- Highmark Health (Pittsburgh, PA)
- …pay-for-value programs, episode payments, prospective bundled payments, gain share and risk share models and will be implemented for the Organization'sMedicare ... Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing quality while reducing healthcare costs. + Keep abreast of new developments in both the public and private reimbursement space, including new innovative models developed by CMS to… more
- BMO Financial Group (Appleton, WI)
- …assesses and improves the work processes for sales and service management, risk management and compliance within prescribed limits to maximize effectiveness ... and efficiency. Optimizes opportunities through deal teams and sales calls, maximizing business success. Influences the strategic direction of the line of business assisting with the development, prioritization and implementation of business, technology, sales… more
- Ally (Tallahassee, FL)
- …engage other departments to resolve customers' credit bureau disputes. * Mitigate risk by exercising judgement; look beyond the obvious and escalate unusual account ... promoting low effort customer experience in line with all quality and compliance standards. * Actively participate in one-on-one coaching sessions with supervisor. *… more
- Highmark Health (Pittsburgh, PA)
- …home health and durable medical equipment to identify key areas of risk exposure and develop plans to mitigate risks and maximize financial recoveries/savings. ... + Work with audit teams and external audit vendors to identify overbilling, determine data analysis routines and audit approaches. + Work with operational areas to recover identified overpayments, performing a follow-up review to ensure that the claims were… more
- Guidehouse (Los Angeles, CA)
- …paths for modernization. + Advise on performance, scalability, security, and compliance considerations throughout the delivery lifecycle. New Business Development + ... work plans. + Support pursuit teams with level-of-effort estimates, solution risk identification, and stakeholder communication strategies. + Contribute to the… more
- Raymond James Financial, Inc. (Hackensack, NJ)
- …recommends planning alternatives. * Researches and provides recommendations related to risk management concerns, including insurance. * Designs and recommends a ... transactions. * Ensures practice and regulatory policies are followed within compliance standards * Perform other duties and responsibilities as assigned.… more
- RGP (Portland, OR)
- …our global clients-solving problems in the areas of Business Transformation, Governance, Risk and Compliance , and Technology and Digital Innovation. Our unique ... consulting model allows you the radical flexibility and control you demand in the "Now of Work," enabling you to define your career path based on your expertise, passion, desire to travel, work environment and life stage. At RGP, diversity, equity and… more
- Capco, a Wipro Company (New York, NY)
- …analyze, and document market data requirements from business stakeholders across trading, risk , operations, and compliance . + Translate business needs into ... clear, detailed functional and technical specifications for engineering teams. + Analyze data from vendor feeds (eg, Bloomberg, Refinitiv, ICE, SIX, S&P, exchanges) to define ingestion logic and transformation rules. + Collaborate with data engineers and… more
- US Tech Solutions (Atchison, KS)
- …+ Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which ... to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. + Utilizes interviewing… more
- RGP (Ann Arbor, MI)
- …our global clients-solving problems in the areas of Business Transformation, Governance, Risk and Compliance , and Technology and Digital Innovation. Our unique ... consulting model allows you the radical flexibility and control you demand in the "Now of Work," enabling you to define your career path based on your expertise, passion, desire to travel, work environment and life stage. At RGP, diversity, equity and… more