Who are you?   Are you an adept Implementation Manager with a proven track record? Are you experienced in Third-Party Administrators (TPAs) or self-funded groups? If so, we're looking for you! Personify Health is seeking a Solution Architect to spearhead strategic and operational initiatives within our dynamic team.   As a Solution Architect, you will play a pivotal role in executing strategic and operational initiatives. Your responsibilities will include building and nurturing strong cross-departmental relationships, utilizing proactive critical thinking to tackle complex organizational and client needs.   Your primary focus will be on providing on-demand support for specific clients and prospects, aiming to enhance client satisfaction, retention, and revenue generation. As time and projects permit, you will also be involved in owning or supporting proactive organizational efficiency projects. This role will primarily concentrate on our Health Plan Administration anchor product and services.   In this role you will wear many hats, but your knowledge will be essential in the following:     - Become a subject-matter expert within the Health Plan Administrator anchor product, including broker/client markets & nuances, product offerings, processes, and potential intersections with other products & services  - Work directly with clients or prospects to provide thoughtful recommendations based on needs identified in partnership with the account/strategy/sales team, which also account for feasibility operationally and cost of service  - Provide subject matter expertise as warranted via prospect or customer needs including but not limited to pre-sales, implementation, and account management support   - Manage at least 1 proactive operational efficiency project annually that seeks to increase client satisfaction or decrease operational lift without compromise to quality of client or member experience  - Establish and maintain key internal collaborator relationships with Product, Engineering, Client Success, Operations, Sales and/or Strategic Development   - Executes tactics to achieve strategic goals and annual operating plan of Solution Architect Team  - Be Resourceful on continued learning and change    You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   We are seeking an experienced and highly skilled Senior Claims Specialist to join our claims processing team. As a Senior Claims Specialist, you will play a pivotal role in ensuring the accurate and efficient processing of healthcare claims, overseeing complex cases, and providing guidance to claims specialists.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Claims Adjudication: Lead the adjudication of complex and high-dollar claims, applying advanced knowledge of policies, procedures, and guidelines. - Claims Review: Conduct in-depth reviews of disputed or escalated claims, collaborating with internal teams and external stakeholders to reach fair and timely resolutions. - Quality: Ensure a high level of quality in claims processing by consistently achieving a financial accuracy rate of 99% and a procedural accuracy rate of 97%, adhering to established guidelines and procedures. - Documentation: Ensure accurate claims information is recorded in claims and patient notes, including accurate indexing, and archiving of documents to facilitate easy retrieval. - Investigation: Investigate and resolve discrepancies and issues related to claims, ensuring prompt and fair resolution. Provide feedback to leadership on how to prevent discrepancies from occurring on future claims. - Communication: Provide timely and concise updates on the status of assigned claims, highlighting any potential issues or complex cases that may require additional attention or guidance as well as proposed solutions. - Process Improvement: Identify opportunities for process enhancements, lead process improvement initiatives, and collaborate with cross-functional teams to streamline workflows. - Mentorship: Provide guidance and training to claims specialists, fostering their professional development and ensuring consistent and accurate claims processing. - Policy Analysis: Analyze and interpret complex contracts and benefit documents to ensure accurate claims processing and compliance. - Customer Escalations: Handle escalated customer inquiries and complaints, demonstrating expert knowledge and exceptional problem-solving skills. - Stay Informed on Procedures: stay up-to-date with company-wide processing procedures and group-specific processing requirements, ensuring that claims processing remains compliant and efficient with the latest industry and organizational standards. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   The Analytics Engineer will design, develop, and maintain data analytics solutions for core data storage in our Analytics Engineering team. This person will support the success of the analytics engineering team by developing high quality, robust data analytic pipelines and refining data utilization to support quality, performance, cost and availability initiatives. This role is responsible for improving the overall performance of the existing infrastructure while helping to maintain the high level of quality required for our analytic environments. If you have data engineering and analytics experience in the self-funded health insurance industry, enjoy collaborating closely with your peers, and thrive in an environment with clear goals and measurable outcomes, then this may be the perfect role for you!   In this role you will wear many hats, but your knowledge will be essential in the following:   - Works collaboratively with a team of data engineers, data quality engineers and data architects, ensuring high quality delivery of features and bug fixes to maintain and support current production applications. - Participate in scoping and estimating processes to support sprint planning. - Establish and uphold data analytic best practices supporting high quality delivery of client requirements. - Serve as a subject matter expert on HealthComp’s products, services, and client-facing value. - Stays informed of new and emerging data analytic tool and architecture methodologies. - Applies strong analytical and technical skills to understand, define, research, and resolve everyday data analytic issues. - Design, develop and maintain custom scripts, software, and infrastructure for our data analytics environment. - Work with internal stakeholders providing feedback on product design and testability. - Provides on-call support as needed. - Create and maintain documentation and process guidance for all projects. