Neighborhood Health Plan of Rhode Island

Senior Provider Reimbursement Analyst (43439)

North AmericaSenior

Senior analyst developing and managing healthcare provider fee schedules, alternative payment methodologies, and reimbursement financial analyses for a Rhode Island health plan. Day-to-day work spans CPT/HCPCS coding, payment hierarchy/claims-system auditing, dashboard and reporting development, and coordination with actuaries and auditors to support strategic provider payment initiatives.

financial-modeling

Manager of Care Management (44862)

This position oversees operational activities of the Care Management area of the Medical Management department. This includes program development and monitoring, staff development including overseeing frontline…

process-improvement

Integrated Care Manager (44428)

The Integrated Care Manager (ICM) works collaboratively with the integrated care team to manage and coordinate care for a specific population of members whose needs represent high clinical and social risk in order to…

Configuration Management Analyst (44246)

automation edi unit-testing

Entry-to-mid level analyst configuring and maintaining health-plan systems (HealthRules, Optum CES, Burgess Source) — building benefit plan adjudication rules, validating claims data, running unit/regression tests, and supporting SDLC, change control, and audit documentation at a Rhode Island health plan.

Data Governance Specialist (39035)