Provider Contracting Professional in United States

About The Weather Company: The Weather Company is the world’s leading weather provider, helping people and businesses make more informed decisions and take action in the face of weather. Together with advanced technology and AI, The Weather Company’s high-volume weather data, insights, advertising, and media solutions across the open web help people, businesses, and brands around the world prepare for and harness the power of weather in a scalable, privacy-forward way. The world’s most accurate forecaster globally, the company reaches hundreds of enterprise clients and more than 360 million monthly active users via its digital properties from The Weather Channel (weather.com) and Weather Underground (wunderground.com). AI is part of how we work: Human judgment, expertise, and creativity remain essential and are amplified by AI. We expect everyone in this role to use AI thoughtfully and proactively to accelerate their performance, improve the quality of their work, and explore new possibilities. We are looking for people who are curious, adaptable, and excited to help shape an AI-enabled culture that delivers better outcomes for our customers and our company. Job brief: We are seeking a Lead of Data Instrumentation & Growth Measurement to serve as the connective tissue between Product (Web, iOS, Android) and Marketing (Lifecycle, Performance Marketing). In this role, you will eliminate data disparity, establish a unified enterprise event taxonomy, manage Server-Driven UI (SDUI) dynamic tracking schemes, and lead incrementality testing to ensure marketing spend is optimized. You will also oversee performance marketing capabilities, configuring Server-Side Tagging (CAPI), Google Tag Manager (GTM), and a targeted GA4 conversion infrastructure. You will partner with product managers, developers, and specialized agency partners to overhaul our Amplitude environment and build transparent attribution pipelines. The impact you'll

About The Weather Company: The Weather Company is the world’s leading weather provider, helping people and businesses make more informed decisions and take action in the face of weather. Together with advanced technology and AI, The Weather Company’s high-volume weather data, insights, advertising, and media solutions across the open web help people, businesses, and brands around the world prepare for and harness the power of weather in a scalable, privacy-forward way. The world’s most accurate forecaster globally, the company reaches hundreds of enterprise clients and more than 360 million monthly active users via its digital properties from The Weather Channel (weather.com) and Weather Underground (wunderground.com). AI is part of how we work: Human judgment, expertise, and creativity remain essential and are amplified by AI. We expect everyone in this role to use AI thoughtfully and proactively to accelerate their performance, improve the quality of their work, and explore new possibilities. We are looking for people who are curious, adaptable, and excited to help shape an AI-enabled culture that delivers better outcomes for our customers and our company. Job brief: The Weather Company reaches hundreds of millions of people through the world's most-used weather apps. We're hiring our first dedicated Growth PM to own how new and existing users discover value — starting with onboarding and activation, then expanding into the habit and retention loops that turn casual weather-checkers into daily users. The impact you'll make: Drive Core Business Metrics: Measurably improve Day 0 (D0) registration and subscription conversion rates across our primary growth funnels. Expand Engagement Touchpoints: Increase notification opt-in rates and drive surface-level engagement through higher widget adoption. Accelerate Experiment Velocity: Scale our experimentation framework to ship more tests per quarter and shorten decision-making cycles. Unify the Cross-Platform Experien

Become a part of our caring community The Medical Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. You will report to the Manager, Medicare Risk Adjustment. As the Medical Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions. Work with teams to improve documentation, data integrity, and workflow processes Use your skills to make an impact Required Qualifications AHIMA or AAPC CPC (Certified Professional Coder) Certification 3 or more years of medical coding education or auditing in a healthcare setting experience Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience interpreting large data sets Demonstrated knowledge of healthcare risk adjustment, including HCC coding and CMS-HCC model version 28. Experience speaking with leadership, webinars public speaking or presentation skills with healthcare providers Live in NC, SC, GA, VA or TN Preferred Qualifications Bachelor's Degree Value-based care Primary care Medicare Risk Adjustment kn

Become a part of our caring community Humana is looking for Inbound Contacts Representatives to be a part of our Provider Call Center; you are often the first human connection our members have with us. Working remotely, you will report to the Inbound Contacts Supervisor and be a part of the Medicare team. Every interaction is an opportunity to solve a problem, reduce frustration, and create trust. You will support members and providers by answering benefit questions, resolving concerns, and guiding them through next steps, helping ensure they feel informed and supported. This role is ideal for someone who enjoys helping others and takes pride in delivering a high-quality customer experience. As an Inbound Contacts Representative 2, you will: Handle 40+ inbound calls daily from providers in a back-to-back call center environment Address multiple members and provider needs, including benefit questions, service issues, and general inquiries Escalate unresolved and pending customer grievances Document all interactions, actions taken, and outcomes in internal systems Resolve routine to moderately complex issues by following established guidelines and workflows Identify issues requiring escalation and ensure handoff to the appropriate teams Meet quality, productivity, and customer experience expectations What Success Is: Providers feel heard, supported, and satisfied with their experience You are proactive and resolve issues on the first contact whenever possible Documentation is complete, clear, and compliant Experience empathizing with frustrated customers, and accountability in every interaction Use your skills to make an impact Required: 2+ years of Customer Service experie

