The Senior Director, Performance Improvement provides strategic leadership in the planning, development, implementation and execution of all aspects of a robust portfolio of value based programs and strategies within the Prominence Health umbrella. Emphasis will be centered around risk based contract performance, risk adjustment, and quality measurement performance across

The Claims Supervisor will play a crucial role in ensuring the efficient and accurate processing of healthcare claims within our organization. You will lead a team of claims analysts, oversee claim submission, review, and adjudication processes, and collaborate with various stakeholders to maintain high quality claims management practices. This role demands strong leaders

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

Under the direction of the Manager of Operations, the Appeals Specialist is responsible for ensuring the appropriate review, research, processing and responding to written member and provider complaints, appeals, and grievances. This position is required to apply analytical and critical thinking when reviewing contract language, benefits and covered services in researchin