Browse Jobs
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
HMSA
Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements. Secures information from internal and external resources to resolve
HMSA
Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions. Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departme
HMSA
Coordinate and manage deliverables of aspects of utilization management programs by delegated vendors: Ensures that program deliverables, documentation, and reporting are complete and meets contractual, compliance, and accreditation requirements. Develops data templates and submi
HMSA
Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements. Secures information from internal and external resources to resolve
Rhythms
About Rhythms Rhythms is building the AI that helps you run your business autonomously. Founded by the team behind Ally.io (acquired by Microsoft), backed by GreenOaks, Madrona, and Accel—earning GeekWire's Deal of the Year and recognized among the top AI innovators of 2025. Alr
HMSA
Quality Improvement Interventions Analysis and Development: Work as part of a quality team to continuously identify, plan, develop, implement, and evaluate interventions. Complete program and initiative evaluations such as return on investment and health outcomes Gather and synth
HMSA
Quality Improvement Interventions Analysis and Development: Work as part of a quality team to continuously identify, plan, develop, implement, and evaluate interventions. Develop reports, analyses, and data mining to support program planning and interventions. Complete program an
HMSA
Prioritizes approved invoices and check requests according to payment terms. Assist with month-end accruals as needed. Familiarizes with company policies and navigating steps in Dynamics GP, Certify and CentreSuite. Verifies approver's level of authority to ensure that the cost c
Rhythms
About Rhythms Rhythms is building the AI that helps you run your business autonomously. Founded by the team behind Ally.io (acquired by Microsoft), backed by GreenOaks, Madrona, and Accel—earning GeekWire’s Deal of the Year and recognized among the top AI innovators of 2025. Alr
HMSA
Product Strategy & Portfolio Management Own the end to end product strategy for the assigned segment, including benefit design, competitive positioning, rate considerations, and portfolio optimization. Establish short and long term product goals in partnership with leadership; tr
HMSA
Job Description Evaluation: Administers job description process: Reviews job evaluation requests for new or revised job descriptions to determine appropriate job leveling and FLSA exemption status. Utilizes job evaluation criteria and available salary market data. Reviews job des
HMSA
Perform FWA incident oversight and SIU staff development activities: Provide direct oversight to other SIU staff by reviewing and providing feedback to Investigators for written correspondences and regulatory referrals. Provide day-to-day advice/guidance to SIU staff on FWA incid
HMSA
SIU case investigation management, resolution and prevention: Manage complex FWA case investigations, collaborate with federal, state and law enforcement entities, and provide applicable notifications as required. Conduct pro-active FWA case investigations and resolutions. Mainta
HMSA
Provides general production support: Monitor daily production performance and inventory levels as assigned. Conduct data and trend analysis to identify areas of improvements. Triage daily production issues. Recommend and implement interim workarounds. Recommend solutions and/or c
HMSA
Mentor servicing representatives to ensure the best customer experience by supporting representatives after they complete classroom training; completing quality assurance audits that ensure timeliness, accuracy, professionalism, and an optimal customer experience; and providing t
HMSA
Provides general production support: Monitor daily production performance and inventory levels as assigned. Conduct data and trend analysis to identify areas of improvements. Triage daily production issues. Recommend and implement interim workarounds. Recommend solutions and/or c
HMSA
SIU case investigation management and resolution: Manage FWA case investigations, collaborate with federal, state and law enforcement entities, and provide applicable notifications as required. Maintain extensive documentation and evidence for SIU cases. Recommend and implement p
HMSA
Evaluation, interpretation, and processing of clinical review requests to include but not limited to applying the following requirements: Validation that requests has met submission requirements based on accreditation / governmental regulation requirements. Educate and/or communi
HMSA
Performance Proactively service and grow HMSA products and services through various methods including site visits, on-line meetings, telephone and email correspondence, power point presentations, and one-on-one customer servicing. Protect HMSA's market share through the successfu
HMSA
CUSTOMER EXPERIENCE Provide all customers with an exceptional customer-focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excelle
HMSA
CUSTOMER EXPERIENCE Provide all customers with an exceptional customer-focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excelle
HMSA
Claims Resolution & Support Serve as the primary liaison for complex escalated claim inquiries from providers, members, account management, and internal departments. Research and resolve complex claim discrepancies, denials, adjustments, and payment issues within established serv
HMSA
Manage community health by establishing and maintaining trusting relationships with individuals, families, and providers to promote health, recovery, resiliency, and wellness. Advocate and support members and their families by prioritizing their needs and preferences, making sure
HMSA
Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business. Monitors trends in data exchange with external entities and recommends adjustments as needed. Researches highly nuanced claim-member-provider scenarios to determine r
HMSA
Research and Data analysis Provide quality, objective, and professional analysis of relevant topics Gather and analyze information to identify trends, issues, innovations, and potential problems and solutions related to internal operations performance Develops analysis Present re