Delta Dental of NM jobs in Providence, RI - 133 jobs
Physician Assistant / Geriatrics / Rhode Island / Locum Tenens / Nurse Practitioner or Physician Assistant - Senior Care (Per Diem) - Rhode Island
Unitedhealth Group 4.6
Warwick, RI job
$10,000 Sign On Bonus For External Candidates Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
$168k-334k yearly est. 1d ago
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Customer Service Representative
Delta Dental of Rhode Island 4.7
Providence, RI job
Job Description
Responds to questions from members, groups, and dental offices regarding products and plans. This position requires resolution of problems with claims, complaints and appeals with dentists, and group enrollment. Works with a wide variety of internal resources to resolve issues to ensure customer satisfaction.
Essential Functions:
Responds to current and prospective customer questions and complaints/appeals in a timely and empathetic manner via telephone or web inquiries
Researches of complaints, appeals, claims, processing issues, benefit and eligibility requests and all communication with external and internal customers
Collaborates with Operations to review claims and decisions regarding payment
Answers inquiries from dental offices to clarify coverage levels, identifies allowable procedures, and resolves claims payment issues
Builds a strong rapport with dental office staff, groups and members to ensure a positive perception of the company within the community
Performs other duties as assigned
Requirements:
High school diploma or equivalent, college degree preferred
Previous customer contact experience (i.e. customer call center, dental office experience, or experience within a similar insurance system)
Medical or dental insurance experience, dental office or clinical assistant experience a plus
Excellent communication skills (verbal and written)
Attention to detail and accuracy essential
Work Environment / Physical Demands:
Typical office environment
$32k-38k yearly est. 5d ago
Personal Lines Client Manager
World Insurance Associates 4.0
Lincoln, RI job
World Insurance Associates is a unique insurance organization offering top products and services from major providers, combined with attentive service from local agents.
Founded in 2011, World is one of fastest-growing insurance brokers in the U.S. with over 2,200 employees in over 210 offices across North America. We specialize in personal and commercial insurance lines, surety and bonding, employee benefits, financial and retirement services, and human capital management solutions.
Our rapid growth and market leading presence has created opportunities throughout the state and we offer top talent the choice to work from one of our multiple offices throughout the region.
Position Summary
This position supports the Account Executive with responsibilities related to client management and retention
Essential Duties and Responsibilities
Effectively managing a high volume book of Personal Lines Insurance business, ensuring all required tasks are completed accurately and on-time
Growing client loyalty by building positive relationships and providing high levels of advocacy, excellent service, and professional communication
Handling renewals, service requests, claims, billing and new policies
Maintain a thorough understanding of the markets and their appetites, underwriting guidelines, submitting and procedures
Review all applications, policies, endorsements and audits for accuracy
Complete loss/claim analysis and summaries
Coordinate expiration list with department manager to obtain renewal business information
Qualifications
Bachelor's degree or equivalent work experience, preferred
3-7 years minimum Personal Lines High Net Worth Account Management experience required
Property & Casualty License required
Valid driver's license and insurance, required
Possess strong administrative and computing skills, including Microsoft Office (Word, Excel and Power Point)
Applied/Epic or similar agency management software experience, preferred.
Able to work independently and enjoy a high degree of interaction with team members.
Self-motivated and driven. Maintain a sense of urgency and ability to work with and meet deadlines.
Demonstrate effective written and verbal communication, including the ability actively listen, and problem solve with minimal assistance.
The ability to multi task, prioritize, work independently, and use discretion surrounding sensitive information.
Ability to maintain a professional demeanor and positive attitude
Equal Employment Opportunity
At World Insurance Associates (WIA), we celebrate and support our differences. We know employing a team rich in diverse thoughts, experiences, and opinions allows our employees, our products, and our community to flourish. WIA is honored to be an equal opportunity workplace. We are dedicated to equal employment opportunities regardless of race, color, ancestry, religion, sex, national orientation, age, citizenship, marital status, disability, gender identity, sexual orientation, or Veteran status. In addition, WIA makes reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant or employee with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
TO EXECUTIVE SEARCH FIRMS AND STAFFING AGENCIES:
World does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered World's property, and World will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting World's Human Resources Talent Department.
