- Centene Corporation (Jefferson City, MO)
- …and benefit development . Conducts risk assessments, including impact to member contract documentation and downstream output, and monitors pending legislation ... in the Continental United States **Position Purpose:** Responsible for creation of member contract documents, including Evidence of Coverage (EOC) and related… more
- HealthEdge Software Inc (Jefferson City, MO)
- …senior level role in analyzing claims data, as well as translating contract terms, policies, and regulatory guidelines into actionable requirements for our ... Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity… more
- The Cigna Group (Jefferson City, MO)
- The Investigator role is responsible for the development , investigation, and presentation of complex fraud and/or abuse cases. Using analytical skills, in-depth drug ... and prepare written summary/recommendations * Lead virtual interviews of member /providers and pharmacies as necessary to obtain necessary information regarding… more