JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other mem...
JOB SUMMARY: The Enterprise Data Architect provides strategic and technical leadership for the design, governance, and evolution of the organization’s enterprise data ecosystem. This role serves as the senior authority on data architectur...
JOB SUMMARY: Responsible for providing daily guidance, instruction and training to inspire the team to perform at their optimum. Will work directly with Customer Service Supervisor to create a team that works efficiently together to maxim...
JOB SUMMARY: Responsible for selling Medicare products and Individual Health Plan products via telemarketing calls and person-to-person meetings, including seminars. KEY RESPONSIBILITIES: Discuss products and benefits with eligible be...
JOB SUMMARY: The Data Engineer will be responsible for expanding, optimizing and monitoring our data and data pipeline architecture, as well as optimizing data flow and collection across organizational teams. The Data Engineer will suppor...
JOB SUMMARY: Responsible for marketing the company’s commercial products to prospective clients and for assisting in the servicing and retaining existing accounts. KEY RESPONSIBILITIES: Identifies and sells lines of business directly ...
JOB SUMMARY: This position is a part of a team that provides support to Brokers and Employer Groups via email and phone communication. Support is provided for billing/invoice inquiries, eligibility inquiries, claims inquiries, and benefit...
JOB SUMMARY: The Director of Risk Adjustment is responsible for the strategic design, implementation, and oversight of CCOK’s risk adjustment program for both ACA and Medicare Advantage businesses. This individual will coordinate with var...
JOB SUMMARY: The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying issues related to and/or participates in various projects aimed at identifying areas of non-compliance and/or potential f...
JOB SUMMARY: Ensure integrity of member enrollment data and investigate and resolve complex and exception errors. Duties include identifying potential changes in eligibility, seeking verification of changes and disseminating enrollment in...
JOB SUMMARY: Responsible for selling Medicare products and Individual Health Plan products via telemarketing calls and person-to-person meetings, including seminars. KEY RESPONSIBILITIES: Discuss products and benefits with eligible be...
JOB SUMMARY: The UI/UX Developer is responsible for the development of front-end portals using the Angular framework. The UI/UX Developer will be responsible for collaborating with the User Experience team to ensure cohesive branding acro...
JOB SUMMARY: The Customer Service Supervisor will build a strong team of Customer Service Representatives and shape staff behaviors to accomplish desired results to meet the expectations and needs of our members, providers and internal cu...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: The Director Actuary will coordinate work with CCOK’s external actuaries, work closely with Marketing, Finance, Underwriting and other departments to find solutions to assist the company in achieving long-term profitable grow...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: Senior Statutory Accountant is responsible for assisting in carrying out the responsibilities of the Controller. This includes assisting in the organization's monthly closing processes, statutory reporting requirements, recon...
JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, ...
JOB SUMMARY: Responsible for providing customer service support for behavioral health benefits, directing members to appropriate in network services, processing prior authorizations according to CMS and State regulations, sending out prov...
JOB SUMMARY: Oversee all aspects of operations of the Pharmacy department including delivery of pharmacy benefits, network, administration, budgeting, reporting, and claims adjudication. Supervise all employees of the Pharmacy department....