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$70k-94k yearly est. Auto-Apply 60d+ ago
Personal Lines Associate Client Representative
World Insurance Associates, LLC 4.0
Woonsocket, RI job
Job Description
World Insurance Associates (“World”) is a unique financial services organization with a global network of brokers and specialists who empower people to make informed decisions to improve their risk management outcomes, modernize their benefits programs, and help them achieve their long-term financial goals.
Founded in 2011, World is one of the fastest-growing, Top 25 insurance brokers in the U.S. with nearly 3,000 employees in more than 300 offices across North America and the U.K. World specializes in personal and commercial insurance, surety and fidelity bonding, employee and executive benefits, investment advisory and retirement plan services, and payroll & HR solutions.
Position Summary
Receives guidance and/or direction, to provide support to Client Managers and/or Client Advisors, by following established workflows and procedures on routine work including ALL primary activities listed below.
Primary Responsibilities
Setup and maintain accurate account details, contacts, and policy information in EPIC
Process renewals, endorsement, acknowledgments, cancellations and proofs of insurance
Attach, organize, and name documents in EPIC
Initiate endorsements, proofs of insurance and invoices
Leverage templates and system generated letters and forms to produce standard communications to clients and carriers, including BOR, client pre-renewal letters, proposal letters, change request, etc.
Create activities in EPIC and assign to applicable team member
Other Responsibilities, as applicable
May pull items such as MVR, CLUES, Risk Meters, RCE etc.
Generate and send renewal proofs, if requested
Check policy per policy check workflow and complete checklist
Check endorsement against request
Document maintenance/retrieval
Other responsibilities as applicable
Position Specific Skills/Qualifications
Work Experience
0-2 years' experience in Personal Property and Casualty
Professional Licenses/Certifications
Licensed or obtaining state Property & Casualty insurance license within a specified time frame.
Essential Skills/Competencies
Knowledge of Excel, Word, and other MS Office products to include basic formatting
Able to learn coverage fundamentals.
Dedicated to meeting the expectations and requirements of co-workers and clients. Able to quickly find common ground and solve problems.
Seeks to obtain industry information, new product information, coverage, and technology to continuously improve knowledge performance.
Strong written, oral, and interpersonal communication skills.
Able to follow a well-established and familiar set of activities and/or process to derive a solution.
Sets priorities and manages workflow to ensure effective, timely, and efficient service delivery.
Works to achieve stated objectives and delivers results at the close direction of a senior team member.
Physical Demands & Working Conditions
Office work involves working at a desk most of the time, using a stand-up/sit-down adjustable desk. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. Typing, grasping, and repetitive motion typically is required every day, and walking and standing are required occasionally.
Equal Employment Opportunity
At World Insurance Associates (WIA), we celebrate and support our differences. We know employing a team rich in diverse thoughts, experiences, and opinions allows our employees, our products, and our community to flourish. WIA is honored to be an equal opportunity workplace. We are dedicated to equal employment opportunities regardless of race, color, ancestry, religion, sex, national orientation, age, citizenship, marital status, disability, gender identity, sexual orientation, or Veteran status. In addition, WIA makes reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant or employee with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
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$32k-38k yearly est. 19d ago
Associate PIP Claims Representative
Amica Mutual Insurance 4.5
Lincoln, RI job
Rhode Island Claims 10 Amica Center Blvd, Lincoln, RI 02865 Thank you for considering Amica as part of your career journey, where your future is our business. At Amica, we pride ourselves on being an inclusive and supportive environment. We all work together to accomplish the common goal of providing the best experience for our customers. We believe in trust and fostering lasting relationships for our customers and employees! We're focused on creating a workplace that works for all. We'll continue to provide training, guidance, and resources to make Amica a true place of belonging for all employees. Want to learn more about our commitment to diversity, equity, and inclusion? Visit our DEI page to read about it!
As a mutual company, our people are our priority. We seek differences of opinion, life experience and perspective to represent the diversity of our policyholders and achieve the best possible outcomes. Our office located in Lincoln, RI is seeking an Associate PIP Claims Representative to join the team!
Job Overview:
The job duties include but are not limited to handling personal lines Personal Injury Protection and Medical Payments insurance claims. Substantial customer contact via the telephone and correspondence is required. Responsibilities include working in an electronic claim file environment, taking claim telephone reports, investigating, negotiating and settling claims and general office functions.
Candidates will be required to obtain a state insurance license and meet continuing education requirements.
