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You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Note: To qualify for this Senior Actuarial Analyst role, you must have a Bachelor's degree and meet the Rule of 5. The Rule of 5 means your years of actuarial experience plus the number of actuarial exams passed must equal at least 5 (e.g., 2 years of experience and 3 exams passed). If you're already an ASA or FSA, please see our Associate or Actuary postings.*Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.*Position Purpose: <ul> <li> Assist in pricing, financial analysis, and risk assessment to estimate outcomes for Individual commercial (ACA) products. </li> <li> Support health plan specific actuarial needs and produce actuarial reports to aid in developing corporate strategy. </li> <li>Collaborate with actuaries and non-actuaries to assist with achieving well-rounded healthcare products. </li> </ul>In this Senior Actuarial Analyst role, you will: <ul> <li>Develop, analyze, and support optimizing pricing strategies for ACA Marketplace plans that consider the need for adequate premium rates and the competitive dynamics of a market </li> <li>Review key pricing inputs and assumptions, including experience, reimbursement, and morbidity analyses</li> <li>Lead the rate filing process in at least one state/market, including preparing rate filings and effective communication with federal and state regulators</li> <li>Serve as the main point of contact for all actuarial related activities for an assigned health plan</li> <li>Research and analyze the impact of various federal and state legislative/regulatory changes</li> <li>Performs other duties as assigned</li> <li>Complies with all policies and standards</li> </ul>What is appealing about this role: We are a highly collaborative actuarial team with varying levels of experience. This role will have the opportunity to:<ul> <li>Work directly with company leaders to provide actuarial input on pricing strategies</li> <li>Dive into interesting, complex problems while maintaining work / life balance</li> <li>Even though this role is fully remote, we maintain strong lines of communication with all team members to foster a community</li> <li>This will be an Individual Contributor role with future opportunity to move into a management track</li> <li>We also have a highly competitive study program and full managerial support of study hours</li> </ul>Education/Experience: Bachelor's degree in related field or equivalent experience. Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams.License/Certification: Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams.Highly preferred skills:<ul> <li>ACA pricing related experience, including rate filing submissions, or an equivalent background in pricing/rate setting for health insurance products</li> <li>Excel, R/R-Studio, SQL</li> <li>Strong financial acumen, with a solid grasp of financial and actuarial principles within a health context</li> <li>Strong attention to detail and written and verbal communication skills, with a proven record of being able to communicate complex actuarial concepts to a variety of audiences</li> </ul>Pay Range: $68,700.00 - $123,700.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Oklahoma Complete Health

Sr Actuarial Analyst - ACA

American Electric Power

Project Cost Analyst - Project Cost Analyst Sr.

