Investigate instances of potential healthcare fraud, waste, and/or abuse (FWA) Conduct telephonic and/or in person interviews of members, providers, and other related parties to gather information in support of investigations Review and analyze claims data to identify patterns and indications of potential FWA Conduct onsite provider investigations for claim and/or clinica

Design and execution of training strategy, plan, and deliverables for Horizon The development of comprehensive and effective training materials which includes process documentation, end to end how to documentation, quick reference guides, train the trainer materials, and videos to ensure easy and immediate access to content Develop and execute a training plan that targets

Leverage modern selling strategies to effectively acquire new business and then build a new opportunity pipeline with Fortune 2000 level companies in specific market verticals Financial, Insurance, Healthcare, Distributors, Non Profits, Automotive, and Retail Represent all affiliates of Taylor Corporation to address the customers' needs by aligning value based solutions w

Extracting and linking data from multiple DBMS sources and creating analytic limited datasets for use by analysts. Scheduled data refreshes, quality control, and infrastructure ETL management including addressing data follow up questions, issues, enhancements, etc. Managing data processing environment e.g., folder design, disk space, backups, archiving Maintaining secure

The Team Member is the core of the Caribou experience. They are responsible for creating day making experiences through delivering unparalleled guest service, making world class hand crafted beverages and bringing the Purpose and Values of Caribou to life in every interaction. DOING What you deliver Provides incredible Guest Service by Developing personal ongoing relation

Designs, writes, creates, and maintains curriculum and adoption materials, including multimedia deliverables, to be used with in person and virtual instructor led training, self paced online learning, and other system adoption initiatives for a variety of audiences as assigned Incorporates instructional design best practices and adult learning theories to address a target

Perform research which advances the state of the art in AI and ML Implement algorithms and evaluate their performance on healthcare data Communicate results across an interdisciplinary team and explore use cases which improve real world healthcare outcomes Document research internally and externally, including publications in machine learning and other scientific conferen

Bring traditional actuarial skills to provider organizations as the health care market continues to evolve, including Assist in developing innovative strategies, value based contracts, and innovative risk based arrangements Develop, conduct, and evaluate studies on pricing, utilization, and health care costs for our broad range of provider clients Prepare, forecast, and a

Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an exciting career path, feel welcome to be your whole self and nurture your wellbeing, Petco is the place for you. Our core values capture that spirit as we work to improve lives by doing what's right for pets, people and our planet. We love all pets like o

Conduct MS DRG and APR DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification Expert knowledge of and the ability to identify the ICD 10 CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD 10 Official

Position at Lifespark Lifespark is a complete senior health company headquartered in St. Louis Park, Minnesota. Since 2004, we've been helping seniors stay healthy, navigate their health care options with confidence, and live fuller, more independent lives as they age. That's where our people come in from accounting and health technology to front line nurses, advanced pra

Leadership responsibilities Manage all aspects of the P&L, including driving growth, reducing medical expense, STARs performance, coding accuracy and administrative cost efficiency Lead the strategy creation and implementation, spanning assets in the benefit and care delivery space Organize the current businesses into a cohesive unit to deliver best in class integrated me

Food Champion Prepare food ingredients Assemble food orders and check to make sure orders are correct Package products Maintain a clean, safe work environment Be knowledgeable about menu items and promotions Service Champion Greet customers in the restaurant Take orders Handle payments and thank customers Maintain a clean, safe working and dining environment Be knowledgea

Perform research which advances the state of the art in AI and ML Implement algorithms and evaluate their performance on healthcare data Communicate results across an interdisciplinary team and explore use cases which improve real world healthcare outcomes Document research internally and externally, including publications in machine learning and other scientific conferen

This role will perform a mix of routine and ad hoc actuarial activities in support of our team's underwriting tools. Example of recent business problems include Improving monitoring of our tools' performances by automating data collection and reporting Designing analyses and interpreting results to answer client queries Developing new tools and processes to enhance our te