As RapidScale's National Partner Manager , this individual will be responsible for designing and leading a nationwide go to market strategy via RapidScale's diverse in direct sales channel. This individual will serve as the primary point of contact leading strategic go to market initiatives & efforts with select technology distributors, including, but not limited to, the d

Hi there! We are Semrush, a global IT company developing our own product a platform for digital marketers. New stars are born here, so don't miss your chance. This is our Director of Sales Operations role for those who are goal and success oriented. Tasks in the role Provide business insight into the sale of an expanding portfolio of Semrush products in a fast paced and g

At Franklin Templeton, we're driving our industry forward by developing new and innovative ways to help our clients achieve their investment goals. Our dynamic and diversified firm spans asset management, wealth management, and fintech, offering many ways to help investors make progress toward their goals. Our talented teams working around the globe bring expertise that's

At Franklin Templeton, we're advancing our industry forward by developing new and innovative ways to help our clients achieve their investment goals. Our dynamic and diversified firm spans asset management, wealth management, and fintech, offering many ways to help investors make progress toward their goals. Our talented teams working around the globe bring expertise that

The Clinical Care Manager provides holistic medical care management services for members throughout the continuum of care by assessing the member clinically as well as member's readiness to make behavioral changes and actively participate in a care plan, establish goals and meet those goals. Well Sense Health Plan members may include those who have chronic conditions and

Uses SAS and/or SQL coding to pull claims and membership data to support involved healthcare analytics Supports the development of effective medical management programs/initiatives through analyzing, monitoring, and reporting the effectiveness of these programs Develops and implements plans to measure and report on corporate wide health care delivery cost and utilization

WellSense Health Plan is seeking a dedicated and experienced Senior Health Data Analyst to join our team on a full time, regular basis. The Senior Health Data Analyst is a key member of the team and serves as a strategic partner to various functional areas throughout the organization to meet corporate objectives. Under the leadership and guidance of Senior Director of Cli

Investigate, document, track and assist with claims resolution Interact with various operational departments to assure accurate and timely payment of claims in accordance with WellSense policies and procedures Identify system changes impacting claims processing and work internally on resolution Identify systematic issues and trends and research for potential configuration

The Project Coordinator (PC) will work closely with Project and Program Managers to ensure the success of strategic initiatives at WellSense. PCs assist with the preparation and maintenance of key project & program artifacts, such as charters, project plans, schedules, budgets, timelines, and status reports. They also assist with administrative duties related to project e

Responsible for accurate and timely implementations of pharmacy benefits and operations configurations Provides project management support for all pharmacy services initiatives across all lines of business Responsible for initiation, planning, tracking, documenting, execution, and monitoring and controlling of program implementations Proactively works with the project tea

Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan's adjudication system(s) Monitors DHHS, EOHHS, and CMS websites, listservs and other sources to identify existing payment practice and upcoming changes Determine the scope and impact of the change on Plan operations and seek to

Responsible for the daily supervision and operations of the Prior Authorization Specialists. Develops training, trains staff, assigns work, implements policies and procedures, and resolves complex issues to ensure accurate and timely management of prior authorization requests. Maintains compliance with state and federal requirements. Performs quality assurance audits. Imp

The Operations Reporting and Performance Analyst (ORPA) plays an essential role in improving organizational effectiveness by analyzing operational data and identifying opportunities for learning and development. The OPRA collects and analyzes data to assess performance metrics, identifies training needs, and implements strategies to improve employee performance and skill

Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral health, functional status, and socioeconomic needs Administers MDS HC assessments and other required assessment tools Facilitates meetings of the PCT and serves as clinical subject matter

Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral health, functional status, and socioeconomic needs Administers MDS HC assessments and other required assessment tools Facilitates meetings of the PCT and serves as clinical subject matter