Grievance & Appeals Nurse Specialist CalOptima CalOptima Health is seeking a highly motivated an experienced Grievance & Appeals Nurse Specialist to join our team. The Grievance and Appeals Nurse Specialist participates in managing CalOptima Health's medical appeals and state hearing reviews for all lines of business, including handling expedited and standard requests. The incumbent will ensure appeals and state hearing requests are processed in accordance with regulations, compliance standards
Care Manager (Transitional Care Services) CalOptima CalOptima Health is seeking a highly motivated an experienced Care Manager (Transitional Care Services) to join our team. The Care Manager of Transitional Care Services (TCS) will facilitate communication and coordination among all participants of the health care team and the member to ensure the services provided promote quality and cost-effective outcomes for members who have recently discharged from the hospital or emergency department (ED).
Claims Examiner CalOptima CalOptima Health is seeking a highly motivated an experienced Claims Examiner to join our team. The Claims Examiner will be responsible for analyzing and validating claim data elements and claims processing. The incumbent will be responsible for adhering to the regulatory and internal processing guidelines in conjunction with CalOptima Health policies and procedures related to claims adjudication. Position Information: Department: Claims Administration Salary Grade: C -
Based on the qualifications and education requirements provided: Minimum 5 years of development experience with Rhapsody Integration Engine, and experience with competitor integration engines would be beneficial.Epic bridges certification or previous Epic conversion experience would be advantageous.Preferred 7+ years of healthcare integration experience using HL7.Strong written, communication, and interpersonal skills are necessary.Ability to multitask and manage several projects or tasks simult
Strategic Sourcing Consultant / Sourcing Lead Onsite 1-2 days per week as requested at one of these locations - Ashburn, VA or Basking Ridge, NJ or Irving Texas or Alpharetta, GA. This position is with the Sourcing Resale Category. Must have Contract negotiation with suppliers, drafting and red-lining experience. Will draft, red-line, negotiate and support Commercial Resale Suppliers contractual agreements (Master Agreements, SOWs and product and/or service exhibits) to include: Deliverables F
This position is 100% remoteThis position is NOT open for C2C candidatesRole: Oracle Database Administrator W2 Contract: 6 months (Possible extension)Location: 100% RemoteThe resource must be located in Eastern and Central Time Zones.Overview Our client is seeing a Senior Oracle DBA to join a team that supports the organization s Care-To-Pay (C2P) value stream which primarily leverages Facets for back-office services. A number of projects are on the horizon (i.e. a new Authorization project, a F
Description Job Summary: The Programmer/Analyst IV will be responsible for a variety of duties in support of the Company s Virtual OneStop (VOS) software solution. The Programmer/Analyst IV will work closely with other team members in an Agile environment who have responsibility for prompt and timely delivery of new development, maintenance incidents, configuration tasks, setup tasks, responding to customer questions, data change requests, and other duties as assigned by the Team Lead. Requireme
Title : Automation Testing With FIS Touchpoint Location : Naperville, IL Duration : 12+ Months Rate : OPEN Visa Status : ANY Relevant Experience (in Yrs.) : 9+ Detailed Job Description: 10+ Year of solid experience in Automation Testing and Manual Testing.Must have FIS Touchpoint system experience.Must be proficient in Micro Focus UFT\QTP, Micro Focus ALM\QC, Test Complete, VBScript, Jira, Confluence , PL\SQL.Should have designed and developed Data Driven\Hybrid Frameworks in UFT, Test Compl
Title: DevOps Engineer: Data Mart Start: 12+ Months (High possibility of Extension) Type: W2 w/ benefits & 1099 Location: REMOTE s / Holders Rate: USD 50 60 per hour Job Description Required Skills: Years of Experience: 5 years Education Requirements: A Bachelor s Degree in computer science, electronics engineering or other engineering or technical discipline is required. Program Description: Create an end-to-end management perspective to ensure proper compliance and oversight of GI Bill program
One of my direct client, a leader in providing web hosting and premium dedicated server solutions, is looking for a Sr. Perl Developer 100% remote - CST work timings Skills : OO Perl, ORM, SQL, async processing Duration - 6+ months, long-term, c2c, no transfers Rate - DOE Client details will be shared post technical call JD Bachelor s Degree in Computer Science, Mathematics, or a related discipline or equivalent experience Proven ability in a software development role Experience finding and fixi
