payment integrity Jobs in new york, ny

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Senior Medical Director Health Plan Analytics & Policy Strategy

Ztek Consulting

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Remote

Part-time

Job title: Senior Medical Director Health Plan Analytics & Policy Strategy role Location: Remote Department: Medical Management / Payment Integrity Reports to: Chief Clinical Officer or SVP of Medical Affairs Experience Level: 10+ years in a senior leadership role within health plan or payer environments Position Overview: We are seeking a strategic, data-driven Senior Medical Director with deep expertise in health plan operations, medical policy development, and cost management analytics. This
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Posted 5 days ago

Sr Data Scientist - Generative AI/ML/Databricks - Remote

Molina Healthcare

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Remote or Long Beach, California, USA

Full-time

Job Description Job Description Job Summary Perform data and error analysis to improve models, and clean and validate data for uniformity and accuracy. Execute data science and statistical analytical experiments methodically to help solve various problems and make a true impact across various healthcare domains. Developing and deploying advanced machine learning models and AI solutions that enhance our products and services. Leverage their expertise in data science, machine learning, and AI t
Posted 6 days ago | Updated 2 hours ago

Application Development Advisors- Hybrid

Cigna

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Remote or St. Louis, Missouri, USA

Full-time

The job profile for this position is Application Development Advisor, which is a Band 4 Contributor Career Track Role with Cigna-Evernorth Services Inc. Responsibilities- Develop software applications within AAPS (Affordability & Accuracy Pre/Post Pay Solutions) to support payment integrity programs, produce accurate claim payments, and reduce medical cost expenditures.Contribute to software development, strategy, and product roadmap.Use system development life cycle methodologies, including Sc
Posted 36 days ago | Updated 2 hours ago

Sr Data Scientist - ML/AI/Databricks - Remote

Molina Healthcare

•

Remote or Long Beach, California, USA

Full-time

Job Description Job Description Job Summary Perform data and error analysis to improve models, and clean and validate data for uniformity and accuracy. Execute data science and statistical analytical experiments methodically to help solve various problems and make a true impact across various healthcare domains. Developing and deploying advanced machine learning models and AI solutions that enhance our products and services. Leverage their expertise in data science, machine learning, and AI t
Posted 14 days ago | Updated 2 hours ago

Medical Director - Clinical Review - CA, AZ or NM licensure - Remote

Optum

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Remote or Albuquerque, New Mexico, USA

Full-time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op
Posted 1 day ago

Medical Director - Clinical Review - CA, AZ or NM licensure - Remote

Optum

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Remote or Phoenix, Arizona, USA

Full-time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op
Posted 1 day ago

Medical Director - Clinical Review - CA, AZ or NM licensure - Remote

Optum

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Remote or Las Cruces, New Mexico, USA

Full-time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op
Posted 1 day ago

Application Development Advisors- Hybrid

Cigna

•

Remote or Plano, Texas, USA

Full-time

The job profile for this position is Application Development Advisor, which is a Band 4 Senior Contributor Career Track Role with Cigna-Evernorth Services Inc. Responsibilities- Develop software applications to support payment integrity programs, produce accurate claim payments, and reduce medical cost expenditures.Contribute to software development, strategy, and product roadmap.Use system development life cycle methodologies.Assist with the re-writing of end-to-end (E2E) vendor programs and t
Posted 58 days ago | Updated 2 hours ago

Jr. Data Scientist, Machine Learning - Remote

ConsultNet, LLC

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Remote or South Jordan, Utah, USA

Full-time

Title: Jr. Data Scientist, AI and Machine Learning Location : 100% Remote Target Start Date : ASAP Type: contract or contract to hire Pay Rate: DOE We're looking for an industry-leading Data Scientist focused on building production-level machine learning solutions. Rather than a research role, this position emphasizes applying ML/AI to real-world healthcare challenges-such as reducing costs and improving care quality. You'll work with structured and unstructured data (claims, membership, provi