Responsibilities:
* Handling personal lines Personal Injury Protection and Medical Payments Insurance Claims
* Substantial customer contact via the telephone and correspondence is required
* Working in an electronic claim file environment, taking claim telephone reports, investigating, negotiating, and settling claims and general office functions
* Candidates will be required to obtain a state insurance license and meet continuing education requirements
Total Rewards:
* Medical, dental, vision coverage, short- and long-term disability, and life insurance
* Paid Vacation - you will receive at least 13 vacation days in the first 12 months, amounts could be greater depending on the role. While able to use prior to accrual, vacation time will accrue monthly.
* Holidays - 14 paid holidays observed
* Sick time - 6 days sick time at hire, 6 additional days sick time at 90 days of employment
* Generous 401k with company match and immediate vesting. Additionally, annual 3% non-elective employer contribution
* Annual Success Sharing Plan - Paid to eligible employees if company meets or exceeds combined ratio, growth and/or service goals
* Generous leave programs, including paid parental bonding leave
* Student Loan Repayment and Tuition Reimbursement programs
* Generous fitness and wellness reimbursement
* Employee community involvement
* Strong relationships, lifelong friendships
* Opportunities for advancement in a successful and growing company
Qualifications
* High School Diploma or equivalent education required
* Maintain state insurance license
* Excellent written and verbal communication skills
* Knowledge of Microsoft Excel, Word, and Outlook
* Previous insurance, claims, and customer service experience preferred
Amica conducts background checks which includes a review of criminal, educational, employment and social media histories, and if the role involves use of a company vehicle, a motor vehicle or driving history report. The background check will not be initiated until after a conditional offer of employment is made and the candidate accepts the offer. Qualified applicants with arrest or conviction records will be considered for employment.
The safety and security of our employees and our customers is a top priority. Employees may have access to employees' and customers' personal and financial information in order to perform their job duties. Candidates with a criminal history that imposes a direct or indirect threat to our employees' or customers' physical, mental or financial well-being may result in the withdrawal of the conditional offer of employment.
About Amica
Amica Mutual Insurance Company is America's oldest mutual insurer of automobiles. A direct national writer, Amica also offers home, marine and umbrella insurance. Amica Life Insurance Company, a wholly owned subsidiary, provides life insurance and retirement solutions. Amica was founded on the principles of creating peace of mind and building enduring relationships for and with our exceptionally loyal policyholders, a mission that thousands of employees in offices nationwide share and support
Equal Opportunity Policy: All qualified applicants who are authorized to work in the United States will receive consideration for employment without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, family status, ethnicity, age, national origin, ancestry, physical and/or mental disability, mental condition, military status, genetic information or any other class protected by law. The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are 40 years of age or older. Employees are subject to the provisions of the Workers' Compensation Act.
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$40k-50k yearly est. 2d ago
Actuarial Intern - Life Product & Risk
Amica Mutual Insurance 4.5
Lincoln, RI job
Life Actuarial Intern Life Product & Risk Department 10 Amica Way, Lincoln, RI 02865 Thank you for considering Amica as part of your career journey, where your future is our business. At Amica, we pride ourselves on being an inclusive and supportive environment. We all work together to accomplish the common goal of providing the best experience for our customers. We believe in trust and fostering lasting relationships for our customers and employees! We're focused on creating a workplace that works for all. We'll continue to provide training, guidance, and resources to make Amica a true place of belonging for all employees. Want to learn more about our commitment to diversity, equity, and inclusion? Visit our DEI page to read about it!
As a mutual company, our people are our priority. We seek differences of opinion, life experience and perspective to represent the diversity of our policyholders and achieve the best possible outcomes. Our office located in Lincoln, RI is seeking an Actuarial Intern to join our Life Product & Risk team!
This is a paid internship and the working hours are 37.5 hours per week during the summer months. Work from home may be available up to two days a week once trained to work independently.
Our internship program is designed for individuals who are enrolled in an accredited college/university before the start of the summer internship. Candidates should be seeking a degree in Actuarial Science or a related field.
Job Responsibilities:
* Collaborate and assist the team with the development of our internal risk and governance tool
* Assist with product testing
* Create and maintain various reports within the department
* Assist with competitive intelligence reporting
* May be called upon to handle other duties as required to support Life Product, Risk & Data team.
