Lead Software Engineer for Apple developing personalized mobile streaming experiences. Collaborate with cross - functional teams and deliver best - in - class iOS and tvOS applications.
About the role
- Manager Senior Engineering providing analytical support to Cost of Care organizations focusing on lowering claims costs and improving quality of care. Working on large scale initiatives with high dollar cost savings opportunities.
Responsibilities
- Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction
- Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues
- Works on large scale initiatives with high dollar cost savings opportunities
- Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process
- Can work with multiple provider types, e.g. physician, ancillary, medical groups, or hospitals
- Supports a full range of contract arrangements and pricing mechanisms
- Works on complex enterprise-wide initiatives and acts as project lead
- Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process
- Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures
- Recommends policy changes and claim's system changes to pursue cost savings
- Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable
- Recommends standardized practices to optimize cost of care
- Educates provider contractors on contracting analytics from a financial impact perspective
- May recommend alternative contract language and may go on-site to provider premises during contract negotiations
- Participates on project team involved with enterprise-wide initiatives
- Acts as a source of direction, training and guidance for less experienced staff
Requirements
- Requires BS/BA degree in Mathematics, Statistics, or related field
- minimum of 5 years experience in broad-based analytical, managed care payor or provider environment
- considerable experience in statistical analysis and healthcare modeling
- Experience in designing and implement software solutions using .NET technologies, including C#, ASP.NET, and related frameworks preferred
- Experience in the the latest .NET technologies and trends
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Tech skills
Location requirements
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