What is PerfectServe? PerfectServe is a leading provider of clinical communication and physician scheduling solutions in the health IT space. The company was founded in 1997 and has grown steadily since then, with a notable jump after several major acquisitions were announced in 2019. PerfectServe now has 400+ employees, 30,000+ customers — spanning medical practices, hospitals, and health systems — and $100 million+ in annual revenue. PerfectServe’s mission is to accelerate speed to care by optimizing provider schedules and routing communications — including messages, pages, calls, and alerts — to the right place at the right time in any care setting. By facilitating real-time information sharing, building better schedules, and automating important clinical workflows, we believe we can help our customers advance patient care and improve the well-being of their clinicians. Leading analyst firms like Gartner® and KLAS Research have consistently validated our approach: In 2026, PerfectServe was named highest in execution and furthest in vision in the Gartner Magic Quadrant™ for Clinical Communication and Collaboration — the clear segment leader. PerfectServe also received two Best in KLAS awards in 2026 — one for physician scheduling and another for ambulatory clinical communications. That makes for 11 Best in KLAS awards over the past 9 years. At PerfectServe, you'll have a unique opportunity to join a collaborative team with decades of experience that finds new ways to delight our customers every day. This involves consistent efforts to stay on the cutting edge of product development, which includes everything from implementing AI in new and existing solutions to brainstorming with customers about novel workflows. But you don't have to be in product to make in impact — everybody at PerfectServe contributes to important work that moves the business forward. If you're looking for a well-established, tech-forward company full of smart people doing meaningful work

We are a global team of innovators and pioneers dedicated to shaping the future of observability. At New Relic, we build an intelligent platform that empowers companies to thrive in an AI-first world by giving them unparalleled insight into their complex systems. As we continue to expand our global footprint, we're looking for passionate people to join our mission. If you're ready to help the world's best companies optimize their digital applications, we invite you to explore a career with us! Your opportunity New Relic is looking for a strategic, high-energy Senior Cloud Partner Sales Manager to scale our co-sell ecosystem with Amazon Web Services (AWS) and Microsoft (Azure). In this role, you won't just be managing partnerships—you will be a critical growth engine. You will act as the vital bridge between New Relic’s internal sales leadership and our cloud partner counterparts. Your primary mission is to build deep relationships, align go-to-market (GTM) strategies, and execute high-velocity co-sell motions that directly accelerate pipeline and revenue growth. What you'll do GTM Strategy & Sales Alignment Bridge the Gap: Serve as the primary liaison between New Relic’s internal sales leadership (AVPs, RVPs, and Account Executives) and AWS/MSFT partner sales teams. Co-Sell Execution: Drive the day-to-day co-sell motion, mapping accounts, identifying new logos, and accelerating existing deals via AWS Marketplace and Azure Marketplace. Pipeline Generation: Build and execute regional partner plans that generate qualified pipeline, leveraging cloud provider funding programs, incentives, and credits. Relationship & Alliance Management Build Cloud Networks: Cultivate deep, trusted relationships with AWS and MSFT Partner Development Managers (PDMs), Cloud Account Managers, and field sales leadership. Evangelism: Educate cloud partner sales teams on New Relic’s value proposition, ensuring we are top-of-mind for cloud migration, modernization, and observability init

Become a part of our caring community Humana Healthy Horizons is looking for a Value-Based Programs Lead who will support successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. You will lead the beginning-to-end operational support of specialty Medicaid value-based payment (VBP) models in alignment with segment strategy and goals. The Value-Based Programs Lead will be a subject matter expert in VBP and have advanced technical knowledge and experience. Develop new innovative VBP models for range of provider types, such as behavioral health, maternity, specialists, and social determinants of health, creating glide paths to move providers from volume to value. Align scope of work with roadmap for new VBP model development to ensure compliance with Medicaid contractual requirements and RFP commitments. Analyze financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care. Creation of VBP payment strategies and model design, such as developing payment model logic, performance metrics and benchmarks, and financial terms, which align with segment goals. Design and contribute to development of provider reporting packages to help providers understand their overall and detailed performance. Partner with finance team to conduct impact analysis and modeling for new VBP models. Collaborate with team members and matrixed teams to operationalize and rollout of new VBP models. Contribute to developing solutions to operational gaps. Monitor VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data. Ability to translate strategy into models that can be piloted and scaled across markets. <