Qualifications:
* Currently enrolled in Mathematics, Finance, or Actuarial Science program
* Proficient Microsoft Excel and Access skills
* Strong interpersonal skills
* Excellent verbal and written communication skills
* Strong analytical and problem-solving skills
* Actuarial exam experience not required but preferred
All candidates must submit a resume. No phone calls please. Only those selected for further consideration will be contacted.
Amica conducts background checks which includes a review of criminal, educational, employment and social media histories, and if the role involves use of a company vehicle, a motor vehicle or driving history report. The background check will not be initiated until after a conditional offer of employment is made and the candidate accepts the offer. Qualified applicants with arrest or conviction records will be considered for employment.
The safety and security of our employees and our customers is a top priority. Employees may have access to employees' and customers' personal and financial information in order to perform their job duties. Candidates with a criminal history that imposes a direct or indirect threat to our employees' or customers' physical, mental or financial well-being may result in the withdrawal of the conditional offer of employment.
About the Program:
Amica offers a top-rate internship program that provides valuable experience and a cross functional, collaborative team environment. We strive to provide students with a multitude of opportunities in their chosen field of study, while fostering connections and experiences throughout various departments. In keeping with our renowned company culture, our internship program also involves various team building exercises and company-wide events to celebrate all of the reasons that make Amica one of the best places to work!
About Amica:
Amica Mutual Insurance Company is America's oldest mutual insurer of automobiles. A direct national writer, Amica also offers home, marine and umbrella insurance. Amica Life Insurance Company, a wholly owned subsidiary, provides life insurance and retirement solutions. Amica was founded on the principles of creating peace of mind and building enduring relationships for and with our exceptionally loyal policyholders, a mission that thousands of employees in offices nationwide share and support.
Equal Opportunity Policy: All qualified applicants who are authorized to work in the United States will receive consideration for employment without regard to race, religion, sex, color, national origin, ethnicity, age, genetic information, disability or sexual orientation. The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are 40 years of age or older. Employees are subject to the provisions of the Workers' Compensation Act.
$81k-120k yearly est. 41d ago
Learning & Development Manager
Starkweather & Shepley Insurance Brokerage 3.8
East Providence, RI job
The Learning and Development manager will oversee the implementation of strategic initiatives in the design, development and implementation of L&D projects in support of improving and enhancing: performance, onboarding, leadership and management skills, and workforce skill development. This role will work with our Trustees and HR to develop an L&D strategy for the agency including both short term and long-term goals. This individual will partner with individual department heads to develop learning paths, including vendor relationships should some of the projects be outsourced.
Our goal is to coordinate all organizational Learning and Development activities through a central source to eliminate redundancy, cracks and provide the best overall learning experience for our associates.
Requirements
· Develop, implement, and maintain a comprehensive learning and development strategy aligned with organizational goals.
· Conduct training needs assessments to identify skill gaps and create targeted learning plans.
· Design, deliver, and evaluate engaging training programs using blended learning methods (in-person, virtual, and self-paced).
· Partner with leaders and subject-matter experts to build role-specific curricula and development pathways.
· Manage onboarding programs to ensure a consistent and effective experience for new employees.
· Oversee leadership development initiatives and succession planning efforts.
· Track and analyze learning metrics, program effectiveness, and ROI; present insights to senior leadership.
· Recommend and implement learning technologies, platforms, and tools to enhance employee development.
· Coordinate external training resources, vendors, and certifications as needed.
· Maintain up-to-date learning materials, documentation, and compliance training.
· Support organizational change management efforts through training and communication strategies.
Education & Experience
· Bachelor's degree in human resources, Organizational Development, Education, or related field.
· 3-5+ years of experience in Learning & Development, Talent Development, or Organizational Development roles.
· Experience designing and facilitating training for diverse audiences.
· Proven ability to build and scale learning programs in a growing or complex organization.
· Strong understanding of adult learning principles and instructional design methodologies.
Skills & Competencies
· Exceptional communication, facilitation, and presentation skills.
· Ability to build strong partnerships with leaders and cross-functional teams.
· Proficiency with learning management systems (LMS) and digital learning tools.
· Strong project management and organizational skills with the ability to manage multiple initiatives simultaneously.
· Analytical mindset with the ability to measure program effectiveness and make data-driven recommendations.
· Creative problem-solver with a continuous improvement mindset.
· Ability to thrive in a fast-paced, evolving environment.
Preferred Qualifications
· Certifications such as CPLP/ATD, SHRM-CP/SCP, or similar credentials.
· Experience with e-learning development tools.
