EmblemHealth Jobs

Summary of Job Responsible for the oversight of the claims inventory management by our external vendor (CTS): develop, implement and manage the claims oversight department, to monitor and evaluate...

SUMMARY OF POSITION : * Provide oversight and leadership for the creation and utilization of key performance indicators for clinical/business ownersand senior executive management that continuously...

Summary: Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance. Participate in product development, pricing, filing, and rating...

Summary: Provide the analytical resources necessary for the development of overall pricing and reserve setting strategies. Lead projects to analyze current rate structures and develop improvements...

Summary: Conceptualize, research, develop, implement, maintain, and enhance Contact Center related training programs/materials. Facilitate training classes to support the Contact Center: provide...

Summary We are seeking a dynamic Expedited Appeals Specialist responsible for processing expedited appeals: those that are complex, require multiple hand-offs, and tend to have extremely tight...

Summary of Position: Manage portfolio of developed and scheduled reports for Claims, FRU, G&A, Provider and UM Data. Interface with internal operations / external departmental customers to define...

Summary of Job To disrupt the traditional wellness point-solutions model by growing the revenue and membership of WellSpark Health's products and services. This consists of increasing market...

Summary of Position * The Care Team Associate I serve as members of the Care Team and supports the team with non-clinical services and administrative tasks which are population health focused. The...

Summary of Position * Provide day to day operational and managerial support and oversight of non-clinical staff, assisting the Practice Administratorto ensure efficiency and stability of medical...