Integrated Care Manager (44428)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Integrated Care Manager (ICM) works collaboratively with the integrated care team to manage and coordinate care for a specific population of members whose needs represent high clinical and social risk in order to ensure qual...
1d
| 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...
1d
| Job Type | Full 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...
1d
| Job Type | Full Time |
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Automation Developer designs, develops, implements, and supports end to end automation solutions that improve efficiency, accuracy, and scalability across the organization. This role works closely with business analysts, tec...
1d
| Job Type | Full Time |
Grievance and Appeals Coordinator (44872)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Grievance and Appeals Coordinator is responsible for supporting the Grievance and Appeals Unit (GAU) by managing intake, assignment, and tracking of appeals and complaints/grievances across all product lines. This role ensur...
1d
| Job Type | Full Time |
Community Care Coordinator (44739)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Community Care Coordinator (CCC) works collaboratively with the health care team to manage and coordinate care for members that have social needs in order to ensure quality and cost-effective patient-centered care. This posi...
1d
| Job Type | Full Time |
Compliance and Privacy Business Partner (44744)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Compliance Business and Privacy Partner (CBPP) is responsible for aligning business objectives by providing regulatory support and compliance and privacy oversight for designated departments across the organization. This pos...
1d
| Job Type | Full Time |
Claims Quality Control Auditor (44912)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description The Claims Quality Control Auditor ensures organizational claim processing complies with contractual and regulatory requirements. The position performs audit functions for "internal and external" clients, provides training stand...
1d
| Job Type | Full Time |
Manager of Care Management (44862)
Smithfield, Rhode Island
Neighborhood Health Plan of Rhode Island
Description This position oversees operational activities of the Care Management area of the Medical Management department. This includes program development and monitoring, staff development including overseeing frontline supervisors. This...
1d
| 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 ...
1d
| Job Type | Part Time |