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Clinical Auditor, Sr.

CalOptima

•

Remote

Full-time

Clinical Auditor, Sr. CalOptima CalOptima Health is seeking a highly motivated an experienced Clinical Auditor, Sr. to join our team. The Clinical Auditor Sr will serve as the auditor for clinical and quality areas within the Case Management department. The incumbent will ensure regulatory (Medicare and Medi-Cal including Whole Child) and accreditation National Committee for Quality Assurance (NCQA) compliance for all CalOptima Health lines of business by conducting routine oversight, monitoring
Posted 17 days ago

CSV Analyst

NTT DATA Americas, Inc

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Remote or Coffeyville, Kansas, USA

Contract

About NTT DATANTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and s
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Posted 7 days ago | Updated 5 hours ago

Project Manager - Unemployment Insurance

Geographic Solutions, Inc.

•

Remote or Palm Harbor, Florida, USA

Full-time

Job Summary: Responsible for the Software Development life cycle using the GRID methodology specifically designed for the Geographic Solutions. The ideal candidate will be accountable for leading and managing the implementation of workforce development and/or software solutions for state and regional clients. Responsibilities will also include managing workforce development and/or Unemployment Compensation software products for Virtual One Stop clients in order to assess client needs, meet and e
Posted 60+ days ago | Updated 8 days ago

Claims Recovery Specialist

CalOptima

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Remote

Full-time

Claims Recovery Specialist CalOptima CalOptima Health is seeking a highly motivated an experienced Claims Recovery Specialist to join our team. The Claims Recovery Specialist will be responsible for performing recoveries on claims that have been overpaid and must understand and adhere to recovery regulations mandated by CalOptima Health policies, AB1455, Centers for Medicare & Medicaid Services (CMS), Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC) regulati
Posted 20 days ago

QI Nurse Specialist (LVN)

CalOptima

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Remote

Full-time

QI Nurse Specialist (LVN) CalOptima CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist (LVN) to join our team. The Quality Improvement (QI) Nurse Specialist (LVN) for Utilization Management (UM) is responsible for overseeing UM for CalOptima Health's direct network and delegated Health Network teams. The incumbent will be responsible for ensuring standards are met for operational and oversight compliance and UM operations are consistent with regulatory requirements
Posted 17 days ago

QI Nurse Specialist (RN) (Utilization Management)

CalOptima

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Remote

Full-time

QI Nurse Specialist (RN) (Utilization Management) CalOptima CalOptima Health is seeking a highly motivated an experienced QI Nurse Specialist (RN) (Utilization Management) to join our team. The Quality Improvement (QI) Nurse Specialist for Utilization Management (UM) is responsible for overseeing UM for CalOptima Health's direct network and delegated Health Network teams. The incumbent will be responsible for ensuring standards are met for operational and oversight compliance and UM operations a
Posted 20 days ago

Data Analyst, Sr. (HEDIS)

CalOptima

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Remote

Full-time

Data Analyst, Sr. (HEDIS) CalOptima CalOptima Health is seeking a highly motivated an experienced Data Analyst Sr to join our team. The Data Analyst Sr (HEDIS) will provide expertise in business requirements for the organization's Healthcare Effectiveness Data and Information Set (HEDIS) data reporting and analysis in the Quality Analytics department. The incumbent will be responsible for conducting quality assurance on data collection, data processing, data analysis and reporting. In addition,
Posted 20 days ago

Job Opportunity: Learning & Development Specialist

Siri Infosolutions Inc

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McLean, Virginia, USA

Contract, Third Party

Job Title: Learning & Development Specialist. Location: Must live within commuting distance of 1600 Tyson's Blvd, #1400, McLean, VA 22102; Hybrid; will only need to be in the office about 10% of the time. Essential Duties and Responsibilities: Based on strategy and defined goals, responsibilities include but are not limited to the following: Support the development of short- and long-term strategies that are actionable and measurable Provide effective project intake with development of project
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Posted 60+ days ago | Updated 7 hours ago

Product Development Project Manager - III

Judge Group, Inc.

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Ashburn, Virginia, USA

Full-time

Location: Loudoun Valley Estates, VA Description: Product Development Project Manager - IiiWork Location Ashburn, VA Time Period : 12+months Contract to W2. JOB DUTIES: Form and lead cross functional project teams, ensuring the project plans are defined, and delivered on time. Ensuring adherence to the agile artifacts and ceremonies to deliver enterprise scale projects. Ensure all statuses of objectives, deliverables, issues, and updates is clearly and consistently delivered at the working t
Posted 60+ days ago | Updated 5 hours ago