CompanyCox Communications, Inc.Job Family GroupSalesJob ProfileSr. Solutions Engineer - CCIManagement LevelManager - Non People Leader Flexible Work Option Can work remotely but need to live in the specified city, state, or regionTravel %Yes, 25% of the timeWork ShiftDayCompensationCompensation includes a base salary of $126,200.00 - $189,200.00. The salary rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's experience. In addition to the salary range identified herein, this role is also eligible for an annual incentive/commission target of $52,800.00.Job DescriptionOur Sales SA positions will require 25-35% travel to conferences, partner offices, and customer sites. At RapidScale, exceptional technology is powered by exceptional people. As a growing leader in secure, reliable managed cloud solutions, we help SMBs and enterprises alike simplify IT and unleash innovation. With a broad portfolio spanning AWS, Azure and Google to a full set of Private Cloud and Cybersecurity solutions, RapidScale helps companies turn technology into their biggest competitive advantage. As part of the Cox family of companies, we offer best-in-class benefits, a commitment to work-life balance, and an award-winning workplace experience. We are seeking a highly skilled and experienced Data Solutions Architect to join our dynamic team. The ideal candidate will have a deep understanding of data architecture, data engineering, and data management, coupled with a strong background in Pre-Sales Solution Architecture. You will be responsible for educating clients on data strategies, articulating how our data experts can help them build robust data solutions, and overseeing data project plans and contracts that drive business value for our clients. This role requires a blend of technical expertise, strategic thinking, and excellent communication skills.Key Responsibilities:<ul> <li>Represent the technical expertise of RapidScale and act to position RapidScale as a trusted data advisor to customers in the sales process.</li> <li>Conduct full technical discovery and assessment workshops to identify pain points and gather business and technical requirements from prospective customers who are looking to modernize their data infrastructure on AWS, Azure, and Google Cloud.</li> <li>Conduct workshops on data strategy, data warehousing, data lake architecture, and cloud-based data processing solutions.</li> <li>Consult with prospects and architect data solutions on public cloud platforms, leveraging your deep experience with cloud-native and third-party data services (e.g., Amazon Redshift, BigQuery, Snowflake, Databricks, Synapse Analytics, etc.).</li> <li>Produce cost and labor estimates and SOWs for potential data-related projects.</li> <li>Collaborate and participate in the creation of technical collateral, documentation, pitch and presentation materials (e.g., SOWs, HLDs, Decks, Reference Architectures).</li> <li>Provide technical training sessions and workshops for Sales and Go-to-Market staff.</li> <li>Clearly document and communicate proposed architectures to implementation teams during and after the pre-sales cycle to validate and verify project success.</li> <li>Interface with the Product team and provide feedback for improving product quality and capabilities by leveraging information gathered in field engagements.</li> <li>Provide thought leadership by speaking at industry events such as trade shows, panels, or marketing events as well as publishing blog posts, white papers, and participating in case studies.</li> </ul>Qualifications:Minimum:<ul> <li>High School Diploma/GED and 7 years’ experience in a related field.<ul> <li>The right candidate could also have a different combination, such as any level degree/certification beyond a HS diploma/GED in a related discipline and 5 years’ experience; or 9 years’ experience in a related field</li> <li>Professional or Expert-Level certification in one or more major cloud platforms (AWS, Azure, Google Cloud).</li> </ul> </li> <li>Experience working in fast-paced sales environments, particularly in pre-sales solution architecture.</li> <li>Must have Professional or Expert-Level certification on one or multiple major cloud platforms (AWS, Azure, Google Cloud).</li> <li>Expertise in data architecture, data modeling, and database design.</li> <li>Understanding of cloud-based data storage, processing, and integration technologies.</li> <li>Expertise in database and data warehousing technologies such as SQL, NoSQL, and distributed databases.</li> <li>Experience with modern data platforms, including data lakes, warehouses, and ETL/ELT pipelines.</li> <li>Understanding of AWS, Azure, and/or Google Cloud data services (e.g., Amazon RDS, Google BigQuery, Azure Synapse, etc.).</li> <li>Familiarity with data governance, security, and compliance best practices.</li> <li>Hands-on experience with cloud migrations and data modernization initiatives.</li> <li>Understanding of containerization &amp; virtualization technologies (e.g., Kubernetes, Docker, EKS, ECS, etc.).</li> <li>Experience with Infrastructure as Code (IaC) tools (e.g., Terraform, CloudFormation, Ansible, Puppet).</li> </ul>Preferred:<ul> <li>Data specialty certification (cloud-agnostic or platform-specific).</li> <li>Proficiency and/or willingness to pursue expertise across multiple clouds (AWS, Azure, Google Cloud).</li> <li>Experience with data pipelines, data transformation, and data orchestration tools (e.g., Apache Airflow, dbt, Glue, Dataflow, Data Factory, etc.).</li> <li>Knowledge of AI readiness strategies, ensuring data infrastructures are optimized for AI/ML adoption.</li> <li>Understanding of data science workflows, feature stores, and MLOps frameworks.</li> </ul>BenefitsThe Company offers eligible employees the flexibility to take as much vacation with pay as they deem consistent with their duties, the company’s needs, and its obligations; seven paid holidays throughout the calendar year; and up to 160 hours of paid wellness annually for their own wellness or that of family members. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Cox Communications is all about creating moments of real human connection; and for employees, that’s true both in the workplace and in the problems we solve for customers. From building advertising solutions to unleashing IoT technologies to creating an exceptional experience for customers in our retail locations and online, we’re creating a world that is smarter and more connected. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer – All qualified applicants/employees will receive consideration for employment without regard to that individual’s age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. In California, we will consider non-driving candidates who use alternate means of transportation in accordance with applicable law.<h3> </h3>Application Deadline: 05/29/2025

Cox Communications

Data Solutions Architect (RapidScale)