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   As a Product Manager, you'll work closely with a highly dynamic, fast-paced, and growing team and passionate team of Product Managers, UX Designers (UX), Content Strategists, Researchers, Engineering Managers, and Tech Leads to shape a cohesive, creative, and innovative vision that business customers and end users find to be useful, easy-to-use, and delightful. You enjoy both the upstream part of the process--figuring out the "right product" or enhancement, and the "done right" part of how best to bring it to life for maximum lift and impact. You'll build relationships with other departments including product marketing, member services, customer success, and sales. You'll develop product requirements and roadmaps, incorporating feedback and input from customers, partners and in-house teams on product strategy and finding ways to expand product market reach. You possess a unique blend of business and technical savvy, strong agile and process skills, and the drive to make your product vision a reality.     In this role you will wear many hats, but your knowledge will be essential in the following:   - Collaborate with key stakeholders (ranging from management to marketing/ sales and customers) to define, develop, shape, and refine requirements. - Define, prioritize, and clarify user stories; working with other Product Managers and Product Owners to understand use cases, features, business & technical domain rules and overall product goals. - Define and communicate project goals, problem framing, major solution design scope decisions and target project timelines. - Work with UX Design to create User Stories based on design mockups. - Create detailed product documentation of User Stories to define end user functionality and enable commercialization. - Work with Engineering to estimate User Stories and continuously improve product ownership and other agile processes. - Build and groom product backlog(s). Create and groom short, medium, and long-term product roadmaps and get internal agreement with key stakeholders. - Conduct sprint planning with prioritized User Story requirements in time for sprint planning deadlines. - Identify cross-team dependencies during requirements creation and work to assure impacted team(s) have available capacity and velocity to hit target dates. - Keep abreast with Agile/Scrum best practices and new trends. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   As a Product Manager, you'll work closely with a highly dynamic, fast-paced, and growing team and passionate team of Product Managers, UX Designers (UX), Content Strategists, Researchers, Engineering Managers, and Tech Leads to shape a cohesive, creative, and innovative vision that business customers and end users find to be useful, easy-to-use, and delightful. You enjoy both the upstream part of the process--figuring out the "right product" or enhancement, and the "done right" part of how best to bring it to life for maximum lift and impact. You'll build relationships with other departments including product marketing, member services, customer success, and sales. You'll develop product requirements and roadmaps, incorporating feedback and input from customers, partners and in-house teams on product strategy and finding ways to expand product market reach. You possess a unique blend of business and technical savvy, strong agile and process skills, and the drive to make your product vision a reality.     In this role you will wear many hats, but your knowledge will be essential in the following:   - Collaborate with key stakeholders (ranging from management to marketing/ sales and customers) to define, develop, shape, and refine requirements. - Define, prioritize, and clarify user stories; working with other Product Managers and Product Owners to understand use cases, features, business & technical domain rules and overall product goals. - Define and communicate project goals, problem framing, major solution design scope decisions and target project timelines. - Work with UX Design to create User Stories based on design mockups. - Create detailed product documentation of User Stories to define end user functionality and enable commercialization. - Work with Engineering to estimate User Stories and continuously improve product ownership and other agile processes. - Build and groom product backlog(s). Create and groom short, medium, and long-term product roadmaps and get internal agreement with key stakeholders. - Conduct sprint planning with prioritized User Story requirements in time for sprint planning deadlines. - Identify cross-team dependencies during requirements creation and work to assure impacted team(s) have available capacity and velocity to hit target dates. - Keep abreast with Agile/Scrum best practices and new trends. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

  In this role you will wear many hats, but your knowledge will be essential in the following:   - Answer and route all incoming phone calls - Provide accurate information to internal and external customers regarding pre-certification process, including gathering demographic, non-clinical, and/or provider data for pre-certification via phone, fax, inter/intranet, Eldorado/Case Pac computer programs - Review service requests and manage the requests as efficiently as possible involving the appropriate department as needed - Perform data entry and maintain complete documentation of case information; assist in document maintenance or revisions; compile monthly reports; maintain logs and files - Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis   You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   Reporting to the Manager, Service Desk, the IT Service Desk Technician will work with the global Service Desk team, supporting 2000 users across 12 countries, and ensuring users are receiving appropriate assistance and service.   