company

This role serves as the primary contact between providers (physicians, dentists, hospitals, ancillary providers) and the organization, focusing on educating, servicing, and retaining providers within a defined market to ensure network adequacy and satisfaction. Key duties involve facilitating provider education on contracts, benefits, and quality programs, while coordinating internally with departments like sales, medical, and operations.

The Software Engineer is responsible for working on projects currently being visualized or developed, involving the Software Development Life Cycle methodology, directing system validation, testing, and programming initiatives. This role requires close collaboration with clients and cross-functional departments to communicate project statuses and proposals.

The analyst performs technical services supporting Health Plan operations by monitoring financial solvency through data understanding and future event modeling, interacting with internal/external partners and regulatory agencies. Essential duties include updating analyses for benefit designs, claims experience, and risk adjustment initiatives, while maintaining processes like reserve programs and trend analysis.

Job Description: Summary: The IT Platform Administrator acts as a liaison between the business and technical resources by ensuring the availability and successful operation of applications for users. This individual will demonstrate a high-level of responsibility and consistency ...

Job Description: Summary The Operations Support Analyst is a critical role in providing a technical interface between User Departments, Applications Development, Computer Operations and technical infrastructure disciplines. This includes job scheduling, Release Management princip...

Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as a...