Become a part of our caring community The Network Operations Coordinator 4 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Works within broad guidelines with little oversight. Use your skills to make an impact Required Qualifications Minimum of 2 years of provider relations experience, healthcare services or related experience Minimum of 1 year of experience managing mid to large scale projects Intermediate experience in Microsoft Word, Outlook, Excel (VLOOKUP’s, lateral lookups & ability to manipulate data) and TEAMS Ability to accommodate a work schedule following Central Standard Time zone hours Preferred Qualifications Advanced experience with Microsoft Excel Provider contract interpretation experience Previous account management or project management Knowledge of medical claims Work at Home Requirements: To ensure Home or Hy

We are developing advanced multi-rack, multi-tenant AI/ML datacenters with NVIDIA GB200, and upcoming GB300 GPUs. NVIDIA seeks a Senior Software Engineer for our CSP (Cloud Service Provider) Engagements team to focus on the cloud-native stack for datacenter products like GB200. In this role, You will define customer workflows, prototype stack enhancements, and debug the toughest Kubernetes &#43; Slurm issues in multi-rack, multi-tenant AI datacenters. You'll tackle complex scheduling challenges across racks, tenants, and clouds as part of the CSP engagements team. What you’ll be doing: Perform deep-dive debugging of multi-rack, multi-tenant clusters: scheduler behavior, container runtime issues, device-plugin crashes, RDMA/IB fabric anomalies, etc. Gather customer requirements and prototype feature extensions for Kubernetes operators, Slurm plugins, and custom micro-services that expose new GPU capabilities. Drive joint architecture reviews and “whiteboard” sessions with CSP and internal platform teams; convert findings into RFCs and upstream pull requests. Create reproducible testbeds (Helm/Ansible/Terraform) that mirror customer environments; automate validation and benchmark suites. Deliver technical collateral-design docs, how-to guides, demo scripts-and present at customer on-sites, KubeCon, and SlurmUG. Collaborate with AE, FAE, and Solution Architect teams to deliver integrated customer solutions and technical documentation. What we need to see: Strong source-level expertise in Kubernetes internals (scheduler, CRI/CNI/CSI, operators) and Slurm (federation, power-save, plugins). Hands-on experience integrating next-gen GPUs (Blackwell/GB200/GB300) or comparable accelerators into containerized clusters. Proven track record debugging large-scale, cloud-native stacks across ne

Become a part of our caring community Join a high-impact leadership role at the forefront of healthcare transformation. As the Lead Enterprise Architect, you will shape the future of technology across a complex and rapidly evolving healthcare ecosystem spanning payer, provider, pharmacy, clinical, corporate, and digital technology domains. This is an opportunity to influence enterprise-wide strategy, drive modernization at scale, and partner directly with executive leadership to deliver innovative, secure, and resilient technology platforms that improve business outcomes and healthcare experiences. You'll collaborate with senior tech domain leaders, product and engineering teams, infrastructure organizations, and cybersecurity stakeholders to define modern architecture standards, accelerate innovation, and enable scalable enterprise capabilities across the organization. We're looking for a strategic technology leader who combines deep architecture expertise with strong business acumen and healthcare industry knowledge. The ideal candidate is passionate about solving complex enterprise challenges, influencing organizational direction, and building future-ready platforms that balance agility, performance, security, and operational excellence. You will report to an Associate Director of Enterprise Architecture. The Lead Enterprise Architect is responsible for defining enterprise-wide technology strategy and architecture standards. These standards and modernization roadmaps apply across a complex healthcare ecosystem, which spans payer, provider, pharmacy, clinical, corporate, and tech domains. Additionally, the Lead Enterprise Architect governs digital transformation initiatives. This role partners with executive leadership, product teams, engineering organizations, infrastructure teams, cybersecurity, and business stakeholders to drive enterprise architect

Location: Remote Orca is expanding into new product verticals, bringing a new class of regulated assets on-chain with the compliance infrastructure and liquidity primitives to make them actually work. Our ambition reaches beyond becoming the leading provider of financial primitives in crypto—we aim to reshape the foundation of finance itself. If you are someone who is tired of just working another job and wants to build something meaningful, then we invite you to join our team. We’re always looking for talented individuals to join our growing team. If you think your skills can contribute to Orca's mission, but don’t see a specific role that matches your expertise in our current open positions, we’d love to hear from you. By submitting your resume here, you’ll be considered for future opportunities that align with your background and interests. If there’s a potential fit for an existing or upcoming opportunity, our team will get in touch. While we’d love to respond to everyone, we’re unfortunately unable to provide individual updates on all open applications. What Orca offers Competitive Salary. Bonus AND Token allocation. Flexible work schedule. Home office stipend. Wellness stipend. Opportunity to co-work with the team multiple times a year from at different locations around the world, fully covered by Orca. Option to work remotely or from Orca’s office in New York City. Paid subscriptions to GitHub Copilot, ChatGPT, or other tools that make you more productive. About: https://orca.so Twitter: https://x.com/orca_so Discord: https://discord.orca.so Podcast: https://orcapod.orca.so Orca is an equal opportunity employer.