· Background in leadership development, workshop planning and organizational design.
Who We Are:
Starkweather & Shepley 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. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
These statements are intended to describe the general nature and level of work performed by the employee and are not intended to be a complete list of responsibilities and duties. These statements do not establish a contract for employment and are subject to change at the discretion of the organization.
$110k-165k yearly est. 36d ago
Commercial Enterprise Account Executive
Starkweather & Shepley Insurance Brokerage 3.8
East Providence, RI job
Requirements
Skills and Abilities:
Fluency in MS Office products.
Effective, professional verbal and technical written communication skills.
Must be a good listener and have a strong work ethic.
Proven analytical skills.
Must be detail-oriented, with the ability to plan, manage, and oversee a book of business.
A self-starter with an entrepreneurial approach and hands-on experience.
Must be willing to work outside of core hours as needed.
Ability to multitask and operate in an ever-changing environment is critical.
Ability to communicate clearly, to work well with others, and to manage time effectively.
Education and Experience:
Bachelor's degree in a relative field preferred, or equivalent in work experience.
3 + years' sales experience, preferably in Insurance; commercial property and casualty or related business-to-business sales experience.
CIC, CPCU, AAI, AIS designations preferred.
Producer license is Mandatory.
Willingness to continue education is essential.
$102k-168k yearly est. 36d ago
Policy and Claims Research Specialist (42227)
Neighborhood Health Plan of Rhode Island 4.4
Smithfield, RI job
The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity initiatives and projects. This role will act as the point of contact for claim related research. Serves as a claims subject matter expert (SME) and handles incoming inquiries regarding Payment Integrity projects related to claims issues, policies and CES edits. Collaborates in planning, works closely with business and operational units to ensure timely resolution of open issues. The Specialist assumes ownership and accountability for the timely and accurate identification and resolution of claims issues through thorough research using the necessary tools such as a review of provider contracts, benefits, JIRA tickets, CES edits, NCCI edits, correct coding, and other appropriate tools.
Duties and Responsibilities:
Responsibilities include, but are not limited to:
* Acts as a claims subject matter expert (SME) and resource/support for claim edit and payment policy initiatives
* Conducts in-depth research on complex claim issues
* Conducts in-depth research on profile claim edits
* Documents research outcomes and makes recommendations to the Payment Policy team and PI leadership
* Follows up with appropriate individuals or areas to gather additional information related to any proposed or open initiatives
* Clearly document sources and validate the accuracy of data/information
* Identify process improvements to effectuate streamlined processes
* Documents root cause analysis and mitigation
* Represents Neighborhood to internal and external customers in a professional manner
* Attends ad-hoc and regularly scheduled meetings within the organization
* Team up with essential collaborators to outline project tasks, breakthroughs, and deadlines
* Collaborate with Payment Policy team for claim payment edits and claim editing software
* Assist in the develop of provider payment policies including collaboration with Provider Relations and Configuration teams.
* Monitor Centers for Medicare & Medicaid Services (CMS), Federal, State, industry standard, and software updates to ensure editing rules are in alignment with organizational needs for each product line.
* Collaborates with other departments to identify and document root cause to resolve claim payment issues.
* Opens JIRA tickets as needed
* Performs other duties/special projects as assigned
* Responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents
$48k-68k yearly est. 4d ago
Senior Production Support Analyst (43483)
Neighborhood Health Plan of Rhode Island 4.4
Smithfield, RI job
The Senior Production Support Analyst is a senior level position that provides front-line support of Neighborhood's production healthcare systems, interfaces, inbound and outbound file processing. Works closely with cross-functional, providers, vendors, SQL/DW, business and IT teams to troubleshoot, identify root cause, and resolve technical issues related to job failures in job scheduling systems and interfaces, including EDI and non-EDI compliant files. This role closely monitors email boxes that includes internal, provider and vendor requests, research root cause and resolution; documents and communicates effectively and timely. In addition, this role coordinates vendor ticket management and change management processes.
