Payments Finance And Reconciliation Manager in United States

Become a part of our caring community The Regional Senior TRICARE Community Liaison (TCL) is an important Humana Military representative committed to operational excellence, consistency, and accountability in the administration of TRICARE services within a defined territory in the East Region. You will provide expert guidance to nationally contracted healthcare providers and support facilities who have footprints across both East and West Regions. The primary focus of the Regional Senior TCL is to develop and sustain strong, collaborative relationships with all National Health System providers in the East Region. You will be cover all National contracted providers and large health systems regardless of location or type of care provided. Through clear and concise written and verbal communication, the Regional Senior TCL ensures provider understanding of the TRICARE health plan, TRICARE Policy and Regulations and how to navigate the Military Health System. The Regional Senior TCL is self-directed and uses independent, critical decision-making in managing time, setting priorities, addressing general inquiries, and resolving both straightforward inquiries, complicated problems and concerns raised by providers. This position upholds rigorous operational standards and ensuring consistent, high-quality delivery of TRICARE services. You will support customer service, conduct outreach, maintain network adequacy and access to care. You will manage provider relations and education, and ensure effective provider management within the assigned area. You will lead the review of TRICARE inquiries, complaints, and concerns from beneficiaries, providers, and government personnel, ensuring a resolution through professionalism and integrity. Additional responsibilities involve supporting the implementation of Alternative Payment Methodologies and Demonstration Pilots that adv

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

Become a part of our caring community The Director, Provider Engagement leads a team of Provider Engagement associates responsible for developing and strengthening positive, long-term relationships with contracted physicians, provider groups, health systems, and ancillary providers across Humana's Medicare Advantage network. You drive provider engagement strategies focused on improving provider experience, quality outcomes, Star Ratings performance, value-based care adoption, risk adjustment performance, and operational excellence. You will report to the VP, Network Performance. You will serve as a key market leader, representing Provider Engagement across cross-functional initiatives and ensuring alignment between provider needs and Humana's strategic priorities. Lead, develop, and support a team of up to 13 Provider Engagement associates responsible for managing relationships with contracted providers and healthcare organizations. Establish team strategy, operating processes, and performance expectations aligned with organizational objectives. Conduct regular performance evaluations and provide coaching, mentoring, and professional development opportunities. Foster a culture of accountability, collaboration, continuous improvement, and provider-centric engagement. Monitor performance against established key performance indicators and organizational goals. Build and sustain strong relationships with value-based provider partners. Represent Humana at key provider meetings, association events, market forums, and strategic provider discussions. Develop and execute provider engagement strategies that support Medicare Star Ratings improvement and quality performance objectives. Partner with provider organizations to drive performance within value-based payment arrangements and alternative payment mode

Location Details: United States, Remote At GoDaddy the future of work looks different for each team. Some teams work in the office full-time; others have a hybrid arrangement (they work remotely some days and in the office some days) and some work entirely remotely.​ This is a remote position, so you’ll be working remotely from your home. You may occasionally visit a GoDaddy office to meet with your team for events or meetings. This position is not eligible to be performed in Alaska, Mississippi, North Dakota, or the Virgin Islands. Join our team We are seeking a strategic and transformational leader to oversee GoDaddy's Commerce Support organization. This leader will define and execute the strategy for merchant activation, adoption, retention, and support while leading AI-enabled transformation that drives scalable growth across GoDaddy's Commerce business. The Director will lead teams supporting merchants across onboarding, activation, payment processing, product adoption and attach , issue resolution, and ongoing success. Partnering closely with Product, Engineering, Sales, Risk, and Go-to-Market teams, this role will shape the future of merchant experiences through AI, automation, data-driven decision making, and operational innovation. What you'll get to do... Define & Drive Business Strategy Develop and drive the strategic roadmap for merchant activation, adoption, retention, and growth Establish organizational priorities aligned to business outcomes and customer success Partner with senior leaders across Commerce, Care, Sales, GTM, Risk, Product, and Engineering to influence strategy and execution Evaluate market trends, customer needs, and emerging opportunities to shape future capabilities Determine areas of opportunity and strategy to further growth with merchants across the GoDaddy portfolio (e.g., AAB, email ) , beyond the Commerce suite of products/services Drive AI & Support Transformation Establis

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary As the Senior Lead Coordinator you will be responsible for implementing and maintaining comprehensive billing review processes. You will identify and quantify trends/issues and effectively communicate/report them to the appropriate members of the management team and payer business partners along with the potential impact. You will assist leadership in building and maintaining a high performing highly engaged team. In this role you will also provide excellent mentorship and support to your colleagues as well as design and implement training classes. The key responsibilities of the Medical Revenue Cycle Senior Lead Coordinator are: Review and analyze patient profiles, benefits, and prior authorizations to identify potential issues affecting clean claims. Collaborate with clinical and administrative teams to ensure accurate documentation is maintained and available for claims processing. Monitor claims submissions and follow up on pending claims to expedite resolution and payment. Identify trends in claims denials and develop strategies for improvement. Conduct training sessions for staff on best practices for claims submissions and compliance. Maintain up-to-date knowledge of insurance policies, regulations, and healthcare trends that impact claims