The Team Platform Engineering is the department within SRE that is responsible for a range of critical infrastructure and operational functions that support the broader engineering organization. Among these are our multi-cloud-provider Kubernetes infrastructure, deployment machinery, and observability and alerting systems. The Fabric team manages the infrastructure that enables secure communication between systems and from the public internet. Their responsibilities encompass network architecture, service mesh, and edge load balancing, ensuring customer data remains safe in transit. The team plays a crucial role in developing and maintaining the reliable and globally connected multi-cloud network that supports MongoDB products. This role can sit in our NYC HQ, our smaller Austin, Palo Alto, or San Francisco offices, or fully remote from anywhere in North America. When based in an office, we provide hybrid work accommodation. Role Overview We are seeking a talented Site Reliability Engineer (SRE) with a strong networking background to join the Fabric team. This role is pivotal in building and maintaining the robust infrastructure necessary for secure and efficient communication between our services. As an SRE on the Fabric team, you will leverage your expertise in networking, distributed systems, and automation to ensure our systems are resilient, scalable, and reliable. The ideal candidate should Have 10+ years of experience working on software and operating distributed systems, with deep expertise in networking fundamentals and a good understanding of how the internet works, e.g. TCP/IP (including IPv6), DNS, TLS/mTLS, BGP, tunnels, overlays, and SDN principles Possess a customer-focused mindset, driving improvements that benefit end-users Value efficiency in processes and operations, and display a strong preference for automation over manual processes (“allergic to ops work”) Be intimately familiar with modern cloud-based infrastructure and the network design prim

About the Team The compute infrastructure team runs the GPU fleet and large-scale compute clusters that serve the models backing ChatGPT and the API, while also supporting training workloads for our next generation models. We operate a large, modern GPU fleet and provide a unified platform for other OpenAI teams to seamlessly run production Applied AI and Research training workloads. We seek to learn from deployment and distribute the benefits of AI, while ensuring that this powerful tool is used responsibly and safely. Safety is more important to us than unfettered growth. About the Role You’ll own the hands-on and automation work that brings WAN, fiber, carrier, and cloud-interconnect circuits into service. Partner with network engineers, fiber providers, cloud service providers, colocation teams, and data-center technicians to move each connection from ordered and patched to verified, stable, and ready for handoff. You’ll own Layer 1 troubleshooting and circuit bring-up while building workflows that translate reliable system or model output into precise, approved technician actions, capture field feedback, and drive each connection to a green-port handoff. The right person combines strong physical-networking judgment with practical automation skills: patch-panel and port mappings, optics and light levels, provider coordination, structured operational data, API or scripting workflows, and human-in-the-loop LLM tooling. Responsibilities Own Layer 1 activation and restoration for carrier circuits, dark fiber, wavelengths, Ethernet handoffs, and dedicated cloud interconnects across data centers and points of presence. Reconcile complete A-side/Z-side as-builts: circuit IDs, LOAs/CFAs, carrier demarcations, MMR/ODF/MDF and patch-panel positions, fiber pairs, cross-connects, optics, and device ports. Investigate no-light, low-light, wrong-port, link-flap, and error-rate issues across providers and CSPs; isolate continuity, dirty connectors, polarity, incorrect patching

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 Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems. Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. Performs claim re-work calculations. Follow through completion of claim overpayments, underpayments, and any other irregularities. Process complex non-routine Provider Refunds and Returned Checks. Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks. Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. Review and handle relevant correspondences assigned to the team that may result in adj

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. Omnicare is a leading provider of pharmacy services to long-term care facilities nationwide, supporting skilled nursing facilities, assisted living communities, and other institutional care settings. Following the sale of Omnicare by CVS Health, this role will support Omnicare and its continued operations as an independent, standalone organization. Candidates should be aware that this role will not remain within CVS Health following the transaction. The individual hired into this role will be employed by Omnicare and will contribute to shaping the future of our organization during this exciting period of growth and transformation. Position Summary: Looking for a career that rewards you? As a Front End Pharmacy Technician with Omnicare, you will not only find rewarding work in your community, but a team focused on providing a supportive and innovative team environment for all members. Day In The Life: As a Front End Pharmacy Technician, you will perform order entry tasks and collaborate with other team members in the medication dispensing process at our closed-door pharmacy. Our front-end team is focused on entering in orders, working alongside the pharmacist to ensure accuracy, and providing best in customer service. Additional tasks and responsibilities include: Triaging customer service requests by department, urgency