Jobs in All Categories (11) Accounting & Finance (5) Healthcare (2) Marketing, Media & Design (1) Operations & General Management (2) Sales & Business Development (1)
Lead the Provider Service team in the development and maintenance of strong provider relationships that ensure the highly competitive network composition and cost position.
Monitoring and reporting compliance with debt covenants, Board approved investment policies, and pertinent regulatory guidelines.
Creates and edits content for many internal communications initiatives including employee engagement campaigns and internal department newsletters.
Support the audit services & investigations unit in identifying risk areas specific to contractual language and claims reimbursement, conducting audits and reducing overall medical costs through the recovery of claims payments pending for review.
Develop and maintain strong relationships with all key vendors that support claims operations, while holding vendors accountable for delivering upon their contractual commitments.
The senior sales representative is a seasoned sales professional with a track record of exceeding performance expectations.
Manage the compliance function's annual operating and capital budgets within industry standards and best practices in order to maintain an affordable and efficient cost structure.
This position is responsible for developing and implementing premium pricing methodologies for all products and business lines.
The provider networks for which the director is responsible will have high provider and member satisfaction, be cost effective, and demonstrate a high level of compliance with quality initiatives.
The Director will be responsible for ongoing evaluation of the network to identify opportunities for new and varied network configurations.