Neighborhood Health Plan of RI Jobs in Barrington

11 jobs

Overview Provide assistance to the Manager in preparing annual departmental budgets, multi-year forecast modeling, actual to budget variance analysis, ad/hoc cost analysis and any internal/external peer cost analysis. In addition, this position will provide administrative cost breakdown for incorporation into the NAIC quarterly and annual submissions. He/she will also be responsible for setting u...

Performs risk based compliance audits (Fraud, Waste and Abuse, operational, provider network) and delegated entities to ensure compliance with procedures and policies, contracts, laws and regulations and other industry standards. He/she will also consult with management and provide counsel to strengthen the organization's internal control structure and risk management practices. Responsibilities...

This position is responsible for managing financial accounting and reporting activities and ensuring they are being performed accurately, efficiently and in accordance with established timeframes, company and professional regulations/standards. He/she manages the process of financial statement preparation, providing day-to-day management of financial reporting, oversight and guidance to the depart...

Overview: This role requires a Project Manager with strong leadership, communication and analytical skills who is an expert in project management. He/she is responsible for the coordination and completion of projects and oversees all aspects of projects, sets deadlines, assigns responsibilities, and monitors and summarizes progress of projects. The Project Manager prepares reports for management...

This role’s primary responsibility is to provide a highly coordinated, comprehensive approach to Neighborhood’s plan member’s health care needs by providing personalized home-care to members that are in need of more tailored care due to chronic conditions. He/she will manage the care of members in accordance with the Nurse Practitioner standards of care (assessment of health status, diagnosis, dev...

This position is the primary point of contact for Encounter Reporting and Processes. He/she has primary responsibility to support State Encounter Submissions, Federal Encounter Submissions and All Payer Claims Database (APCD) submissions. Works directly with business units/delegated entity to ensure compliance and accuracy rates. He/she must be self-directed and solution oriented. He/she will unde...

Under general direction, supports the collection of annual HEDIS rates and efforts to improve HEDIS results across the company and within the plan’s provider network. He/she supports the HEDIS Core Group’s collection of HEDIS data in the areas of project planning and management; quality control; coordination with the HEDIS processer and auditor; process documentation; data analysis; and applicatio...

The Human Resource Administrator is responsible for personnel data management, metrics and reporting for the HR function. The position supports the head of HR, fellow HR team members, as well as their client groups in the development and delivery of HR measurements. Responsibilities include, but are not limited to the following: Provides Human Resources information by compiling and maintaining r...

This position provides assistance in financial planning, operational analysis and assimilating the company’s entire financial picture. He/she prepares and delivers concept development and communication of financial insights and recommendations to senior leaders. He/she serves as a liaison whereby frequently meeting with internal/external stakeholders to gather requirements for complex analysis, fi...

Responsible for monitoring and assessing the quality of inbound and outbound calls. He/she will utilize a consistent methodology across all internal or external staff serving our customer base and utilize a variety of techniques to facilitate a high quality customer experience on each call. Accountable for documentation of results and individual and team level analysis, ultimately working with man...

POSITION TITLE:Healthcare EDI Analyst DEPARTMENT: Information Services Overview: The Health Care EDI Analyst is the primary point of contact for system interfaces between Neighborhood and our vendors. The Health Care EDI Analyst has primary responsibility to triage EDI/Interface issues and support operational needs. The Health Care EDI Analyst works directly with business units, our trading par...