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Current opportunities

Position Posted
Director, Claims
The Director of Claims is a key role within the Claims department and is responsible for assisting in setting strategic direction within Claims and providing tactical guidance to ensure implementation of that strategy. Responsibilities include guiding the management team in the implementation of strategic initiatives, collaborating across the division and enterprise, aligning and furthering departments capabilities, as well as ensuring effective and efficient delivery of key service metrics. This position relies on experience and judgment to plan and accomplish organizational goals and objectives.
Data Analytics Engineer
In this position you will combine your business expertise and your technical knowledge to help various internal stakeholders maximize the business value of the data available to them. You should be familiar with healthcare data and use data analytics and best practices to effectively build strategies and solutions that serve current and future needs. You’ll be using these stills to partner with internal and external stakeholders to provide data-driven insights for use in making business decisions, telling the story behind the data and solving complex problems.
Clinical Quality Improvement Coordinator
This position functions within Health Care Delivery and Wellness by developing and implementing clinically focused performance improvement initiatives in collaboration with internal and external stakeholders to improve quality of care for members, improve population health and reduce the cost of care. Contributes to fulfilling Quality Management Program accreditation and regulatory requirements. Must have strong communication and leadership skills, work well in a team environment, and be capable of building and maintaining positive relationships. Must exceed customer expectations, be cross-functional, and adapt to ever changing corporate and market demands. Knowledge of health plan operations, quality requirements and metrics (such as HEDIS) a plus.
Nurse Care Manager
.The Nurse Care Manager works collaboratively with health care providers to ensure that members receive high quality, medically necessary care in a timely fashion in a setting that maximizes benefit coverage and health outcomes. The Nurse Care Manager educates members to understand innovative benefit structures that promote transparency and affordability and empowers consumers to make informed decisions regarding their healthcare options, coverage, and financial risk. The Nurse Care Manager assists members to navigate the complex health care settings and ensures that they get the support they need throughout the episode of care to optimize health status.
Manager, Account Management and Service (Major Accounts)
This position will be responsible for managing the day to day account management and account service for major and national accounts; typically 500+ eligible members.