Support analytical operations of Provider Services by performing data analyses and creating reports.
Evaluate provider network adequacy and performance via data modeling, analysis, and reporting.
Complete reports and projects for teams like Provider Services, Client Services, Implementation, and Sales.
Navitus is a pharmacy benefit manager (PBM) alternative committed to reducing drug costs and making medications more affordable. They value diversity, creativity, and growth, and focus on excellent service.
Manage and oversee all aspects of employee benefit plans, including health insurance, dental, vision, and retirement plans.
Conduct new employee benefits orientation and assist with open enrollment and life event changes.
Ensure compliance with federal and state regulations such as ACA, ERISA, and COBRA.
Ambient Enterprises is an umbrella company for 25 industry leaders in the custom HVAC market, providing product expertise and operational support. The company offers a collaborative environment as part of an incredible HR team.
Support internal teams with system configurations, documentation updates, and testing for symplr products.
Collaborate with Product, Engineering, and Support teams to ensure successful implementations and resolve issues.
Drive continuous improvement initiatives and product adoption while engaging with US healthcare clients during night shifts.
Symplr is a leader in healthcare operations solutions, helping organizations integrate critical business operations for better outcomes. They are a remote-first company with employees across the US, India, and the Netherlands, focusing on teamwork, customer success, and integrity.
Develop, configure, and maintain healthcare plan designs and benefit configurations in various systems.
Oversee system integration and interoperability to streamline auto adjudication processes.
Perform comprehensive testing of plan configurations to ensure accurate claims adjudication.
We are a National third-party administrator (TPA) that delivers customized self-funded benefit programs. We are a mission-driven company focused on innovative cost containment solutions.
You will maintain and support client benefits websites, document processes, and provide advanced operational and technical support.
You will resolve client issues, triage tickets, and communicate proactively with clients.
You will mentor team members, drive process improvements, and support implementations.
bswift is a leading benefits administration company that simplifies the complex world of employee benefits. We serve thousands of companies and millions of people nationwide, offering a fun, flexible, and creative environment.
Reconcile benefit deductions, upload vendor bills, and perform monthly benefit audits to ensure accuracy.
Assist with HSA, COBRA, STD pay processes, employee inquiries, and updating Benefits webpages.
Consistently look for ways to improve system efficiencies and support Wellness Program communications.
GuidePoint Security provides trusted cybersecurity expertise, solutions and services that help organizations make better decisions and minimize risk. Since 2011, the company has grown to over 1,200 employees, built strategic partnerships, and serves as a trusted advisor to more than 6,200 customers with a strong culture and collaborative environment.
Review healthcare claims and determine appropriate payment methodologies based on contractual terms and client requirements.
Analyze claim information and system data to ensure accurate repricing while meeting productivity and quality metrics.
Collaborate with internal audit and operational teams to support compliance, quality assurance, and process improvement initiatives.
The company provides healthcare claims review and repricing services. It operates remotely with a focus on compliance, accuracy, and continuous improvement.
Handle inbound and outbound member and provider inquiries via phone, email, and chat with professionalism and empathy.
Provide accurate information on benefits, eligibility, claims, prior authorization, billing, and provider portal support.
Collaborate with internal teams to resolve complex cases, identify process improvements, and meet performance goals.
XO Health is the first health plan designed by and for self-insured employers, delivering a unified health experience for members, providers, and payers. We are growing a multi-disciplinary team of diverse and digitally empowered employees committed to rebuilding trust in healthcare through transformation.
Review and process medical, supplemental, or dental claims according to benefits, eligibility, and guidelines.
Validate accuracy of medical codes, assess eligibility, and evaluate authorizations in claim submissions.
Meet or exceed quality and productivity goals while working independently in a virtual environment.
The Cigna Group is a health services company dedicated to improving the health and vitality of those they serve. It is a large organization with a focus on innovation and employee well-being.
Act as a trusted liaison between patients and healthcare providers, providing expert guidance on pharmacy benefits.
Own patient cases end-to-end, resolving coverage, prior authorization, and appeals issues.
Collaborate with stakeholders to ensure members navigate the healthcare system with confidence.
AffirmedRx is a pharmacy benefit management company on a mission to improve healthcare outcomes by bringing clarity, integrity, and trust to the industry. They are a mission-driven organization committed to patient-centered care and ethical practices.
Manage the setup, analysis, validation and integration of partner data exchanges for client implementations.
Serve as primary technical contact, coordinate cross-functional tasks, and develop project scope documentation.
Lead technical implementation calls, execute test plans, and manage technical documentation.
HealthEquity aims to save and improve lives by empowering healthcare consumers. The company is large and emphasizes a culture of belonging and innovation.
Develop and implement reimbursement strategies to improve patient access to healthcare solutions.
Collaborate with cross-functional teams to optimize payer engagement and program performance.
Conduct market research and analysis to influence payer strategies and drive process improvements.
The company specializes in healthcare reimbursement and patient access solutions. It offers a collaborative remote culture with a focus on innovation and impact.
Lead recurring customer sessions to design outcome-driven use cases aligned with business objectives.
Drive consultative conversations to define business issues and remediation possibilities.
Implement and configure Nexthink products, including dashboards, alerts, and integrations.
Nexthink is a leader in digital employee experience management software, providing IT leaders with insight to see, diagnose, and fix issues at scale. The company serves over 1,200 customers and has 9 offices worldwide, focusing on proactive optimization.
Lead end-to-end implementation activities for growth and strategic healthcare clients, ensuring on-schedule, within-scope deployments.
Serve as primary implementation contact, facilitating stakeholder meetings and maintaining alignment throughout the implementation lifecycle.
Develop project plans, lead payer enrollment workstreams, and conduct business reviews to tailor implementations to client needs.
They provide healthcare technology solutions to large organizations. The company fosters a collaborative, fast-paced culture centered on innovation and continuous learning.
Lead the development and improvement of product compliance programs, including policies, procedures, and monitoring frameworks.
Apply regulatory judgment to complex compliance issues, conduct risk assessments, and support corrective actions.
Leverage AI-enabled tools to enhance compliance documentation and analysis, while collaborating with cross-functional teams.
The company provides an AI-powered job matching platform for candidates and employers. It is a partner-driven organization that focuses on compliance solutions in healthcare, with a small to medium size, offering remote work flexibility and a culture of continuous improvement.
Analyze, design, and administer compensation programs including base salary, incentives, and sales commissions.
Partner with HR and Talent Acquisition to provide guidance on compensation decisions and market competitiveness.
Maintain salary structures, conduct job evaluations, and participate in compensation surveys.
This partner company provides recruitment matching services using AI. They operate remotely with a preference for candidates in the Northern Virginia, Maryland, or Washington, DC area, and focus on connecting talent with healthcare and public-sector roles.
Support operational activities throughout the acquisition lifecycle, including initiating and tracking acquisition requests.
Prepare and maintain Statements of Work and other program-related deliverables.
Conduct Labor Category verifications and route Project Work Authorization requests.
Our partner supports a major federal healthcare modernization program by providing business process analysis and operations. They offer a fully remote, collaborative environment focused on mission-critical public-sector initiatives.
Drive HealthEquity Marketplace by gathering business requirements and translating them into actionable decisions.
Engage stakeholders throughout development, manage configuration, and support operational readiness.
Lead discovery, gap analysis, and testing using AI-assisted tools to accelerate delivery.
HealthEquity is a company dedicated to saving and improving lives by empowering healthcare consumers through innovative solutions. They foster an inclusive culture that values employee growth and collaboration.