Irvine, California
Orrick Herrington & Suttcliffe
Overview Orrick's Public Policy Group is seeking a Legislative Assistant to join our highly innovative 50-state government affairs team. This is a hybrid position with flexibility for candidates preferably based in San Francisco, Los Angele...
13h
| Job Type | Full Time |
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description Responsible for conducting comprehensive review of claim data and /or medical record documentation related to Fraud Waste and Abuse (FWA) investigations opened by the Special Investigations Unit (SIU) from various internal and/o...
13h
| Job Type | Full Time |
Grievance and Appeals Specialist (44017)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Grievance and Appeals Specialist is responsible for handling member and provider grievances, complaints, appeals and provider claim disputes across all product lines. This role ensures compliance with contractual and regulat...
13h
| Job Type | Full Time |
Configuration Management Analyst (44246)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Configuration Management Analyst is an entry to mid- level position responsible for the analysis, design, build, testing, implementation, and maintenance of system configuration to support business requirements and optimize ...
13h
| Job Type | Full Time |
Enrollment Representative (44382)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description Under direct supervision, is responsible for a variety of specific functions associated with enrollment and reconciliation transactions to facilitate accurate enrollment data. He/she processes enrollment data within a timeframe ...
13h
| Job Type | Full Time |
Clinical Operations Pharmacist (44572)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Clinical Operations Pharmacist works in conjunction with the Clinical Program Pharmacist and Medical Management teams to review medication utilization and develop/implement initiatives to ensure appropriate drug therapy prio...
13h
| Job Type | Full Time |
Claim Auditor Payment Integrity (44544)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Claim Auditor in Payment Integrity will address problematic and complex audit assignments to identify claim overpayments in accordance with established billing and coding parameters. Claim payment accuracy will be recognized...
13h
| Job Type | Full Time |
Senior Provider Reimbursement Analyst (43439)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Senior Provider Reimbursement Analyst is responsible for development and management of fee schedules, including sample schedules, and alternative payment methodologies (APM) that support strategic and corporate goals. This p...
13h
| Job Type | Full Time |
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Medical Director is to provide clinical leadership and consultation to the Plan's various departments with the goal of promoting clinical excellence, quality care in our provider network, as well as maximizing member access ...
13h
| Job Type | Part Time |
Manager of Configuration Services (44064)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Manager of Configuration Services ensures that the performance, function, and appearance of our products are consistent in our claims system(s). This involves managing the requirements, design and operational information thr...
13h
| Job Type | Full Time |