Neighborhood Health Plan of RI Jobs in Barrington

15 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 the primary point of contact for Encounter Reporting and processes. He/she has primary responsibility to support State Encounter, Federal Encounter and 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 understand the operations and technology in use in all E...

Under general direction, provides support in the efficient and effective management of member benefit coverage and decisions, and is the key contact for member benefit interpretation and implementation within the company. Responsibilities include, but are not limited to the following: Serve as the key contact for member benefits interpretation within the organization, as it relates to all lines ...

Under general direction, provides support in the efficient and effective management of member benefit coverage and decisions, and is the key contact for member benefit interpretation and implementation within the company. Responsibilities include, but are not limited to the following: Serve as the key contact for member benefits interpretation within the organization, as it relates to all lines ...

Works collaboratively with various interdisciplinary health care teams to manage and coordinate care for a specific population of members whose needs represent high clinical, behavioral and social risk in order to ensure quality and cost-effective member-centered care. Responsibilities include, but are not limited to the following: Practice case management within the scope of licensure Utilizes...

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...

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...

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...

This role’s responsibility is to be the technical expert with regard to the set-up, troubleshooting and analysis of Electronic Data Interchange (EDI) interfaces into and out of the company. He/she works closely with the various internal and external stakeholders, their clearinghouses and other EDI partners to address configuration needs as well as resolve production issues. He/she configures, main...

Provides leadership in Financial Planning and Operational Analysis. The Director is responsible for assimilating Neighborhood’s entire financial picture and representing an integrated view in discussions with the senior leadership team and external partners. Responsibilities include, but are not limited to, the following: Provides guidance and oversight to the implementation of Neighborhood’s bu...

Reporting to the Chief Executive Officer, the Chief Financial Officer is responsible for the accuracy and integrity of all financial operations in the company. In this corporate leadership role, the CFO relies on his/her extensive strategic experience and sound judgment to perform a variety of tasks that involve the financial infrastructure of the organization. He or she develops and executes fina...

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 requires strong leadership, communication and analytical skills who is an expert in project management. He/she will be responsible for the coordination and completion of projects and will oversee all aspects of projects, sets deadlines, assigns responsibilities and monitors and summarizes progress of projects. He/she will prepare status reports and resource allocation. A wide degree of ...

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...