Duties and Responsibilities:
Responsibilities include, but are not limited to the following:
* Troubleshoot and resolve failed jobs in Production job schedulers (ActiveBatch, TransSend, etc.), production interface connections, and monitor healthcare systems performance
* Analyze EDI and non-EDI compliant files in various formats, .txt, csv, html, including SOAP
* Monitor shared email boxes (EDI Support, PEC) and creates Jira tickets to be triaged
* Analyze, research, and resolve assigned Jira tickets such as healthcare system access requests or issues, missing files/reports, SFTP connection issues, file transfer requests and other requests/issues
* Owns assigned Jira tickets: research, determine root cause and resolution, update and close tickets per Service Level Agreements (SLAs)
* Create or update existing "how to" documentation with resolution steps
* Collaborate with business, IT and production support teams, Production Support Lead, management and vendors
* Work with providers/vendors as needed to set up an electronic interface. Responsible for testing, certifying', and post-production support
* Monitor all integration systems to proactively identify and resolve issues
* Identify process improvement opportunities
* Own/participate in vendor management calls, vendor ticket lists, meeting notes, follow-ups (internally and with vendor), ensures accurate vendor ticket updates, and other assigned tasks
* Create support tickets vendor ticketing systems and updates Jira tickets with Vendor ticket information
* Own/participate in the Change Control Management process, facilitates meetings and coordinates activities
* Take directions from Production Support Lead and Manager of Production Support on priorities, work assignments and processes
* Communicate statuses effectively and timely with requestors, Production Support Lead (and Manager of Production Support when requested) and escalates issues or work stoppages
* Participate in meetings and/or projects, as assigned
* Other duties as assigned
* Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents
$78k-101k yearly est. 30d ago
Optometrist (Cambridge Eye Group) - Cambridge, MA
VSP Vision 4.0
Cambridge, MA job
There is an excellent full-time opportunity for an Associate Optometrist at Cambridge Eye Group, located in Cambridge, Massachusetts.
Why you should apply
When you join Cambridge Eye Group, you're joining a team dedicated to serving the community and beyond while challenging each other to create the best outcome for every patient encounter. Whether you're a new graduate or a seasoned professional, if you're looking to take your career to the next level, learn from the industry's top professionals, and have the unique opportunity to directly impact the success of a thriving practice, this is your chance!
Located on the north bank of the beautiful Charles River, partly opposite Boston, lies the charming town of Cambridge, which offers the perfect blend of exciting city life and small-town comfort. The city is best known for being the home of two world-class universities, Harvard University and Massachusetts Institute of Technology-within just two miles of each other. Residents and visitors alike will enjoy exploring the area's eclectic mix of neighborhoods rich in options for shopping, dining, sightseeing, arts, theatres, museums, and historic sites. There's also a plethora of outdoor recreational activities, from hiking to skiing-or sit back and enjoy a variety of professional sporting events. Its proximity to some of the East Coast's most visited cities and destinations is just one of the many reasons Cambridge is a fantastic place to call home.
Cambridge Eye Group is offering the following benefits:
Competitive base pay and performance bonus
Partnership opportunity
Medical insurance
Paid time off
401(k)
Malpractice insurance
Continuing education allowance
About Cambridge Eye Group
Cambridge Eye Group is a modern optometry clinic at the forefront of the industry's most advanced technology and vision solutions. Offering a spectrum of eye health and vision care services, the doctors specialize in ocular disease management, pediatric eye care, surgical co-management, and specialty contact lenses. The practice is uniquely located in a luxury residential building adjected to an urgent care clinic, dental practice, and pharmacy-patients can conveniently access multidisciplinary care in a single visit. Plus, the neighboring medical practitioners collaborate and find new ways to serve patients. As Cambridge Eye Group has experienced exponential patient growth due to its excellent staff, loyal patient base, and strong referrals, the business is looking to add an Associate Optometrist to the staff of 10 professionals.
The doctors are proactively engaged in the optometric industry and continuously looking to expand patient services and introduce new technology. The practice features a full suite of optometric and diagnostic technology, including Optical Coherence Tomography, Fundus Camera, Topography, Humphrey Visual Field, Autorefractor, Pachymeter, and in-office MGD treatment options. Customers enjoy shopping in the optical studio, whose mission is “Top fashion, personalized eyewear allowing you to express your owner unique, individual personality.” The Opticians are always ready to provide top-notch service to help patients find the perfect pair of frames-plus, all optical orders are inspected by the Optometrists to ensure the highest quality.
About the Associate Optometrist Opening
Cambridge Eye Group is seeking a full-time Optometrist with a strong desire to provide compassionate care and excellent eye health and vision services for all patients. You'll perform eye exams and diagnose any defects of the ocular system, including refractive error or pathology. You'll also design individual treatment plans, recommend vision-enhancing products, and promote good eye health through patient education-on average, 10 patients are cared for daily. The practice is looking for a positive, inspiring professional with excellent communication skills, patience, and a dedication to helping people.
