Responsible for the attainment of assigned sales and renewal goals by managing a team of representatives and administrative personnel while at the same time enhancing the image of the company within the regional area. Description Recruits, motivates, trains, and supervises the sales staff. Ensures that the sales team is up to date on product/industry changes, corporate ma

Lead position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of Provider Information Management Systems (PIMS). Performs training needs assessments and recommends training courses based on issues found during the quality control process. P

Defines customer needs via Epics and User Stories for the product backlog. Ensure the proposed technical and business solutions meet the customer's objectives for the work effort/business value to be delivered. Provide guidance for sprint planning by contributing to the prioritized product backlog. Are you looking to be a part of a great professional team working in a fas

Intern position utilized for training an active college student towards a professional level role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry level tasks and for learning professional level tasks rel

Responsible for analysis, design, programming, and implementation of the most complex applications tasks and projects in the area. Devise feasible, logical procedures to resolve business problems through the use of computer resources. Formulate scope and objectives through research to develop or modify complex systems. Provide technical direction and support in the develo

Perform all phases of applications systems analysis and design. Analyze systems specifications and develop applications to support information systems processes. Prepare detailed specifications from which complex programs will be written. Design, code, test, debug, document, and maintain these programs. Formulates scope and objectives through research to develop or modify

Responsible for the development and management of various health management programs to include Case Management, Disease Management, Utilization Management, Behavioral Health, and Healthcare Development. Assesses impact of programs which may include performs cost benefit/feasibility analyses, performs market research assessing corporate competitiveness. Provides strategic

Under general supervision, performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, processing disbursements and deposits, keying journal entries and logging items in accordance with standard procedures in one or more of the following areas; general accounting, accoun

Performs varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing mail. Applies knowledge of department policies and procedures, and utilizes a general understanding of other departments' functions to resolve most issues. Maintains records

Coordinates and performs testing for major system enhancements, including reviewing documents for testing, creating test matrices and executing test cases. Functions as a liaison between the operations areas and Information systems by researching technical production issues for immediate and long term resolution. May also partner/communicate with other internal/external c

Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description Responds to written and/or telephone inquiries accordin

Conducts complex business process analyses, needs assessments and cost/benefits analyses in an effort to align operations solutions with business initiatives. Prepares functional, system and program specifications. Provides management support in review of various internal and external reports and data. Provides assistance with complex testing efforts and may provide secur

Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Description Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk in inquiries. Accurately documents inquiries. Initiates or processes adjustments or performs other rese

Responsible for integrating the use of all area systems with the day to day operations of the area's staff, assuring that all upgrades, changes and additions do not negatively impact business functions. Responsible for performing all functions related to systems projects, security access, procedures, auditing, data analysis and ensuring area systems and security practices

Utilize innovative and effective data mining techniques to search and analyze data for useful patterns and/or relationships used to identify aberrant supplier billing behavior. Provide guidance in designing new metrics for reporting. Standardize and implement process improvements for reporting across lines of business (LOBs). Contribute to reduction of necessary risk mana