Replit is the agentic software creation platform that enables anyone to build applications using natural language. With millions of users worldwide, Replit is democratizing software development by removing traditional barriers to application creation. About the Role We're hiring a hands-on Engineering Manager to build and lead Replit's Anti-Abuse team from the ground up. This is a foundational 0-to-1 role: you'll define the anti-abuse roadmap, hire a small team of engineers and data analysts, and ship the systems that protect Replit's platform, users, and economics from adversarial actors. You'll partner across Support, Legal, Security, Infrastructure, and the Money and Growth teams to make abuse economically unviable while keeping friction low for legitimate users. Replit sits at the frontier of AI-native abuse. Our platform is a target for phishing and scam hosting, cryptomining, LLM token farming, card and coupon fraud, and increasingly, abuse driven by AI agents themselves. The team you build will define how Replit defends against all of it. What You'll Do Build the anti-abuse roadmap from scratch : Define the threat model, prioritize across abuse vectors (phishing/scam hosting, cryptomining, token farming, payment fraud, AI agent exploitation), and translate it into a shipping plan with clear sequencing and tradeoffs. Design progressive verification and identity infrastructure : Build the "ladder of trust" that gates increasing platform capabilities (referrals, additional credits, access to powerful agent features, Missions) behind escalating verification. This includes a humanity/identity layer that's distinct from user accounts, integrations with KYC-grade verification providers, and the policy engine that decides what level of trust unlocks what behavior. This infrastructure is core not just to promo integrity but to how Replit safely expands agent capabilities over time. Ship as a hands-on EM : Stay in the code. Use the latest AI coding tools (including Rep

Every day, tens of millions of people come to Roblox to explore, create, play, learn, and connect with friends in 3D immersive digital experiences– all created by our global community of developers and creators. At Roblox, we’re building the tools and platform that empower our community to bring any experience that they can imagine to life. Our vision is to reimagine the way people come together, from anywhere in the world, and on any device. We’re on a mission to connect a billion people with optimism and civility, and looking for amazing talent to help us get there. A career at Roblox means you’ll be working to shape the future of human interaction, solving unique technical challenges at scale, and helping to create safer, more civil shared experiences for everyone. Roblox is seeking a Content Designer to join our Monetization team and drive the future of our platform's economy. In this role, you will play a crucial role in defining the content strategy and information architecture of strategic initiatives across Monetization, creating seamless and compelling experiences that empower both our users and creators. You will be a key player in shaping how we grow revenue, enhance developer earnings, and evolve our core monetization offerings within the Roblox ecosystem. You Will: Own and deliver UX content for key monetization surfaces and flows at Roblox, from early exploration through launch Develop a deep understanding of user and developer needs, behaviors, and motivations to inform content design decisions across payment, purchase, and monetization experiences Bring a fresh perspective and deep industry knowledge to drive innovation in monetization design Collaborate with product managers, designers, researchers, and engineers to ensure experiences are valuable, understandable, and easy to use Apply UX writing and content strategy to improve clarity, usability, and engagement across player, parent, and creator experiences Contribute to building

Every day, tens of millions of people come to Roblox to explore, create, play, learn, and connect with friends in 3D immersive digital experiences– all created by our global community of developers and creators. At Roblox, we’re building the tools and platform that empower our community to bring any experience that they can imagine to life. Our vision is to reimagine the way people come together, from anywhere in the world, and on any device. We’re on a mission to connect a billion people with optimism and civility, and looking for amazing talent to help us get there. A career at Roblox means you’ll be working to shape the future of human interaction, solving unique technical challenges at scale, and helping to create safer, more civil shared experiences for everyone. As an Economy Fraud engineer, you defend Roblox from all types of fraud, including theft, scams, money laundering, and payment fraud. Roblox is a high-growth, unique product environment. You will be developing anti-fraud and abuse solutions for web, mobile, and 3D environments. This high impact work and your innovation is critical for the well-being of our community and to the future of our company. We aim for our users to have peace of mind that their communities and transactions are protected. Our defenses also protect our company’s rapid expansion and safeguard billions in revenue. Roblox’s virtual marketplace handles over 4 million transactions a day, and enables our top developers to make millions of dollars a year. Our team’s challenges are not just regular day-to-day technical challenges. Fraud and abuse approaches need to shift over time, depending on the current behaviors of fraudsters. As an Economy Fraud engineer, you will be in a data-driven environment developing both classical and novel approaches to detect and prevent this bad behavior. You Have: 4+ years of professional experience working with scalable, distributed systems Strong experience in large-scale, data-driven

At Snowflake, we are powering the era of the agentic enterprise. To usher in this new era, we seek AI-native thinkers across every function who are energized by the opportunity to reinvent how they work. You don’t just use tools; you possess an innate curiosity, treating AI as a high-trust collaborator that is core to how you solve problems and accelerate your impact. We look for low-ego individuals who thrive in dynamic and fast-moving environments and move with an experimental mindset — who rapidly test emerging capabilities to discover simpler, more powerful ways to deliver results. At Snowflake, your role isn't just to execute a function, but to help redefine the future of how work gets done. About the Monetization team: Snowflake Marketplace serves as the vibrant hub which enables customers to do more with data. We are building a platform that empowers organizations to seamlessly discover, access, and build with datasets, applications, and AI agents. The monetization team owns the commerce layer of the Snowflake Marketplace — building the end-to-end transactional infrastructure and buyer/seller experiences that power how data and AI products are priced, purchased, and settled across Snowflake's global ecosystem. AS A SENIOR FULLSTACK ENGINEER YOU WILL: Build and own end-to-end full-stack features — from polished React-based checkout and billing UIs to the backend services that process, validate, and settle marketplace transactions at scale Design and implement robust backend APIs and services in Java or Python that handle the lifecycle of commercial transactions: entitlements, metering, invoicing, and payment orchestration Develop reusable, accessible React component libraries and frontend systems that give buyers and sellers clear visibility into usage, spend, and revenue — working closely with design to deliver intuitive experiences Contribute to the reliability, correctness, and observability of high-stakes transactional pipelines — including fraud preventio