Caresource

A/B Testing AWS Azure Business Intelligence Cloud +15 skills

Job Summary: The Data Scientist I is responsible for supporting the design and validation of predictive models, machine learning models, and artificial intelligence that inform and improve business processes across the…

6 days ago

Hybrid RN Clinical Care Manager - Springfield, MA

New North America

Job Summary: The Integrated Care Clinical Manager - Massachusetts at CareSource/Commonwealth Care Alliance is a community based registered nurse responsible for providing monitoring, follow-up and clinical care…

Integrated Care Clinical Manager - Springfield

New North America

New RemoteNorth AmericaSenior

Job Summary: The Integrated Care Clinical Manager - Massachusetts for CareSource/Commonwealth Care Alliance is a community based registered nurse responsible for providing monitoring, follow-up and clinical care…

Senior Financial Data Analyst - Reconciliation & Controls

Analytics Data Warehousing Databricks Financial Reporting Root Cause Analysis +2 skills

About the role: This position is ideal for an experienced financial analyst or auditor who combines strong financial reconciliation and controls experience with technical skills in SQL and Excel. Job Summary: Financial…

New RemoteNorth AmericaSenior

6 days ago

Director, Operations Regulatory and Accuracy Assurance Oversight(Preferred Experience In Operational Transformation)

Agentic AI Automation Corrective Action Root Cause Analysis Stakeholder Management

Job Summary: The Director, Operations Regulatory and Accuracy Assurance Oversight is responsible for representing and leading regulatory, compliance, and accuracy assurance activities on behalf of the Operations…

6 days ago

Digital Product Designer III

Accessibility Analytics Design Thinking Figma Information Architecture +6 skills

Job Summary: The Digital Product Designer III is responsible for leading user research and experience design activities across member- and provider-facing digital products and experiences. This role operates with a…

last week

Pharmacy Technician II

Job Summary: The Pharmacy Technician II is responsible for data entry and review of submitted authorization requests, providing assistance to providers or pharmacies calling for assistance, and ensuring resolution for…

Manager, Cost Reporting

Databricks ETL Financial Reporting Power BI Process Improvement +6 skills

Job Summary: The Manager, Finance - Cost Reporting is responsible for managing the cost reporting processes within the finance department. This role involves ensuring accuracy and completeness of financial data,…

New RemoteNorth AmericaContract

last week

Director, Utilization Management Operations(Preferred Experience in Prior Authorization Strategies)

Job Summary: The Director, Utilization Management Operations assists the UM Department with all open projects and progress towards company and department initiatives including program descriptions, evaluations,…

Customer Care Specialist I (Healthcare/Medicare Experience, must live in Ohio)

Job Summary: The Customer Care Specialist I assists members/beneficiaries or providers with routine service inquiries. Essential Functions: Resolve member/beneficiaries or provider routine service inquiries; examples…

Hybrid RN Case Manager Chicopee-5k SIGN ON BONUS!

North America

Job Summary: The Integrated Care Clinical Manager - Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with…

Manager, Clinical Appeals

Job Summary: The Manager, Clinical Appeals is responsible for the oversight of all clinical appeals activities ensuring consistency of services and achievement of compliance targets. Essential Functions: Assist in…

Business Analyst IV

Agile AI Analytics Automation Azure +7 skills

Job Summary: The Business Analyst IV serves as a business analysis leader responsible for shaping business strategy, guiding enterprise initiatives, and driving alignment between organizational objectives and…

2 weeks ago

Hybrid Registered Nurse (RN) Clinical Care Manager - Ipswitch - 5k Sign on Bonus

North America

Job Summary: The Integrated Care Clinical Manager - Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with…

Operations Business Analyst IV - Claims adjudication and/or Facets claims adjudication (preferred)

Job Summary: The Operations Business Analyst IV oversees the business analysis initiatives to drive operational excellence and efficiency of existing processes and systems, leads cross functional process improvements,…

Community Marketing Representative II- Must Reside in Franklin County or Contiguous County

North America

Job Summary: The Community Marketing Representative II is responsible to support the enrollment and retention strategy in collaboration with management to ensure all membership goals are successfully achieved.…

Integrated Care Clinical Manager - RN - Lynn, MA

RemoteNorth AmericaContract

Job Summary: The Integrated Care Clinical Manager - Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with…

Director, Actuarial Science (Medicaid Rate Advocacy, Month End Close, Forecasting)

AI Business Development SAS SQL

Job Summary: The Director, Actuarial Science is responsible for guiding the strategic direction, driving innovation and producing key insights for the organization that drive company performance. Essential Functions:…

2 weeks ago

Product Manager - Data Migration