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: As part of Fidelis Care, a subsidiary of Centene, the Senior Healthcare Analyst provides analytic support for financial modeling, trend analysis, therapeutic class strategy, and initiative implementation and measurement. Develops custom reports and models used in identifying issues, trends, patterns and relationships to be applied in financial and operational decisions.*Candidates residing in EST time zone, preferred. The role is fully remote and may have 10% travel.<ul> <li>Develops financial models to project cost or estimate savings for specific business decisions.</li> <li>Develops and manages therapeutic class cost and utilization projection models to support budget forecasting, pricing, and strategy development.</li> <li>Develops exception reporting and conducts drill down analysis to proactively identify specific opportunities and risks that warrant assessment by the Strategy Development Committee.</li> <li>Develop data analytics solutions using Power BI.</li> <li>Use SQL to query, manipulate, and manage large datasets efficiently.</li> <li>Gather and clean data from various sources, ensuring accuracy and completeness.</li> <li>Present insights to stakeholders in a clear and actionable format.</li> <li>Analyze large datasets to identify trends, patterns, and insights.</li> <li>Monitors projection targets. Analyzes, researches, and interprets results, variances, and trends.</li> <li>Prepares and maintains strategy documents for therapeutic classes.</li> <li>Prepares and communicates trend analysis and recommendations verbally and in writing to committees, clinical staff, management, and clients.</li> <li>Develops and manages reporting templates used to analyze and interpret data.</li> <li>Designs complex ad hoc reports to support a variety of functional areas.</li> <li>Advises Healthcare Analysts in producing reports and interpreting data.</li> </ul>Education/Experience: ​<ul> <li>Bachelor’s degree in business, finance, public health, health informatics or related field required. Master's degree preferred.</li> <li>Minimum five years related experience with minimum two years financial modeling experience required.</li> <li>Experience in Healthcare analytics of financial/clinical data, with knowledge of analytical or data mining techniques including data modeling, trend analysis, and root-cause analysis strongly preferred.</li> <li>Experience using advanced analytical/reporting tools such as R, Python, SAS, SQL, Snowflake, Micro-strategy, Tableau, Hadoop, or related tools strongly preferred.</li> </ul>Pay Range: $68,700.00 - $123,700.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Senior Healthcare Analyst

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.Position Purpose: Responsible for the timely, consistent, and accurate communication of state and federal regulatory updates related to the regulatory filing of commercial plans. Prepares, organizes, and submits the annual QHP and Off-Exchange product filings for assigned states using Health Insurance Oversight System (HIOS) and System for Electronic Rates &amp; Forms Filing (SERFF).<ul> <li>Monitors regulatory guidance and requirements affecting Centene’s commercial products. Analyzes, interprets, summarizes and distributes regulatory filing guidance to impacted cross-functional departments. Provides guidance to business to help them understand regulatory filing requirements and timelines.</li> <li>Executes timely and accurate formal regulatory filings, including the annual QHP and off-exchange product filings, seeking approval of our commercial health products within Health Insurance Oversight System (HIOS) and System for Electronic Rates &amp; Forms Filing (SERFF) for assigned states ensuring deliverables spanning across multiple departments are received and appropriately filed.</li> <li>Acts as the primary contact between Regulators and the company, supporting communication during the filing season as needed. Manages relationship with regulatory agencies (Department of Insurance and Centers for Medicare &amp; Medicaid Services (CMS)) related to the commercial filings. Leads responses to DOI objections and CMS correction communications for assigned states. Partners closely with health plans in managing relationships with regulatory agencies, including state regulators and State Based Exchanges.</li> <li>Conducts assigned special projects and maintains multiple critical trackers related to filing work. Should have the ability to understand the needs of internal and cross-functional departments and communicate those needs effectively at the appropriate level of detail for the audience.</li> <li>Performs regulatory filing research to aid in the development of new products and initiatives for the Enterprise related to commercial products. Responsibility for understanding regulations and business needs for multiple states, as well as federal regulations pertaining to the commercial health insurance market.</li> <li>Interprets and distributes data collected throughout the filing season to aid in proactively updating processes for ongoing improvement across multiple departments.</li> <li>Creates and maintains a deliverables chart which outlines all required documents needed for state specific filings. Audits trackers and deliverable for assigned states to ensure consistency and quality across teams.</li> <li>Develop trust-based relationships and collaborates with other functional areas to collect information, follow up with team and others for project deliverables and serves as a Subject Matter Expert. Leads sub-projects and smaller initiatives.</li> <li>Maintains and implements department policies, procedures, and work processes.</li> <li>Identifies, analyzes, and manages resolution of filing related issues for low risk states. May attend external and/or virtual conferences and seminars to evaluate industry trends.</li> <li>Performs other duties as assigned.</li> <li>Complies with all policies and standards.</li> </ul>Education/Experience:<ul> <li>Bachelor's Degree Business, Communications, Healthcare, Political Science/ Pre-Law or equivalent experience required.</li> <li>3+ years Regulatory experience, including product regulatory filings (CMS and/ or State DOI).</li> <li>Experience in commercial health insurance required.</li> </ul>Pay Range: $26.50 - $47.59 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Regulatory Operations Filing Analyst II

