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As a Senior Metadata Application Development Engineer, you will create and maintain metadata solutions, manage metadata repositories for various databases, and guide data engineers in complex data management tasks. Responsibilities include integrating metadata from sources, supporting its distribution, and providing training for data stewards.
The Community Resource Coordinator connects members to community and care resources, supports care teams, documents resources, and conducts assessments. They work primarily in the field to promote health education and community outreach, assisting members with social service inquiries and facilitating connections to appropriate services.
The Community Resource Coordinator II connects members to community resources, supports care management, documents resource utilization, conducts health assessments, and assists the clinical team in outreach and education. The role includes both telephonic and in-person outreach to engage hard-to-reach families and individuals, ensuring compliance with health plan standards and policies.
As a Senior Actuarial Analyst, you will focus on ACA marketplace pricing, financial analysis, and risk assessment. Responsibilities include performing actuarial analyses, developing probability tables, analyzing premium rates, and assessing cash reserves to support the financial framework of insurance benefits.
The Provider Network Assistant supports physician contracting processes by researching provider nominations, managing documentation, and facilitating communication between providers and health departments. Responsibilities include sending contracts, maintaining databases, and assisting with general administrative support.
Assist with the contract submission process and auditing provider information systems. Responsibilities include maintaining spreadsheets, tracking statistical data, coordinating compliance, updating databases, producing reports, and interfacing with credentialing staff.
The Community Resource Coordinator II is responsible for connecting members with community resources, supporting care management, and facilitating member outreach and education. Duties include conducting health assessments, managing community inquiries, and assisting clinical teams in outreach efforts while documenting resource standards and compliance.
The Accountant II role focuses on managing critical accounting functions including claims payment, accounts payable, accounts receivable, maintaining cash balances, and reconciling General Ledger accounts. The position also involves financial data analysis and assisting in audits.
The Complex Discharge Planner develops and coordinates discharge plans for high-risk members, ensuring a smooth transition from acute care. Responsibilities include assessing member needs, managing discharge plans, coordinating with providers and community agencies, educating families, and ensuring compliance with policies.
The Authorization Specialist II assists the Medical Management/Health Services team with prior authorization requests, ensuring accurate documentation and compliance with guidelines. Responsibilities include verifying member insurance coverage, performing data entry for authorizations, and supporting the authorization review process.
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