Senior Security Threat Detection Engineer

Zettalogix INC

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Remote

Third Party, Contract

Job Title: Sr. Security Threat Detection Engineer - AWS Duration: 6-months - REMOTE Note: They must have AWS Investigations and Splunk Experience in addition to what is on the Job Description. About the Opportunity: seeking a Security Threat Detection Engineer Consultant to support clients Threat Management objectives to build, maintain and improve threat detections and alerting infrastructure and to ensure the right data collection and detections are in place to discover threats against infras
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Posted 60+ days ago | Updated 12 days ago

Senior Enterprise Business Analyst: Healthcare Insurance Payer Side - Full Time Only

Stone Search

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Remote

Full-time

CANDIDATES MUST BE A SENIOR BUSINESS ANALYST NOW IN HEALTHCARE INSURANCE INDUSTRY ON PAYER SIDE. This position is full time only, remote.. Our client, a company in the healthcare insurance payer market, is seeking a Senior Enterprise Business Analyst who can collaborate effectively with internal and external stakeholders to analyze, define and manage requirements to launch new products & services. The ideal candidate will have worked in-depth for top payers across one or more domains (Enrollment
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Posted 60+ days ago | Updated 10 days ago

Service Desk Engineer

Nexus Tek

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Remote

Full-time

NexusTek is a U.S based, managed IT service provider to small and medium sized organizations. We excel in tackling the complexities of IT, such as cloud services, cyber-security, document management, data back-up and protection, and more. Our mission is to take away technology headaches allowing our clients to focus on their core business. NexusTek s 300 employees span 35+ states to service our growing client base. We have physical offices in Denver, Irvine, and Boston. Working hours Service
Posted 20 days ago

Business Analyst, Healthcare

DP Search

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Remote

Full-time

No Consulting firms. No sponsorship available. Senior Business Analyst - Healthcare payer To be considered for this roleyou must have healthcare payer experiencein one of the following: Enrollment & Benefit Administration, Claims processing & Reimbursements, Member & Provider Portals/Service, Clinical & Care management, Funding & Billing, Reporting. About the Role We are seeking a passionate, results-oriented Senior Enterprise Business Analystwho can collaborate effectively with internal and ext
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Posted 60+ days ago | Updated 15 hours ago

SAP MM Consultant - MDG / Material Master (Remote)

Tranzeal, Inc.

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Remote or Foster City, California, USA

Contract

Description: Work on SAP specific domain related master data analysis and business process requirements Manage SAP specific domain master data conversion tasks in accordance with the business process design and data migration plan Supports the execution of internal and external manufacturing/supply chain system solution initiatives to achieve process targets Develops and maintains documentation to reflect the effectiveness and efficiency of specific process domain Manage the MDG Workflow design,
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Posted 60+ days ago | Updated 15 hours ago

PTC - SAP Convergent Meditation SME

Aspired Solutions INC

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Remote

Third Party, Contract

SAP Convergent Meditation SME **Remote/Hybrid - Please review Engagement Requirements in the Complete Description. Engagement Requirements The Candidate shall be located within the Continental United States. There is no opportunity for "Off-shore" resources for this Statement of Work. The Candidate work in a Hybrid location mode, where the Candidate will be remote for one week then will be onsite at the PTC's CAB or TIP buildings for two weeks. This hybrid rotation may continue for the duration
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Posted 60+ days ago | Updated 10 hours ago

MECM/Intune Engineer

JDA TSG

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Remote

Full-time

We have immediate opportunities for MECM+ Intune Expertsto join our team working as Customer Engineers (CEs). Positions are full time, salaried roles offering comprehensive benefits. A CEs time is dedicated to working with some of the largest, and most sophisticated companies in the world, usually F1000 companies. CEs support and assist customers in building, deploying, operating and optimizing complex enterprise environments.You will be responsible forcustomer satisfaction, deployment, adoption
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Posted 60+ days ago | Updated 13 days ago

Technical Writer / Editor

Trigent Solutions

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Remote

Full-time

Title: Technical Writer / Editor Duration: Full-Time Location: DC area (Alexandria, VA) - remote work Client: The National Center for Science and Engineering Statistics (NCSES) This position serves as a Technical Writer Editor in the Public Information (STI-PI) section of the National Center for Science and Engineering Statistics (NCSES) at the National Science Foundation. NCSES conducts comprehensive, nationally representative statistical surveys that serve as the basis for detailed statistica
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Posted 60+ days ago | Updated 27 days ago

Senior Data Analyst

A2C Consulting

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Remote or Philadelphia, Pennsylvania, USA

Contract, Third Party

Opportunity Exciting Project Based and or career roles for experienced Data management analysts with consultive approach supporting large scale data transformation management. Greenfield Business/IT transformation implementation team sponsored and owned by the CTO. You will be managing data requirements on Greenfield Data Factory-Data Lake build. Goal is to build state of the art analytics and enterprise reporting environment. Environment EDW-Oracle-TeradatafintechWorld Class Data Factory:etl da
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Posted 60+ days ago | Updated 28 days ago