Core responsibilities will include ensuring efficient servicing of support tickets from internal users and will focus on Tier 1 support including ownership/stewardship of Office 365, Active Directory, Azure, Intune, and other cloud-based applications.  Additionally, the IT Service Desk Technician is responsible for ensuring meeting rooms, corporate technology, and audio-visual services are operational across all offices.   This is a hands-on role involving servicing tickets while ensuring high levels of customer service quality and availability.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Reports directly to the Manager, Service Desk - Provide first level support to corporate users via phone and email to diagnose and resolve issues; escalating to senior team members proactively where required to ensure efficient closure of tickets. - Respond promptly to support requests and maintain the 4-hour response and 24-hour fix / escalation SLA. - Responsible for office deployments and the maintenance of technologies in that region. - Assist in resolving hardware problems, system upgrades, networking setup and diagnosis, software problems, backup issues and file recovery. - Assist in management of file transfer platform, creating and testing new connections, perform updates and changes to existing connections, review automation rules and workflows to aid in issue resolution. - Triaging tickets effectively - Assisting with SOC/HITRUST evidence and audit requirements - Ensure tickets are closed with correct resolution to avoid tickets being reopened. - Manage end-user expectations and following up on end-user feedback. - Create and maintain a functioning Service Catalog within the ticketing system. - Ensure secure configuration of all user machines and systems to make sure OS and Anti-Virus patching is up to date. - Assist in maintenance of Active Directory and related accounts and services, including mail and file services through standard tools to ensure settings and accounts created / removed in a timely fashion. - Create process and user documentation relating to laptop / PC setup and review configurations before delivery to user, ensuring issues are fed back and corrected before deployment. - Assist in the procurement of hardware and software and manage configuration and deployment throughout the organization. - Track licensing statistics and manage IT asset list, ensuring all records are kept up to date. Help to maintain software licensing requirements. - Delivery of assigned projects within a timely manner. - Test applications and systems to ensure functionality before production deployment. - Assist with special projects as requested. - Perform other duties as assigned. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

  In this role you will wear many hats, but your knowledge will be essential in the following:   - Work in conjunction with the management to establish work procedures and processes that support Company and departmental standards, procedures, and strategic directives. - Use appropriate judgment in upward communication regarding department or employee concerns - Monitor, audit and analyze employee performance; identify and resolve problems; prepare and complete action plans; assist in managing system and process improvement. - Meet periodically with staff as directed by manager to review performance. - Plan, organize and distribute work; keep team informed of updates and changes in policy or procedure; instruct employees regarding procedures and methods; resolve difficult or non-routine situations or problems. - Telephonically manage cases on a long or short term basis per established Company guidelines, policies and procedures, as well as other standardized criteria in the healthcare industry. - Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs. - Develop treatment plan in collaboration with the patient, caregivers or family, community resources and multidisciplinary healthcare providers that include obtainable short and long term goals. Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions. - Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance. - Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

  In this role you will wear many hats, but your knowledge will be essential in the following:   - Supervise the chronic disease management team personnel including participating in interviewing, hiring, and training employees; plan, assign, and direct work; appraise performance; rewarding and disciplining employees; addressing complaints and resolving problems. - Keep team informed of clinical updates with trainings, meetings and memos. - Work in conjunction with the VP of UM to establish work procedures and processes that support Company and departmental standards, procedures, and strategic directives. - Track reporting for groups and build good relationships with groups and brokers utilizing account managers as instructed. - Use appropriate judgment in upward communication regarding department or employee concerns. - Maintain and improve CDM operations by monitoring system performance; identify and resolve problems; audit and analyze staff performance; prepare and complete action plans; assist in managing system and process improvement and quality assurance programs as it relates to clinical management and plan - language interpretation. - Oversee the negotiation and implementation of cost management strategies to affect quality outcomes and reflect this data in monthly chronic disease management reviews as it relates to clinical aspects. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   The Health & Wellbeing Program Manager is a client-dedicated member of the Virgin Pulse account team, focused on designing and delivering a comprehensive strategic wellbeing plan, aimed at building a culture of health, enhancing health and wellbeing engagement, and driving health behavior change through awareness and activation. The Health & Wellbeing Program Manager works side by side with the Virgin Pulse account leadership and the client’s HR, benefits, and/or stakeholder teams. This individual will provide advocacy for Virgin Pulse products and demonstrate Virgin Pulse’s mission of Changing Lives for Good. This position will include approximately 10% to 15% travel.