About Lumen Lumen connects the world. We are igniting business growth by connecting people, data and applications – quickly, securely, and effortlessly. Together, we are building a culture and company from the people up – committed to teamwork, trust and transparency. People power progress. We’re looking for top-tier talent and offer the flexibility you need to thrive and deliver lasting impact. Join us as we digitally connect the world and shape the future. <h2>The Role</h2> Are you motivated by driving business outcomes and interested in partnering closely with the business leadership in Lumen? Does working with agility in a fast-paced environment sound exciting? The Lead Analyst will provide business partnering, financial analysis and insight for business and finance leadership, supporting the Product organization in achieving their operating expense (opex) objectives. This role is expected to take ownership of partnering with business leadership and delivering insightful analysis and reporting. This will require a strong analytical, reporting and business partnering mindset to drive performance, communicate risks and opportunities and build strong relationships with senior stakeholders. <h2>Location</h2> This is a remote opportunity open to candidates located anywhere in the U.S. <h2>The Main Responsibilities</h2> <ul> <li>Analysis and reporting of month-end results, variance analysis and commentary.</li> <li>Budgeting, forecasting and analytics across the Product organization, to ensure high quality outputs and identification of opportunities and risks to business performance.</li> <li>Deep financial analysis, model and report creation, insight generation and business partner communication; high acumen in modelling financial outcomes, utilizing multiple inputs and data tools.</li> <li>Build insightful reporting to monitor key metrics across the Product organization, for use in modelling and building accurate financial projections.</li> <li>Effectively communicate with business stakeholders to ensure risks and opportunities are understood and addressed.</li> <li>Partner with business leadership and stakeholders, ensuring effective communication, delivery of commitments, and accurate and timely deliverables.</li> <li>Creation and simplification of standardized reporting and outputs, through various tools such as Excel, Power BI and Power Query.</li> </ul> <h2>What We Look For in a Candidate</h2> Required <ul> <li>Proven ability to take high level direction and produce results which show thought leadership and drive value creation for the business with limited supervision.</li> <li>Savvy in solving complicated data and analytical challenges – evolves reporting and analysis to guide business and drive impact more effectively (individually and through team members).</li> <li>Thrives on continuous improvement - simplifying and automating processes and data using technology, while taking a hands-on approach to getting into the detail.</li> <li>A strong communicator with business partnering background and a proven track record at building relationships with stakeholders.</li> <li>Self-motivated; manages and prioritizes multiple deadlines and deliverables.</li> <li>Creative approach to problem solving, with a predisposition to look for root causes and implement lasting change rather than quick fixes.</li> <li>Attention to detail – spots underlying trends and inconsistencies in financial data and analysis.</li> <li>Skilled in advanced Microsoft Excel functionality (experience with Power Query, SQL or Power BI a significant advantage).</li> </ul> Preferred <ul> <li>Experience with analytic and business intelligence software (Power BI, Essbase, SAP).</li> <li>Understanding of data manipulation and analytical tools such as SQL, Power BI or Power Query. </li> <li>Finance focused degree (or equivalent education).</li> <li>Previous business partnering experience within the Technology industry would be advantageous. </li> <li>Strong Commercial or Business Finance background.</li> <li>Ability to communicate data-driven insights through charts and visuals. </li> </ul> <h2>Compensation</h2> This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Individual pay is based on skills, experience and other relevant factors. Location Based Pay Ranges: $82,969 - $110,625 in these states: AL, AR, AZ, FL, GA, IA, ID, IN, KS, KY, LA, ME, MO, MS, MT, ND, NE, NM, OH, OK, PA, SC, SD, TN, UT, VT, WI, WV, and WY. $87,117 - $116,156 in these states: CO, HI, MI, MN, NC, NH, NV, OR, and RI. $91,266 - $121,688 in these states: AK, CA, CT, DC, DE, IL, MA, MD, NJ, NY, TX, VA, and WA. Lumen offers a comprehensive package featuring a broad range of Health, Life, Voluntary Lifestyle benefits and other perks that enhance your physical, mental, emotional and financial wellbeing. We're able to answer any additional questions you may have about our bonus structure (short-term incentives, long-term incentives and/or sales compensation) as you move through the selection process. Learn more about Lumen's: <ul> <li><a href="https://jobs.lumen.com/global/en/benefits-statement" target="_blank">Benefits</a></li> <li><a href="https://jobs.lumen.com/global/en/compensation-information" target="_blank">Bonus Structure</a></li> </ul> Requisition #: 337119 Background Screening If you are selected for a position, there will be a background screen, which may include checks for criminal records and/or motor vehicle reports and/or drug screening, depending on the position requirements. For more information on these checks, please refer to the Post Offer section of our <a href="https://jobs.lumen.com/global/en/faq" target="_blank">FAQ page</a>. Job-related concerns identified during the background screening may disqualify you from the new position or your current role. Background results will be evaluated on a case-by-case basis. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Equal Employment Opportunities We are committed to providing equal employment opportunities to all persons regardless of race, color, ancestry, citizenship, national origin, religion, veteran status, disability, genetic characteristic or information, age, gender, sexual orientation, gender identity, gender expression, marital status, family status, pregnancy, or other legally protected status (collectively, “protected statuses”). We do not tolerate unlawful discrimination in any employment decisions, including recruiting, hiring, compensation, promotion, benefits, discipline, termination, job assignments or training. Disclaimer The job responsibilities described above indicate the general nature and level of work performed by employees within this classification. It is not intended to include a comprehensive inventory of all duties and responsibilities for this job. Job duties and responsibilities are subject to change based on evolving business needs and conditions. In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information. Please be advised that Lumen does not require any form of payment from job applicants during the recruitment process. All legitimate job openings will be posted on our official website or communicated through official company email addresses. If you encounter any job offers that request payment in exchange for employment at Lumen, they are not for employment with us, but may relate to another company with a similar name. Application Deadline 03/01/2025

