Jobs in United States of America

Job Description: Utilize a collaborative process of education, assessment, planning and engagement to promote participants’ adopting improved lifestyle behaviors that support…

Job Description: Load all Professional, Facility, and Ancillary contracts across all EmblemHealth lines of business in a timely and accurate manner.

Job Description: Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance. Various other ad-hoc analyses.

Job Description: The Lead HEDIS-QARR Analyst leads and develops meaningful insights, actionable analytics, and applicable plans and/or. Master’s Degree a plus.

Job Description: Proofread and edit vendor translations and desktop publishing of print and digital materials for EmblemHealth, ConnectiCare, and AdvantageCare Physicians to…

Job Description: Underwrite existing medical and dental accounts, including Broker, Commercial and Labor and Government accounts, within published time frames.

Job Description: Ensure compliance and/or identify issues of non-compliance through audits and monitoring. Issue CAPs where needed to functional areas and/or vendors/delegates.

Job Description: Utilize a collaborative process of education, assessment, planning and engagement to promote participants’ adopting improved lifestyle behaviors that support…

Job Description: Utilize a collaborative process of education, assessment, planning and engagement to promote participants’ adopting improved lifestyle behaviors that support…

Job Description: Manage portfolio of developed and scheduled reports for Claims, FRU, G&A, Provider and UM Data. Interface with internal operations / external departmental…

Job Description: Partner with functional departments/vendors/delegates to ensure they are in full compliance with all actionable and. Assist in the completion of duties.

Job Description: Oversee and implement the ongoing management of Medicare plan design and benefit changes as they impact EmblemHealth and CCI operational departments.

Job Description: Support the department’s quality of care and cost containment. Provide utilization management as needed to ensure coordination of health care delivery.

Job Description: Present to, follow up and sell Individual Medicaid, Essential Plan, QHP and CHP products on a direct sales basis. Maintain and grow book of enrollments.

Job Description: Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance. Hiring Range: $63,000-$110,000.

Job Description: Manage the month end close for the EmblemHealth Enterprise to ensure it is being performed timely, accurately, and in accordance with GAAP.

Job Description: Oversee accounting and analysis functions for premium revenue and medical expense. Ensure that the monthly close for EmblemHealth is performed timely,…

Job Description: Manage a team of financial analysts who provide timely, accurate, actionable data and analysis supporting the department,. Area, and corporate key initiatives.

Job Description: Provide the analytical resources necessary for the development of overall pricing and reserve setting strategies. Perform other duties as assigned or required.