Health plan of san mateo jobs in Newark, New JerseyCreate job alerts

Monitor Health Plan Compliance: Review and audit of self-funded health plan financial processes to ensure compliance with contractual obligations, regulatory requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. Audit Planning and Exec

Manage an Out-of-Network strategy that addressed high cost out-of-network cases for all lines of business, but primarily for the Commercial and Exchange products. Coordinate MetroPlusHealth's network development and contracting strategy as MetroPlusHealth expands into new lines of business. Minimum

Review and audit of self-funded health plan financial processes to ensure compliance with contractual obligations, regulatory requirements, and internal policies related to the payment of daily healthcare claims and monthly administrative fees. The Office of Labor Relations (OLR) represents the Mayo