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Provide direction and subject matter expertise in defining, designing, developing, communicating, and executing a comprehensive health and wellbeing strategy - Utilize project management skills to develop and execute health and wellbeing programs according to timeline and budget - Monitor, evaluate, and respond to program measurements and participant feedback, including operations and quality, to drive continuous quality improvement initiatives and goals - Serve as an integrated partner and the face of wellbeing to the client population, guiding members to appropriate resources and offerings - Engage and partner with client leadership, stakeholders and internal groups (Diversity & Inclusion, Employee Resource Groups, etc…) to build and support a culture of health - Leverage community partnerships to support client goals including initiatives related to social determinants of health, diversity and inclusion, health, and holistic wellbeing (mental, physical, social, community, financial, and safety wellbeing) - Collaborate with the client’s health plan and vendor partners to identify opportunities for health awareness and engagement, and to drive utilization of the client’s suite of health, benefits, and wellbeing offerings - Launch and lead a Wellness Champion Network across key client locations - Support Virgin Pulse platform enrollment and ongoing engagement to associated solutions, resources, and partners - Lead implementation of health promotion programs including health screenings, flu shots, and open enrollment events - Lead regular data assessment and reporting to internal and external stakeholders and leadership, while defining opportunities, tracking impact, and determining next best steps - Collaborate with Virgin Pulse and client support teams including Marketing, Product, Business Operations, and Customer Service - Partner with Virgin Pulse peers to share best practices and opportunities to drive best-in-class services to our clients - Provide support for renewal and expansion planning as appropriate - Perform other related duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   The Process Manager will be responsible for overseeing cross-functional coordination of operationalizing incremental product iterations and major product releases involving, but not limited to, Product Management, Commercial Enablement, Client Operations, DSR, Finance, Member Services and Live Services   In this role you will wear many hats, but your knowledge will be essential in the following:   - Facilitate relationship building and communication with primary stakeholders involved in operational readiness for releases and on-going process improvement. - Coordinate considerations across product streams, where applicable. - Manage bi-weekly review of Sprint Release notes with primary stakeholders. - Manage processes and communications for any beta testing efforts. - Facilitate internal client-impacting projects on an as-requested basis - Establish and measure against key performance indicators and metrics - Identify gaps in process knowledge and help develop standard operating procedures - Document existing process knowledge - Implement process management best practices, preferably informed by a certification in or related experience with a recognized program (such as, but not limited to, Six Sigma) You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

In this role you will wear many hats, but your knowledge will be essential in the following:   - Telephonically manage cases on a long- or short-term basis per established Company guidelines, policies, and procedures, as well as other standardized criteria in the healthcare industry. - Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs. - Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs. - Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals. - Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions. - Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care. - Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance. - Be able to meet productivity, quality, and turnaround time requirements on a daily, weekly, and monthly basis. - Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports. - Establish and maintain working relationships with healthcare providers, client/group, and patients to provide emotional support, guidance, and information. - Evaluate and make referral for wellness programs. - Maintain complete and detailed documentation of case managed patients in Eldorado and UM Web; maintain site specific files ensuring confidentiality; prepare reports and updates at 30-day intervals for high-risk cases and 90 days interval for low-risk cases ensuring confidentiality according to Company policy and HIPAA - Perform Utilization Review for assigned members. - Serve as mentors to LVNs and provide guidance on complicated cases as it relates to clinical issues. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

In this role you will wear many hats, but your knowledge will be essential in the following:   - Telephonically manage cases on a long or short term basis per established Company guidelines, policies and procedures, as well as other standardized criteria in the healthcare industry. - Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs. - Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs. - Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions. - Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care. - Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance. - Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis. - Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports. - Establish and maintain working relationships with healthcare providers, client/group, and patients to provide emotional support, guidance and information. - Evaluate and make referral for wellness programs. - Maintain complete and detailed documentation of case managed patients in Eldorado Quick link, and UM Web; maintain site specific files ensuring confidentiality; prepare reports and updates at 30 day intervals ensuring confidentiality according to - Company policy and HIPAA You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   In this role, your will support the insurance claim and reimbursement process. This is an amazing opportunity to learn more about the health care industry and advance your career with a rapidly expanding organization!   