Provides support to the Network Provider Operations department with daily operations, project initiatives, system updates, special projects, and all regulatory reporting and analysis.
Audits departmental operations with a focus on data integrity, improving accuracy, and identifying training opportunities for department.
Leads system upgrades and implementations for the department, and provide technical support as needed.
Support Shields operations team at health system partners with day-to-day operations.
Organize and maintain required documentation to enable operational success.
Partake in liaison audit process, including conducting audits and providing feedback to Manager of Patient Services.
Shields Health Solutions partners with health systems to develop specialty pharmacies. We provide integrated pharmacy solutions to improve patient care, drive growth, and reduce costs.
Drive operational consistency across independent physician practices.
Provide operational, analytical, and project coordination support.
Ensure practice success initiatives are organized and data-informed.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Analyze and support non-clinical workflows across CM, CDM, and UM programs.
Translate operational and clinical requirements into process maps, SOPs, and job aids.
Support workflow automation and system optimization initiatives.
Personify Health created a personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes.
Assist with healthcare operations projects, including workflow analysis and process improvement.
Support corporate compliance and regulatory documentation.
Apply healthcare policies, industry trends, and best practices.
UnityPoint Health is recognized as a Top 150 Place to Work in Healthcare. They champion a culture of belonging where everyone feels valued and respected, honoring the ways people are unique and embracing what brings us together.
Monitor federal and state laws impacting government programs.
Provide cross-functional guidance for compliance with legal requirements.
Coordinate and support compliance audits, ensuring timely responses.
CareCentrix is focused on healthcare at home, aiming to simplify care delivery and management. They offer services like home health, durable medical equipment, and home infusion, managing care for over 19 million members across the U.S. and Puerto Rico.
Collaborate with Client Success Partner and Technical Business Analyst to develop recommendations to solve problems and issues related to business operations.
Conducts quantitative and qualitative analysis for Health module EHR analytics using Business Objects or other similar tools.
Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S. committed to delivering solutions that change lives for the better.
Manages a queue of incoming documents to create new clients, update existing clients, and send interdepartmental tasks in the CRM system.
Requires frequent use of Provider Portals and multiple internal databases and document retrieval systems.
Operates within a service level agreement managing speed to start entry while observing various agency specific handling procedures maintaining the highest level of accuracy for billing and compliance purposes.
Mom's Meals is a company focused on providing nutrition solutions. They appear to value community support based on the job descriptions.
Responsible for ensuring that the Value Hub adheres to regulatory standards, contract requirements, and internal quality benchmarks.
Analyzing compliance data, preparing detailed reports, and working closely with various departments to maintain and improve compliance and quality standards.
Supporting the understanding of local regulatory requirements, completion of local audits, participation in quality committees, and supporting health plan needs and interactions to ensure consistent implementation of contractual obligations.
CommonSpirit Health has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside their hospitals and out in the community.
Audits FEP claims, customer service inquiries, member and group enrollment activities in accordance with Plan Incentive Program (PIP) guidelines.
Supports IA and SIU with assistance as needed.
Utilizes the internal SharePoint Audit tool to communicate findings and follow up assuring corrective action is taken and documented.
Capital Blue Cross is committed to going the extra mile for their team and community. It's why their employees consistently vote them one of the “Best Places to Work in PA.”
Partner with leadership to understand workflows and regulations.
Document current and future state pharmacy processes and data flows.
Translate business needs into clear requirements and specifications.
We are currently looking for a Pharmacy Business Analyst - REMOTE. This role plays a crucial part in supporting pharmacy operations by planning, designing, and enhancing business systems and workflows.
Maintain backend administration for workplace applications and platforms.
Provide first-level technical troubleshooting and user guidance.
Track and manage IT hardware inventory including laptops.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Collect and organize information for preparation of user manuals, training materials, proposals, and reports
Edit functional descriptions, system specifications, special reports, and customer deliverables
Perform financial and administrative tasks related to project documentation and reporting
FWI is building a team to provide Program Management Office (PMO) Support Services for the Defense Agencies Initiative (DAI), supporting financial management, budget and cost analysis, and lifecycle cost estimation for a DoD-wide Oracle ERP shared services program. FWI has been recognized as a Top Workplace by the Washington Post in 2024 and 2025, offering excellent growth opportunities in a collaborative environment.
Work cross-functionally to ensure smooth partner onboarding.
Own client eligibility file setup, monitoring, and accuracy.
Document client business requirements and liaise with technical teams.
Foodsmart is a leading telenutrition and foodcare solution, supported by a network of Registered Dietitians. Their platform promotes healthier food choices and behavior change, serving 2.2 million members across various health plans and insurers, and values customer focus and teamwork.
Collaborate with implementation teams and external customers to ensure data integrity and interface validation for symplr software solutions.
Analyze and manage patient healthcare data for consistency and accuracy while configuring system software during implementation projects.
Leverage analytical, technical, and communication skills to define processes for clinical data management and assist customers in achieving their organizational goals.
Symplr is revolutionizing healthcare operations with a first-of-its-kind platform that drives effective, efficient, and connected workflows, increasing operational benefits and scaling clinical, financial, and quality outcomes. We are a remote-first company with employees across the United States, India, and the Netherlands.
Serve as the subject matter expert in interpreting payer agreements.
Collaborate with the Provider Network Operations team to support the build of standard operating procedures.
Maintain reconciliation trackers to measure contract performance and support audit requests.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. They are the largest network of independent primary care in the country, creating value-based contracts across various health plans.
Own end-to-end census integrity and member coverage continuity
Accountable for the design, performance, and scalability of enrollment and eligibility operations
Set the roadmap for process maturity, risk controls, audit readiness, and cross-functional operating model alignment
Habitat Health envisions a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. They are growing and looking for new team members who wish to join their mission of redefining aging in place.
Support the Ops team in developing, sourcing, and reporting key operational metrics and data analysis.
Perform research, analysis, and reporting on data around new initiatives.
Assist in the coordination of finance and business planning related functions including routine analysis, reporting, and budgeting.
NorthStar Anesthesia is a company of caregivers, founded by an anesthesiologist and a Certified Registered Nurse Anesthetist (CRNA). With more than 4,000 anesthesiologists and CRNAs, they partner with more than 280 client sites across over 20 states to deliver a more productive and efficient model of anesthesia care.