The Special Investigations Unit is responsible for investigating and resolving high complexity healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. This position researches, gathers, and analyzes claims data, medical records, corporate policy, state/federal policy, and practice standards to identify trends, patterns, aberrancies, and o

We are a high powered insurance team with explosive growth. We are looking for licensed life insurance agents to join us. Even if you’re not licensed, our fast track program will guide you through getting licensed in as little as a few weeks. We will also sponsor your pre licensing classes for those who are a good fit. Hybrid Sales Platform – Face to Face or V

This position focuses on all CMS submission related operations in support of Prominence Health Plan's Medicare Advantage business. Activities include creating submission files related to chart retrievals per vendor proprietary format, perform data analysis in support of optimizing risk adjusted revenue, maintain compliance with all CMS standards related to health plan sub