Job Search Results for healthcare payer

Supply Chain Oracle Fusion Solution Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Finance Oracle Solution Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Payroll Oracle Fusion Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

HR Oracle Fushion Solution Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Follow Up Representative

Insight Global is looking for a Follow-Up Representative to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals & Performance (DAP) team, a... More centralized hospital denial group supporting 10 hospitals across the Maryland/DC region.This role focuses on post-appeal and post-submission insurance follow-up, helping offload administrative and payer-chasing work from RN teams. Follow-Up Reps will manage a mixed inpatient and outpatient inventory, working with primarily commercial payers and MCOs. This is not an appeal-writing role, though there is opportunity for growth and cross-training over time. The environment is fast-paced, documentation-driven, and collaborative, with a strong emphasis on accuracy, persistence, and accountability.Primary Responsibilities? Perform post-appeal insurance follow-up on hospital denial accounts? Productivity is quality-focused, not quota-driven? Looking for someone who has experience touching <40 accounts/day ? Check claim and appeal status via: ? Payer portals? Phone calls to insurance companies? Written payer correspondence? Work accounts originating from: ? Denials Appeals & Performance (DAP) RNs? Acute Case Management (ACM) RNs? Document all follow-up actions clearly in the appropriate system? Identify cases with insufficient or unclear documentation and escalate appropriately? Track payer responses, timelines, and next steps? Support rebilling or resubmission efforts when required? Navigate long hold times and high-touch payer follow-up while maintaining productivity? Collaborate with: ? RN reviewers? Other follow-up representatives? Leadership as needed? Participate in: ? Team huddles? Workflow updates? Ongoing training and cross-training initiatives? Adapt to evolving workflows as the DAP team continues to expand and absorb new workstreamsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Revenue Cycle Project Manager

Insight Global is looking for a Project Manager for one of their healthcare clients in New Jersey. This Financial Project Manager will be responsible for assessing and stabilizing a significant... More collections backlog resulting from EPIC implementation challenges by analyzing aged A/R, stalled and denied claims, and clearinghouse rejections to identify root causes and recovery opportunities. Working closely with billing specialists, IT, Epic analysts, and external vendors, the PM will troubleshoot claim edits, payer rejections, eligibility and authorization issues, and interface errors, while prioritizing high-value accounts for resolution. The role involves overseeing daily collections activity, monitoring account balances and key revenue cycle metrics, and driving short-term backlog reduction plans while simultaneously implementing standardized workflows and process improvements to prevent recurrence. Reporting directly to the CFO, this individual will provide clear executive-level updates on cash recovery, risks, and performance trends, ensure compliance with payer contracts and healthcare regulations, and serve as the central point of coordination to restore revenue cycle efficiency and maximize reimbursement across the organization.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Senior Data Engineer

- Design and implement scalable SQL stored procedure pipelines in SQL Server and PySpark pipelines in Databricks, optimizing for data quality and performance- Lead efforts to operationalize and... More standardize data ingestion from diverse payer sources- Document and champion best practices for unit testing and data validation to maintain the integrity of healthcare datasets- Collaborate with Product Management and Population Health Analysts to refine requirements for CMS Stars initiatives- Coach peer and junior engineers through code reviews and pair programming, fostering a collaborative learning environmentWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

REMOTE AI Product Manager

Insight Global is seeking to Lead AI Product Managers to join a global healthcare insurance provider client. One of the Product Managers will be providing support to a rapidly growing platform that... More enables members to understand and act on their healthcare benefits, claims, medications, and recommendations. The other role will focus on driving vision and evolution of products, with a focus on enhancing the right-hand search experience through relevant recommendations, third-party integrations, and deterministic AI-powered capabilities.The ideal candidate profile for both of these roles is someone who has demonstrated knowledge of technical AI and agentic concepts and has strong communication skills and experience working with technical stakeholders. These 2 opportunities are great for candidates looking to making an impact on the future of healthcare through the use of AI. . Compensation: $70 - 90/hr. Exact compensation may vary based on several factors, including skills, experience, and education.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Denial Coordinator

Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals and Performance team, a centralized... More hospital denial team serving 10 hospitals. This role is hospital-based and denial-type driven, with work assigned via CARC codes rather than by inpatient or outpatient setting. Denials primarily include no-authorization (technical) and medical necessity / level-of-care (clinical) denials. Denial Coordinators work closely with RN reviewers and fellow technical staff in a fast-paced, collaborative environment.This is a production-focused role, with an expected daily volume of approximately 40 appeals per day, varying in complexity. Primary Responsibilities:- Work hospital denial accounts routed through proprietary system based on denial reason- Review denial letters to determine appeal feasibility and next steps- Draft and submit clear, detailed appeal letters for: ? No-authorization denials (technical)? Medical necessity and level-of-care denials (in partnership with RNs)- Collaborate daily with: ? RN reviewers? Other denial coordinators? Leadership and managed care partners as needed- Maintain timely follow-up on appealed accounts to ensure resolution- Identify denial trends and escalate issues appropriately- Participate in: ? Daily huddles? Case review meetings? Interdisciplinary denial discussions- Support special projects related to denial trends, payer behavior, or backlog reduction- Adapt to evolving workflows as the DAP team continues to build and scaleWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Remote Enrollement Data Analyst

The Medical Staff Enrollment Data Analyst manages and optimizes provider enrollment data. This role ensures data accuracy, compliance with payer and NCQA standards, and supports integration,... More reporting, and audit readiness. It?s key to streamlining workflows, enabling timely reimbursement, and driving operational efficiency.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less