CenturyLink

Lead Finance Analyst Product & Technology

The Opportunity At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The Operations Transformation and Technical Quality Operations organizations include diverse teams of Quality Analysts that address core business challenges within MetLife. This role will conduct quality reviews of the Return to Health clinical team, collecting and analyzing quality opportunities and root causes to ensure quality standards are achieved. How You’ll Help Us Build a Confident Future (Key Responsibilities) <ul> <li>Conducts clinical quality reviews of the Vocational Rehabilitation Counselors (VRC) within the Vocational Health Unit (VHU) for the Return to Health organization.</li> <li>Identifies trends, root causes, and areas of opportunity from the analysis of data developed from the completed quality reviews.</li> <li>Provides consistent, timely, and meaningful feedback regarding behaviors identified and quality standards.</li> <li>Participates in problem solving discussions and proposes potential solutions to identified areas of opportunity with the Return to Health organization to drive results.</li> <li>Detects, analyzes, and presents Objective and Key Results to operational partners on an ongoing basis.</li> <li>Collaborates within a team dynamic to promote and sustain a culture of quality improvement.</li> </ul> What You Need to Succeed (Required Qualifications) <ul> <li>MA/MS in Rehabilitation Counseling and 5+ years of relevant experience </li> <li>Advanced written and verbal communication skills </li> <li>Ability to provide constructive feedback at all levels and build relationships through these interactions</li> <li>Desire and ability to cross train into additional health unit(s) to expand scope of quality reviews</li> <li>Demonstrated critical thinking, attention to detail, analysis, and problem-solving skills </li> <li>Microsoft Office, Power Point, and Excel knowledge </li> <li>Ability to work independently and as a team</li> <li>Certified Rehabilitation Counselor (CRC) certification or Behavior Health experience (LCMHC or LCSW license).</li> </ul> What Can Give You an Edge (Additional Skills) <ul> <li>Strong knowledge of psychiatric conditions, symptoms, and terminology.</li> <li>Certified Rehabilitation Counselor (CRC) certification and Behavior Health experience (LCMHC or LCSW license). </li> </ul>

