denials, and contract interpretation issues-not clinical denials or patient balances. The representative ensures accurate ... reimbursement by analyzing Explanation of Benefits (EOBs), identifying discrepancies, and initiating corrective actions with payers. This team focuses on facility claims only, and this role is focused only on outpatient claims follow up, specifically to BCBS.… more
- Oracle (Frankfort, KY)
- …work on the Front End of the next generation Oracle Health Clinical Applications. Join the team modernizing healthcare with cloud-native, AI-powered applications ... that you'll design end to end-from elegant, accessible UIs to resilient microservices at massive scale. You'll partner with product, UX, and platform teams to ship secure, high-availability features that clinicians and patients rely on every day. Expect to… more
- UPMC (Pittsburgh, PA)
- …and gain support for data-based recommendations with team members from product, clinical , network, and strategy functions. + Bring clarity to complex problems using ... exceptional communication skills when engaging with senior leadership and technical audiences. + Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations and deliver results to leadership. + Creatively leverage… more
- Molina Healthcare (WA)
- …Visio (flow chart equivalent) **PREFERRED QUALIFICATIONS:** + Degree in Preferred field: Clinical Quality, Public Health, or Healthcare + 5 years of experience in ... health plan quality management + Experience with data reporting, analysis, and/or interpretation + Active, unrestricted Certified Professional in Health Quality (CPHQ) + Active, unrestricted Nursing License (RN may be preferred for specific roles) + Active,… more
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …non-covered items + Facilitate prior authorization process for customers + Provide clinical services in TherigySTM + Customer service coverage for incoming calls and ... wage requirements** **.** Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/13192/patient-benefit-specialist-- remote /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) **Job Locations** _US-NY-Syracuse_ **Posted Date**… more
- ThermoFisher Scientific (Wilmington, NC)
- …client-ready response. Focused on drug development and strategy alignment for clinical studies. + Engages cross-functionally with key stakeholders to ensure ... operational strategy and budget align with customer needs and win strategy. + Translates complex offerings into optimized solutions that align to customer needs. + Directs a high-impact, cross-functional team through the development and delivery of high… more
- Molina Healthcare (Rochester, NY)
- …pharmacy and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming and problematic ... contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care models. **Knowledge/Skills/Abilities** + Develop key strategic reports and analysis using SQL programming,… more
- Mount Sinai Health System (New York, NY)
- …work experience in IT + Experience with the Epic software or other clinical or business systems + Epic MyChart certification and experience highly preferred + ... Experience working independently and demonstrated accountability for groups of tasks or processes + Familiarity with third-party libraries and API integrations **Compensation Statement** The Mount Sinai Health System (MSHS) provides salary ranges that comply… more