Position: JDA Technical Lead Location: Miami, FL -Remote role Skills: SCM(Apps)-JDA-Planning-JDA - Enterprise Supply Planning JDA 7- 9 years Should have 7-9 years experience in SCM Domain, preferably in JDA Demand and Fulfilment/i2 DM and SCP, SAP APO, Oracle SCM Planning suites. Proficient in SQL, PL/SQL, debugging skills, writing SQL queries, excellent debugging skills in PL/SQL. Windows Batch Scripting knowledge will be a plus. Any previous experience in Jenkins will be plus (job scheduling)
Senior-level Degree Works / Banner Consultant needed for fully remote, direct hire position based in the United States. Must have extensive Degree Works experience, along with other functional/technical skills (querying, report writing, ). The candidate should be able to operate as the link between technical resources and customers in functional areas. Responsibilities: Subject matter expert on Degree Works including, but not limited to, understanding the Scribe language and functionality within
Job Title: Oracle SCM Technical consultant Experience : 10 Years Location: Remote Work Authorization : Any Visa Except L2 TN, Transfers Job Description: We are looking for a Technical Consultant with atleast 10 years of expertise in Oracle SCM along with experience in OIC, MuleSoft, AWS API Management, Rest API, Oracle Fusion, Supply Chain, Platform-as-a-service (PaaS). Proficiency in extensive development using VBCS and design tools like draw.io is desirable. Experience performing CI/CD proces
This position is 100% remote Opportunity. Required: Minimum 6+ years experience as a Network Engineer (Automation) Experience with automating network functions through tools such as Ansible Experience with writing Python applications to support network automation Strong Hands on Knowledge in PERL or Python to support developing scripts Experience in CI/CD implementation. Experience in tools like CA NetOps, Infoblox DDI, NetMRI, NetScout, Netbrain, Appneta, SolarWinds, Ansible. Understanding of
Hi, Hope you are doing great..!! Role: OAC Developer Location: Remote, US Term: 6-12 months Job Description: Looking for an experienced database developer to support Oracle cloud application including Oracle Analytical Cloud and Oracle Integration Cloud. Advanced SQL writing / development skills required as well. Knowledge of Python and Workday is a plus. Experience Desired: Acquires requirements, designs and develops databases or systems that access or integrate with databases. Analyzes databa
Job Description We are looking to onboard an accomplished Legal Invoice Review Quality Assurance Analyst to join our client in the USA. The candidate will be responsible for the Legal Bill Analysis process which involves the prompt, accurate and efficient auditing of electronically submitted legal fees and expense invoices submitted by law firms and vendors of our clients. Responsibilities: Audit electronically submitted legal fees and expense invoices for accuracy and efficiency. Conduct exper
Title: SAP Application Support Analyst Location: Remote This is a backfill position. Manager wants someone to start May 13th. Interviews early next week NEED SOMEONE ASAP TO START on 5/13/24 - 100% Remote is OK but need someone who is EST or CST time zone.. Someone is being let go, need an SAP ECC EXPERT TO BACKFILL ASAP Candidate will join an in-process project with an experienced team. SPECIFIC SAP FINANCE ROLE - needs someone who understands this SAP Finance Module SAP ECC AR (SD & FI modu
Job Description We are looking for a developer with experience in: SAP ABAP SAP/Ariba CIG ERP integration Sourcing/SLP PR-PO Procurement/collaboration Forecasting Fiori Technical spec writing
URGENT REQUIREMENT: SAP HCM with FIORI REMOTE 12months HCM OM, PA, BN, PY, EH&S, TM, SuccessFactors Learning, ESS, MSS including Portal, Gateway, and Fiori Applications Financials and Logistics - FI, CO, AP, AR, AA, FM, PS, MM, IM, WO, GM, OpenText Invoice Management and Workflow. Kronos - Workforce Central, Workforce Attendance, Workforce Attestation, Workforce Leave (Time Off and FMLA), Enterprise Archive The vendor must have a proven functional and technical background, with at least three ye
15+ Years of functional / Configuration experience in SAP-SDExperience in SAP S/4 HANAHands-on skills in SAP SD E2E OTC design configuration and integration with other SAP modules.Experience in leading blueprint workshops, SAP Configuration, Custom Development, Cutover activities, Data Migration, Testing, User Training and Hypercare support.Expertise in SAP OTC(SD) flow process, output determination.EDI interface design and configuration strongly desired.Strong experience in SAP pricing configur