MetLife

Behavior Health Senior Quality Analyst

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary CVS Health has an exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for researching, resolving, and communicating any issues, questions, or concerns our members have about their coverage and benefits provided through Medicare Part D. You will have the opportunity to work cross functionally with different departments within CVS Health to support the research into these members’ issues. Once resolved you will be responsible for outreach to each member with a verbal and/or written response explaining the resolution of the issues. As you support our Med D members, we will support you by offering all the tools and resources you need in a collaborative team-based environment. Our goal is to ensure you can provide top tier service and resolution for our members. We use our own emphasis on quality as well as government mandated turnaround times to ensure we do our job effectively, always focusing on helping people on their path to better health. In order to be successful in this role you will need to be detail-oriented with proficient research skills and demonstrate the ability to analyze data, apply learnings, and construct a resolution in a timely manner. A successful Analyst is receptive to constructive feedback and flexible in adapting to change while effective in planning, prioritizing, and organizing their time and workload to achieve production goals and turnaround time requirements. Analysts are expected to close grievances cases daily, close 15-20 cases per week (depending on inventory) and close all cases within 25 days of TAT while maintaining the highest quality standards. In this position you will be measured by your ability to use your judgement to execute to reach these department goals. Additional responsibilities of the Analyst include creatively constructing written formal communication to members, multitasking, and working with up to 15 various computer applications and documenting the issue and resolutions in the database, while adhering to the strict turnaround times established by the Center for Medicare and Medicaid Services (CMS). Required Qualifications - 2 plus years of experience working within a customer service role on several computer applications and complex databases for research, including Microsoft Office products (Excel, Word, and Outlook). Preferred Qualifications - Previous experience within Pharmacy Benefit Management (PBM) or pharmaceutical related industry. - Previous Med D grievance experience. - Bachelors Degree Preferred. Education High School Diploma or equivalent General Education Degree (GED) Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$43,888.00 - $85,068.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 03/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Grievance Analyst (Caseworker)

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Executes and supports the enterprise IT Disaster Recovery and I/S Crisis process with the goal to ensure that the Enterprise Critical I/S services and work processes can be resumed with agreed upon service and resumption levels. Leads in Disaster Recovery requirements gathering and recommends recovery strategies and options. Facilitates the implementation of recovery solutions.<ul> <li>Develops and implements a business recovery plan and procedure; review, revise, and expand existing plans and protocols</li> <li>Develops, maintains, and implements the Enterprise Disaster Recovery Plans, risk assessments, and application and technical strategies together with other teams</li> <li>Conducts risk assessments for various departments and functions, analyzing potential business impact of unpredictable business interruptions such as natural disasters, security breach, legal claims, and market disruptions]</li> <li>Drives the alignment of IT organization priorities and plans with key business objectives</li> <li>Identifies, troubleshoots and implements recovery operations and methods to allow the company to function at limited or partial capacity in the event that part or all of the infrastructure is damaged or destroyed</li> <li>Creates and facilitates practice drills for plan execution</li> <li>Develops and track program metrics (as developed) to show activities and progress</li> <li>Reviews, configures and maintains business continuity and crisis management tools</li> <li>Coordinates with health, safety, and security staff and local, state, and federal agencies to align the organization's emergency management plan with established best practices and community standards</li> <li>Supports the event of a business disruption to manage the response coordination and communications</li> <li>Performs other duties as assigned</li> <li>Complies with all policies and standards</li> </ul>Education/Experience: A Bachelor's degree in a quantitative or business field (e.g., statistics, mathematics, engineering, computer science). Requires 4 – 6 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.Preferred Skills: <ul> <li>Ensure disaster recovery plans are robust, tested, and capable of meeting recovery point objectives (RPO) and recovery time objectives (RTO)</li> <li>Create and maintain disaster recovery capabilities and risk profiles</li> <li>Ensuring compliance standards</li> </ul> Soft Skills:<ul> <li>Intermediate - Seeks to acquire knowledge in area of specialty</li> <li>Intermediate - Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions</li> <li>Intermediate - Ability to work independently</li> <li>Intermediate - Demonstrated analytical skills</li> <li>Intermediate - Demonstrated project management skills</li> <li>Intermediate - Demonstrates a high level of accuracy, even under pressure</li> <li>Intermediate - Demonstrates excellent judgment and decision making skills</li> </ul> License/Certification:<ul> <li>Certified Business Continuity Professional (CBCP)</li> <li>Crisis Communication Certified Expert (CCCE)</li> <li>Disaster Recovery Certified Planner (DRCP)</li> <li>Master Business Continuity Professional Certification (MBCP)</li> </ul>Pay Range: $85,300.00 - $158,100.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Senior Disaster Recovery Analyst