In this role you will wear many hats, but your knowledge will be essential in the following:   - Prepare Stop Loss claims and applicable documents to determine stop loss filing eligibility applicable to the excess loss policy - Files submissions of spec claimants (running reports, gathering necessary documents and email correspondence), processing all submissions within established internal timeframes - Coordinate advanced funding requests, with the client and their stop loss carrier - Creates initial specific file for each claimant and files all submissions in our EDOCS platform - Coordinates the release of “on hold” claims - Acts as the liaison between the PBM’s and internal clients, as it pertains to our stop Loss claimants - Keeps immediate supervisor apprised of open or disputed items - Contributes to daily workflow with regular and punctual attendance - Generates weekly outstanding reimbursement report and follows up with the Stop Loss carrier You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   This is a full-time, 32 hour per week onsite position supporting Main Line Health, in Philadelphia, PA. In accordance with the client’s policy, employees working onsite will be required to show proof of current flu and Covid-19 vaccinations, per CDC guidelines, on or before the first day of employment. The Health & Wellbeing Specialist is a client-dedicated member of the Virgin Pulse account team, focused on building a culture of health, enhancing health and wellbeing engagement, and driving health behavior change through awareness and activation. The Health & Wellbeing Specialist collaborates with Virgin Pulse account leadership and the client’s HR, benefits, and/or stakeholder teams. This individual will provide advocacy for Virgin Pulse products and demonstrate Virgin Pulse’s mission of Changing Lives for Good. This position will include approximately 20% of local travel.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Design, develop, communicate, and execute an annual health and wellbeing programming plan, in alignment with client’s strategic goals and priorities - Monitor, evaluate, and respond to program measurements and participant feedback, including operations and quality, to drive continuous quality improvement initiatives and goals - Serve as an integrated partner and the face of wellbeing to the client population, guiding members to appropriate resources and offerings - Engage and partner with client stakeholders and internal groups (Diversity & Inclusion, Employee Resource Groups, etc…) to build and support a culture of health - Leverage community partnerships to support client goals including initiatives related to social determinants of health, diversity and inclusion, health, and holistic wellbeing (mental, physical, social, community, financial, and safety wellbeing) - Collaborate with the client’s health plan and vendor partners to identify opportunities for health awareness and engagement, and to drive utilization of the client’s suite of health, benefits, and wellbeing offerings - Build, nurture, and drive engagement through a Wellness Champion Network across key client locations - Support Virgin Pulse platform enrollment and ongoing engagement to associated solutions, resources, and partners - Support implementation of health promotion programs including health screenings, flu shots, and open enrollment events - Drive localized health engagement and awareness through educational opportunities and creative programming - Conduct regular data assessment and reporting to internal and external stakeholders, to define opportunities, track impact, and determine next best steps - Collaborate with Virgin Pulse and client support teams including Marketing, Product, Business Operations, and Customer Service - Partner with Virgin Pulse peers to share best practices and opportunities to drive best-in-class services to our clients - Perform other related duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you? This role will work closely with the Trust team and other members of the general accounting team. This person should have effective verbal and written communication skills. Proficiency with technology including an ability to quickly adapt to new technologies and operate in a fast-paced environment is critical.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Responsible for completion of monthly bank reconciliations. - Standard monthly reporting (client remittances/client special reports) using accounting / billing data. - Perform monthly reconciliations for PPO (Anthem/BlueShield) network claims. Evaluate potential to automate. - Responsible for annual escheatment process / tracking and updating throughout the year. - Assist with client banking and funding. - Pull funds from bank accounts as needed for provider claim payments and premium payments. - Setting up of carrier payments. - Completion of funding control to validate receipt of cash prior to claims funding. - Billing invoice uploads including reconciliation of files to final upload. - Standard monthly reporting specific to the billing function. - Cash application. - Other duties as assigned. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   The role of Associate Cloud Systems Engineer is responsible for maintaining server infrastructure and providing first point of escalation support for corporate service desk team. This role will support cyber security investigations and deploy OS and third party patches to remediate vulnerabilities.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Maintain server infrastructure according to security and uptime standards. - Maintain network infrastructure, including WAN links, VPNs, and LAN/WLAN. - Track all changes and work through tickets and document steps followed. - Provide first point of escalation support for Corporate Service Desk team. - Deploy OS and 3rd party patches to remediate vulnerabilities. - Maintain systems integrations and data syncing tools and processes. - Assist security teams with information requests to support audits and questionnaires. - Support cyber security investigations. - Maintain automation workflows and scheduled scripts. - Configure and maintain SSO applications for cloud applications. - Research and implement new technologies and services. - Continually evaluate systems to identify and implement improvement projects and tasks. - Open and manage support tickets with vendors. - Participate in roadmap projects to support company-wide initiatives. