Claims/Cust Care Spec -TPA (Dental)
Brooklyn, OH
Claims/Customer Care Specialist I TPA Processes routine healthcare claims while providing customer service via inbound/outbound phone calls and written communications. Assists with proje...

Supplier Manager
Brooklyn, OH
Communicates with business unit(s) and sourcing to ensure collaboration with any potential performance issues with supplier along with any other. Helps identify high risk suppliers and d...

Provider Network Performance Analyst (Hybrid - Cleveland, Ohio)
Brooklyn, OH
Working under direct to general supervision, monitors the Company's provider network with respect to quality and utilization performance standards. Develops standard reporting and analyt...

Enterprise Data & Analytics Project Manager
Cleveland, OH
IT Project Manager II Manage all stages of the IT projects assigned with management support, including planning, implementing and monitoring activities. Work with IT line managers and te...

Clinical Systems Solutions Analyst
Cleveland, OH
Collaborates with leadership and end users (nurses, physicians, pharmacists, support staff) to conceptualize and solution opportunities to meet the business needs and improvements. Condu...

Provider Contract Manager
West Chester, OH
Provider Contract Manager I Under direct supervision, develops and maintains relationships with typically smaller sized and/or less complex provider community via email, telephonic and f...

Value Based Contracting Data Analyst (Hybrid-Cleveland, Ohio)
Cleveland, OH
Value Based Contracting Data Analyst Working under general supervision, supports the operational infrastructure for the Value Based Contracting (VBC) provider incentive program. Develops...

Sr Tax Accountant
Brooklyn, OH
Reviews assigned general ledger accounts ensuring the accuracy of reported balances. Researches any reconciling items and take necessary action to correct these items. Reviews period end...

Population Health Science Analyst
Cleveland, OH
Population Health Science Analyst I Builds, supports, and evaluates new and existing programs, and improves targeting. Conducts clinical analytics to support decision making, and ensures...

Account Executive
Brooklyn, OH
Sr. Account Executive Develops and sustains relationships with customers and brokers. Responds to inquiries regarding claims, eligibility, plan design and reporting. Analyzes client plan...

Group Underwriting Operations Analyst
Cleveland, OH
Group Underwriting Operations Analyst I Learning to support the underwriting system, collaborates with other system developers, and liaisons to translate basic user requirements and syst...

Account Administrator
Brooklyn, OH
Account Administrator I Performs Account Management duties (e.g., Benefit Quote Requests; new business quotes/RFPs; account worksheets; certificate review; WebBen system creation and rev...

Manager, Provider Network Informatics
Cleveland, OH
Plans and manages the determination of appropriate rates for professional, ancillary and hospital contracts. Manages internal business relationships with Actuarial and Underwriting to de...

MedMutual Protect-Compliance Analyst II
Cleveland, OH
Gathers applicable statutes, regulations and documentation and compiles and reports compliance data for product filings to regulatory agencies. Supports workflow associated with statutor...

Senior Appeals Specialist-Medicare Advantage
Cleveland, OH
Reviews and evaluates appeal requests and electronic inquiries in order to identify and classify member and provider appeals and Ohio Department of Insurance (ODI) inquiries. Using inter...