Req ID: 76276 Location: Tulsa -TUL Areas of Interest: Bank Operations Pay Transparency Salary Range: Not Available Application Deadline: 04/06/2025 BOK Financial Corporation Group includes BOKF, NA; BOK Financial Securities, Inc. and BOK Financial Private Wealth, Inc. BOKF, NA operates TransFund and Cavanal Hill Investment Management, Inc. BOKF, NA operates banking divisions: Bank of Albuquerque; Bank of Oklahoma; Bank of Texas and BOK Financial®. <h2>Bonus Type</h2> Discretionary <h2>Summary</h2> The bank operations team supports smooth financial transactions and innovative infrastructure modernization. They excel in system integration, secure data handling, and fostering a collaborative workplace. By prioritizing risk mitigation alongside regulatory compliance, operational resilience, and cost-effective management, they fuel the bank’s growth and success. <h2>Job Description</h2> Adjustments Analyst are responsible for researching, analyzing, and resolving complex discrepancies related to financial transactions across all lines of business. This role ensures accurate and timely adjustments are made to customer and internal general ledger accounts, maintaining the integrity of financial data, and providing exceptional service to both internal and external clients, while working to mitigate against loss, due to fraud and regulatory guidelines. <h2>Team Culture</h2> Our culture is built on collaboration and partnership, where we prioritize building strong relationships. We are dedicated to exceeding expectations by delivering top-quality products, services, and advice, while ensuring effective communication and portfolio growth. By creating streamlined solutions, mitigating risk, and increasing scalability, we support continuous operations and organizational resilience, all while aligning our goals with the business lines we support to ensure the safety of our customers and the bank. <h2>How You'll Spend Your Time</h2> <ul> <li>You will conduct investigations into disputed transactions and resolve them according to bank policies, industry rules, and regulations.</li> <li>You will manage and promptly process a portfolio of various adjustment cases in line with regulatory requirements.</li> <li>You will review communications from financial institutions and partners to identify issues and determine actions.</li> <li>You will complete financial entries to rectify cases, working with clearinghouses and peer banks to manage funds.</li> <li>You will maintain detailed records of adjustments and communications, ensuring regulatory compliance.</li> </ul> <h2>Education &amp; Experience Requirements</h2> This level of knowledge is normally acquired through completion of an associate degree in finance or Bank Accounting related fields and 2-3 years of related experience in complex case management resolution and/or Adjustments processing or equivalent combination of education and experience. <ul> <li>Ability to analyze and interpret financial data to identify discrepancies and determine corrective actions.</li> <li>Working knowledge of accounting principals</li> <li>High level of accuracy in reviewing transactions and processing adjustments.</li> <li>Strong problem-solving skills to investigate and resolve complex issues efficiently.</li> <li>Excellent verbal and written communication skills for interacting with clients, colleagues, and external institutions.</li> <li>Strong customer service skills to effectively address client inquiries and concerns.</li> <li>Ability to manage multiple tasks and prioritize workloads to meet deadlines.</li> <li>Capability to work collaboratively within a team and across departments.</li> <li>Understanding of relevant banking regulations and compliance requirements.</li> <li> Exceptional organizational abilities to maintain detailed records and documentation.</li> <li>Flexibility to adapt to changing processes and procedures.</li> <li>Commitment to maintaining confidentiality and handling sensitive information securely.</li> </ul> BOK Financial Corporation Group is a stable and financially strong organization that provides excellent training and development to support building the long term careers of employees. With passion, skill and partnership you can make an impact on the success of the bank, customers and your own career! Apply today and take the first step towards your next career opportunity! The companies in BOK Financial Corporation Group are equal opportunity employers. We are committed to providing equal employment opportunities for training, compensation, transfer, promotion and other aspects of employment for all qualified applicants and employees without regard to sex, race, color, religion, national origin, age, disability, pregnancy status, sexual orientation, genetic information or veteran status. Please contact <a href="#">recruiting_coordinators@bokf.com</a> with any questions.

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