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   The RBP Member Advocacy Manager is responsible for structuring, developing and providing leadership  to a team specialists who are tasked with delivering industry leading concierge level member services to our RBP plan members. This team consisting of member services specialists will look to this leader to empower and embolden through maintaining a culture of knowledge building and process training. Working closely with internal stakeholders (peers and leadership) as well as external RBP vendors, clients and partners to continuously strengthen our offerings to its current and future membership through enhancements and efficiencies.    In this role you will wear many hats, but your knowledge will be essential in the following:   - Responsible for the day to day and overall performance of the RBP Advocacy Team and results of assigned metrics/KPIs/SLAs/CSAT - Continuous training and development of RBP plan offerings for new and existing team members - Provides coaching through feedback management and performance  adherence - Maintains clear channels of communication with Account Management, Member Service leadership and Clinical staff in regard to escalations and client/broker sediment - Partners with the Account Management and Implementation Team to ensure seamless implementation of plan requirements - Represents Personify Health by regularly attending client reviews and vendor meetings - Partners with functional leaders to provide direct input into RBP product assessment and solutions to ensure alignment with organizational goals and vendor capabilities - Simplify and reimagine processes and procedures to improve Personify Health offerings You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   As a Benefit Plan Builder you will be responsible for the build and maintenance of plan benefits for new and existing groups upon implementation, renewal, and changes. If you have experience in health benefits or claims management with excellent organizational skills and a strong attention to detail, this is the perfect opportunity to grow your career with a progressive leader in healthcare!    In this role you will wear many hats, but your knowledge will be essential in the following:   - Support Implementation and Account Management teams by consolidating information during new client implementation and/or renewal to ensure the accuracy of benefits - Create benefit SMART sheets - Translate benefits from ICD10, HCPCS, CPT, CDT and other insurance billing codes - Audit plan build work of other teammates   - Build out groups and upload benefit summary to website for members and faxback system for providers - Ensure compliance with applicable government regulations - Process Group terminations - Correspond with account managers, account coordinators, claims department, and other technical areas - Troubleshoot claims errors and refer escalated issues to team lead You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Who are you?   This is a full-time hybrid position supporting a government contractor in the Pittsburgh/West Mifflin, PA or Albany/Schenectady, NY area. The Health & Wellbeing Specialist is a client-dedicated member of the Virgin Pulse account team, focused on building a culture of health, enhancing health and wellbeing engagement, and driving health behavior change through awareness and activation. The Health & Wellbeing Specialist collaborates with Virgin Pulse account leadership and the client’s HR, benefits, and/or stakeholder teams. This individual will provide advocacy for Virgin Pulse products and demonstrate Virgin Pulse’s mission of Changing Lives for Good. This position will include approximately 10% travel for the first year and may increase to up to 25% for subsequent years.   In this role you will wear many hats, but your knowledge will be essential in the following:   - Design, develop, communicate, and execute an annual health and wellbeing programming plan, in alignment with client’s strategic goals and priorities - Monitor, evaluate, and respond to program measurements and participant feedback, including operations and quality, to drive continuous quality improvement initiatives and goals - Serve as an integrated partner and the face of wellbeing to the client population, guiding members to appropriate resources and offerings - Engage and partner with client stakeholders and internal groups (Diversity & Inclusion, Employee Resource Groups, etc…) to build and support a culture of health - Leverage community partnerships to support client goals including initiatives related to social determinants of health, diversity and inclusion, health, and holistic wellbeing (mental, physical, social, community, financial, and safety wellbeing) - Collaborate with the client’s health plan and vendor partners to identify opportunities for health awareness and engagement, and to drive utilization of the client’s suite of health, benefits, and wellbeing offerings - Build, nurture, and drive engagement through a Wellness Champion Network across key client locations - Support Virgin Pulse platform enrollment and ongoing engagement to associated solutions, resources, and partners - Support implementation of health promotion programs including health screenings, flu shots, and open enrollment events - Drive localized health engagement and awareness through educational opportunities and creative programming - Conduct regular data assessment and reporting to internal and external stakeholders, to define opportunities, track impact, and determine next best steps - Collaborate with Virgin Pulse and client support teams including Marketing, Product, Business Operations, and Customer Service - Partner with Virgin Pulse peers to share best practices and opportunities to drive best-in-class services to our clients - Perform other related duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.