Senior Quality Analyst, Assistant Manager ExlService Holdings IncSenior Quality Analyst, Assistant ManagerNY$73,000–$110,000 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. This role will be responsible for embedding AI into QA processes, improving product quality proactively, and driving intelligent automation initiatives that reduce manual effort, improve defect prevention, and accelerate delivery timelines.
FT Pharmacist Technician ICARE PHARMACY PLUSFT Pharmacist TechnicianPaterson, NJFull timeIcare Pharmacy Plus in Paterson is on the lookout for a motivated and detail-oriented Pharmacy Technician to become a vital part of our dynamic team! Provide outstanding customer service by assisting patients with inquiries and resolving concerns.
Senior Accountant Catholic Charities Community ServicesSenior AccountantNew York, New York$92,000–$100,000 / yearReporting to the Finance Manager(s), the Senior Accountant ensures timely and accurate fiscal operations, including claims processing, budget development, audit preparation, forecasting, and financial reporting. Summary: The Senior Accountant plays a key role within the CCCS Finance Department's Program Support team, overseeing operational financial reporting and contract compliance.
Account Manager III (Public Sector) Horizon Healthcare ServicesAccount Manager III (Public Sector)Newark, New JerseyMust be proficient and possess advanced skills in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications. This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
Account Manager IV (National Large Group) Horizon Healthcare ServicesAccount Manager IV (National Large Group)Newark, New JerseyThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The Account Manager acts as a trusted advisor to the client and consultants while coordinating across internal Horizon teams to ensure service delivery, compliance, and performance expectations are met.
Business Systems Analyst TechDigital CorporationBusiness Systems AnalystFlorham Park, NJRemoteFDB Drug Nomenclature, Formulary & Preferred Drug List Design. • Drug Coverage Configuration: Inclusions, Exclusions & Prior Authorization Criteria.
Director - MGA & Program Claims Sirius International Insurance Group Ltd (Inactive)Director - MGA & Program ClaimsNY$150,000–$175,000 / yearYour responsibilities will include: Oversight of claim handling entities associated with Programs/MGAs to ensure authority is not breached, claims reporting is accurate and timely, coverage is appropriate, consumer and customer service is compliant, quality auditing program is in place and up to date, and general monitoring of reserving and loss exposures. Monitor risk arising from claims programs against agreed SiriusPoint risk appetite/tolerances; promptly escalating risk events/control failures and taking appropriate actions to report and assist claims leadership to address matters arising from these events.
NewSoftware Architect - Healthcare AI & Cloud Solutions ExlService Holdings IncSoftware Architect - Healthcare AI & Cloud SolutionsNY$93,900–$154,200 / yearThis role blends product leadership, technology execution, and business alignment to drive enterprise value through large scale, data driven, cloud-first solutions that support payment integrity and data intelligence use cases. As the Software Architect - Healthcare AI & Cloud Solutions, you will be responsible for developing Solution, Application, Performance and Enterprise architectures and designs for solutions that power EXL Health's digital transformation in the U.S. healthcare market.
Appeals and Grievances Clinical Specialist/ Quality Of Care HealthfirstAppeals and Grievances Clinical Specialist/ Quality Of CareNY$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.
Ai/Ml Engineer Starr CompaniesAi/Ml EngineerNew York, NY$135,000–$175,000 / yearThe wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets: experience and training: licensure and certifications: and other business and organizational needs. 2+ years expert level R or Python analytics experience with a proven track record in advanced analytics as well as hands-on experience with digital and CRM data (structured and unstructured).
AI Solution Architect TechDigital CorporationAI Solution ArchitectHolmdel, NJSolution & Enterprise Architecture Deep expertise in solution architecture disciplines: capability modelling, application architecture, integration architecture, data architecture, and security architecture. Technology Stack (Hands-On Proficiency) Java / J2EE: Java 11–21, Spring Boot, Spring Framework, Jakarta EE, microservices with REST/gRPC, Apache Kafka, JPA/Hibernate, PostgreSQL, Oracle.
Pharmacist in Charge PIC ICARE PHARMACY PLUSPharmacist in Charge PICMorris Plains, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. - Balanced Schedule: Maintain a healthy work-life balance with our balanced work schedules.
PHARMACIST IN CHARGE ICARE PHARMACY PLUSPHARMACIST IN CHARGEPaterson, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. Job Description: Icare Pharmacy Plus is seeking a dedicated and highly skilled Pharmacist to join our team.
PART TIME PHARMACIST ICARE PHARMACY PLUSPART TIME PHARMACISTPaterson, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. Job Description: Icare Pharmacy Plus is seeking a dedicated and highly skilled Pharmacist to join our team.
Field Service Agent - Queens - Bilingual Mandarin/Cantonese HealthfirstField Service Agent - Queens - Bilingual Mandarin/CantoneseQueens, NY$48,600–$65,960 / yearThis individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Agent maintains the Healthfirst culture and drives improvements to ensure the best possible customer experience as measured by First Encounter Resolution and Customer Experience measures for our "North Star" Members and the Providers who service them.
Field Service Agent - Queens - Bilingual Spanish HealthfirstField Service Agent - Queens - Bilingual SpanishQueens, NY$48,600–$65,960 / yearThis individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Agent maintains the Healthfirst culture and drives improvements to ensure the best possible customer experience as measured by First Encounter Resolution and Customer Experience measures for our "North Star" Members and the Providers who service them.
Private Client Account Executive Personal Risk Management SolutionsPrivate Client Account ExecutiveNew York, NY$90,000–$110,000 / yearAs a Private Client Account Executive, you will be responsible for a variety of client focused tasks and will be an integral part of a team who services our client accounts, ensuring customer satisfaction throughout the process. This role is essential in providing comprehensive support to clients, ensuring a high level of customer service and is an integral part of our service team, which is well known for being among the best in the business.
Field Service Agent - Manhattan - Bilingual Spanish HealthfirstField Service Agent - Manhattan - Bilingual SpanishManhattan, NY$48,600–$65,960 / yearThis individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Agent maintains the Healthfirst culture and drives improvements to ensure the best possible customer experience as measured by First Encounter Resolution and Customer Experience measures for our "North Star" Members and the Providers who service them.
Field Service Agent - Bilingual Spanish - Manhattan HealthfirstField Service Agent - Bilingual Spanish - ManhattanManhattan, NY$48,600–$65,960 / yearInitiate investigations, partner with other assigned parties to participate in root cause analysis, communicate complex information, take proactive and/or corrective measures and/or recommend solutions and methods for process improvement and follow-up on outstanding customer inquiries and complaints within defined timeframes. Manage face-to-face encounters by interacting with customers to provide information in response to inquiries about products and services, improve overall member experience, and reduce waiting time to expedite traffic flow.
CCO Service Agent - 100% Remote HealthfirstCCO Service Agent - 100% RemoteNJRemote$40,200–$54,570 / yearThis individual receives and addresses member & provider inquiries, resolves complaints, educates clients, retains members, helps to prevent dis-enrollments, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within our traditional and/or Omni-channel contact center environment. Initiates investigations as required, partnering with other assigned parties to participate in root cause analysis, takes proactive and/or corrective measures and/or recommends solutions and methods for process improvement and follow-up on outstanding customer inquiries and complaints within defined timeframe.