Zelis Jobs (3)

Software Support Engineer - Healthcare Claims The Software Engineer - Healthcare Claims position inside the ZELIS / Payer Compass R&D Technology team focuses on troubleshooting and post-release maintenance of the Payer Compass healthcare RCM (Revenue Cycle Management) claims modeling technology, which batch-processes large claim datasets through various repricing scenarios to envision effects on overall revenue. This system is also used as part of our DevOps release-testing Quality Assurance process. This Software Support Engineer - Healthcare Claims position interacts frequently with the core engineering team. The ensuing exposure to many aspects of the system opens up other roles and advancement possibilities within the organization. The position entails frequent troubleshooting and debugging from stakeholder-originated support requests, and collaborating with other Engineering Team members, but also includes crafting bugfixes when appropriate. As such, this position requires participation in all aspects of the software development lifecycle including the development of design specifications, solution prototyping, implementation, development of unit and system tests. The Software Support Engineer will be responsible for : Supporting Engineering tickets by analyzing debugging & diagnosing issues using C# Assisting in the design and development of document database structures needed to support new engineering efforts. Assisting and perform application performance analysis and tuning Develop unit and system tests for code Performing and supporting code changes Education and Work Experience : Minimum 1 - 5 years experience using C#, SQL Server, source code and Git. Experience in requirements gathering from project stakeholders BA / BS in Computer Science preferred Healthcare experience helpful Knowledge, Skills and Key Competencies : Ability to troubleshoot and debug complex defects with debugger and profiler tools, such as Microsoft Visual Studio. Familiarity with Microsoft IDE’s such as Visual Studio and Visual Studio Code Working knowledge of Git based version control systems As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process. Zelis provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. SCAM ALERT : There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

Overview The Zelis Dental Network Recruiter is a result driven performance role responsible for obtaining signed contracts from dental providers that are part of the company’s recruitment list, and in accordance with individual goals and the dental division's goals. Key Responsibilities Identify, recruit, negotiate, and contract dental providers within established targets, to meet network needs Track and report performance through recruitment interactions and goal metric information using various tracking mechanisms Demonstrate self-motivation and the ability to work independently and as a team associate in a goal-oriented environment Understand and prioritize provider challenges, while proactively finding solutions to solve those challenges Perform within a results-driven environment, contributing to the growth and value of the Zelis Dental Network Maintain knowledge of provider contracts and support providers on contracting protocol Maintain confidentiality of Zelis Assets Position Summary of Qualifications Experience with network recruitment, or sales and production position(s) Substantive knowledge of insurance and dental terminology would be favorable Understanding of provider office dynamics and optimal approaches to communicating and educating providers and provider staff Advanced level knowledge and proficiency of MS Office, including Excel, Word, Outlook, PowerPoint etc. and related applications Knowledge of dental and / or healthcare benefit marketplace Strong organizational skills with an ability to handle multiple priorities Excellent communication including listening and persuasive speaking, negotiation, analytical and problem-solving skills, and ability to maintain key professional relationships LI-RZ1 As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process. Zelis provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. SCAM ALERT : There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

Position Overview The Carrier Relations Manager position is responsible for successfully managing the Carrier Relations team. The Carrier Relations team is a critical role within Zelis Network Analytics (ZNA) ProviderNexus API business, responsible for implementation of requests for customized data sets from our clients, which includes gathering, clarifying, and transferring custom business rules from our carrier partners to our Data Operations team and our proprietary data mapping application. This role will be responsible for managing the team’s personnel, assigning work, training and mentoring team members and assisting with questions and escalations as they arise. The Carrier Relations Manager will also be responsible for establishing and monitoring performance metrics for the team, working equally well in both technical and non-technical environments and effectively communicating technical information in a common, non-technical manner. The individual must work well in a fast paced, demanding environment. The ability to efficiently organize and prioritize work to meet deadlines is essential to success. Key Responsibilities Escalation resource for all team members, as well as internal and external clients Ensure Root Cause Analysis documents for client issues are clear and accurate Establish and manage to team goals with performance metrics Perform team reviews and performance management Work with team to document processes, and update existing processes Work with carriers to negotiate carrier data use agreements, ensuring terms are acceptable; work with Zelis & Carrier legal teams to execute agreements Coach and mentor team members to : Facilitate meetings, internal & external Manage all communications, internal & external Track progress of tasks Manage agreements and document updates Collaborate with other ZNA teams to document identified gaps or missing process needs and implement process improvements as needed Summary of Qualifications Associate degree minimum / Bachelor’s preferred 6+ years of management experience preferred 4+ years of experience in the healthcare industry preferred industry (particularly in the realm of provider networks and directories) Thorough understanding of data structure basics, with knowledge of how to apply business rules to retrieve data from those formats is required Innovative problem-solver who constructively overcomes obstacles utilizing resourceful solutions Demonstrates ability to lead in a collaborative, team setting Tools used : SQL or other data management tools Trello.com Confluence Internal data management system Office products Word, Excel, Outlook, PowerPoint LI-RZ1 As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process. Zelis provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. SCAM ALERT : There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.