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Work for a major health system in a visible position leading managed care contract modeling and analytics in relation to negotiations with insurance payors. Job Summary Develops and maintains analytical tools, manages and trains staff, and uses data to provide recommendations on reimbursement methodology and rates for managed care contracts. Prepares financial analyses of current state, models the financial impact of potential reimbursement methods and rates, and determines the optimum....

- Las Vegas, NV

Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare’s evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone. We are hiring several....


Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare’s evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone. We are hiring several....


Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare’s evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone. We are hiring several....


Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare’s evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone. We are hiring several....


Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare’s evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone.Can be based in any state


Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare’s evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone.Can be based in any state


Our client is a leader in utilization management and are using evidence-based approach to leverage their exceptional capabilities, powerful analytics, and acute sensitivity to the challenges and needs of everyone involved across the healthcare continuum. By applying proven talent and leading-edge technology, they harness healthcare evolving demand and inherent change to realize healthcare innovation and deliver improved results and a positive experience for everyone. Can be based in any state....


We are seeking a Regional Operations Finance Manager to join our Finance team to help drive top line and bottom line improvements through objective analysis, operational insights and strategic initiatives. This position will be reviewing and analyzing the effects of current financial practices, policies, and procedures while working with the operations team to understand and implement changes based on key metrics inside the business units. KEY RESPONSIBILITIES:Prepare internal value add....

- Cicero "Area", IL

Job Title: Digital Marketing SpecialistJob ID: MH75-19Location: Chicago, IL near CiceroCompensation: $60 - $80K “range”Benefits: Full Benefits Package Position Summary:A new Digital Marketing Specialist role has been created to support the marketing efforts of an international company undergoing significant expansion in North America. We believe this to be a great opportunity because the marketing department is growing and the leadership is nurturing an environment for career growth and....

- Boston, MA

HEDIS MANAGER Are you NCQA certified? Well-experienced with HEDIS reporting and quality improvement? Proficient retrieving, managing, analyzing, and reporting data? Have you coordinated medical records retrieval? Coordinated clinical staff training sessions on medical records review? Do you have any health plan experience? Have you assisted, led, or prepared the annual HEDIS roadmap for onsite audit? Have you finalized rates and actually submitted data to NCQA and CMS. If you have done these....


Nationally recognized integrated health plan seeks a Director of Utilization Management to lead a CM / UM team in Southeastern Massachusetts. The Director of Utilization Management will: Manage criteria-based reviews of care, clinical appeals regarding medical necessity, and the interaction with claims payment policies and processes.Support goals, contracts, and accreditation requirements of health plan by conducting reviews of clinical interactions and clinical documentation including reviews


Fantastic opportunity to build the QI initiatives for an expanding full service home health company in South Florida. Their unique PAC management model enables patients to remain in their home and our plan partners receive the benefits of an outcome driven, value-based relationships. Currently serves over 600,000 Medicare Advantage lives in multiple markets. The Senior Medical Director is responsible for the leadership of medical management activities. This encompasses primary responsibility....


Fantastic opportunity to build the QI initiatives for an expanding full service home health company in South Florida. Their unique PAC management model enables patients to remain in their home and our plan partners receive the benefits of an outcome driven, value-based relationships. Currently serves over 600,000 Medicare Advantage lives in multiple markets. The Senior Medical Director is responsible for the leadership of medical management activities. This encompasses primary responsibility....


Multiple openings around the country, flexible on locations as long as near a major airport, and relative proximity to the target type of accounts (ie. large Consumer Brand Manufacturers, Consumer Product, CPG, etc.). Each Global Account rep will have a named account list to target of very large organizations (multi $B+).Our client is a very high growth software organization. One of the most innovative in its market segment (within marketing oriented software solutions) and has earned....

- Jersey City, NJ

With more than 80+ acquisitions since its inception, this carrier has become one of the largest consolidators of run-off books of business which has also diversified substantially into writing specialty lines and other lines on both a direct and reinsurance basis. This carrier is growing, profitable and global. The client seeks an Investments Associate who will support the AVP, Investment Strategist in monitoring the segments of a Bermuda investment portfolio (about $5bn) to ensure that....

- East Brunswick, NJ

Summary: The immediate need is to have a strong Sr. Hadoop presence to help us to operationalize the clusters both for the dev and prod environments. Longer term, the job will evolve into an engineering role with the data science organization and basically liaise between the Architects, Data Science team and the ops team as we define and deploy models and services for fraud and related analytics. Responsibilities:Work as a Senior Developer/Lead for our Fraud Analytics Solution using Hadoop,....

21-37 of 37 results