To be successful in this role, you must demonstrate leadership, communication, interpersonal skills, and compassion for patient health and safety. In addition, the ideal candidate will want to continuously develop skills through mentorship with experienced doctors and be willing to integrate new techniques and innovations that improve patient care and services. For the right Associate Optometrist, a practice partnership opportunity may be available.
Minimum qualifications:
Optometry license in the state of Massachusetts
New graduates are welcome to apply
Preferred specialties:
Additional interest in pediatric optometry or specialty contact lenses is welcomed
Special Notice
This is not a career opportunity with VSP Vision or its companies. VSP Vision is helping Premier Program providers recruit qualified applicants for their private practices. The hiring decision and acceptance of this position is solely between the hiring practice and the applicant.
The above information in this description was provided by the hiring practice. It has been designed to indicate the general nature and level of work performed by an employee in this role. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, and qualifications required of employees hired in this role.
VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, gender identity, sexual orientation, disability or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information.
We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities.
As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees. VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies.
$115k-200k yearly est. Auto-Apply 60d+ ago
Customer Retention Specialist - Warwick
Farmers Insurance Group 4.4
Warwick, RI job
We are Farmers! We are… more than just your favorite commercials. At Farmers, we strive to deliver peace of mind to our customers by providing protection and comprehensive advice and delivering in the moments of truth. That means having people who can help us meet changing customer and business needs. Farmers high-performance culture is focused on results and the people who achieve them. We hold ourselves and others accountable for sustainably growing the business and each other. We seek solutions, own our actions, and grow through discomfort. We see setbacks as opportunities while continuously asking ourselves how we impact our customers.
Farmers is an award winning, equal opportunity employer, committed to the strength of an inclusive workforce. We are dedicated to supporting the well-being of our people through our extensive suite of benefits, as well as the well-being of the communities we serve through employee volunteer programs and nonprofit partnerships. Helping others in their time of need isn't just our business - it's our culture! To learn more about our high-performance culture and open opportunities, check out ********************************* and be sure to follow us on Instagram, LinkedIn, and TikTok.
Workplace: Hybrid ( #LI-Hybrid )
Farmers believes in a culture of collaboration, creativity, and innovation, which thrives when we have the ability to work flexibly in a virtual setting as well as the opportunity to be together in person. Our hybrid work environment combines the best of both worlds with at least three (3) days in office and up to two (2) days virtual for employees who live within fifty (50) miles of a Farmers corporate office. Applicants beyond fifty (50) miles may still be considered.
Job Summary
* Responsible for engaging with external customers to effectively communicate Farmers value proposition, focusing on the policy benefits and conducting thorough policy reviews.
* Assists customers in making informed decisions regarding appropriate coverage options and deductibles for their asset protection needs.
* Dedicated to delivering an exceptional service, ensuring all customer complex inquiries and policy requirements are met.
* Communicates with customers through various channels while adeptly navigating multiple brand systems and platforms to provide comprehensive and complex support. Provides both service and sales support.
* Provides peer support through on-the-job training and knowledge sharing.
* Role is hybrid to Caledonia, MI, Phoenix, AZ, Kansas City, KS, Warwick RI, or Dayton, OH
Essential Job Functions
* Explains renewal and other premium changes, educates on policy benefits, and conducts a full policy review.
* Receives and responds to inquiries related to insurance matters that require expert support. Interacts with customers, agents, and others to resolve complex issues regarding policy provisions and conditions.
* Explains premium changes. Quotes, sells, and generates premium.
* Analyze, clarify and resolve complex policy and account related questions from external customers.
* Accesses account information and communicates while working in multiple systems across all brands.
* Uses account information, advanced product knowledge, and knowledge of compliance or legal requirements to make appropriate recommendations.
* Makes decisions about ambiguous situations. Documents customer interactions and outcomes thoroughly in system, including notation and applicable data tracking.
* Resolves issues requiring expert support.
* Actively listens to customer concerns to identify trends or patterns.
* Recognizes opportunities for innovation and process improvement and makes recommendations to leadership.
* Advocates on behalf of the customer. Devises customer-centric solutions for complex insurance issues.
* Leads implementation of process changes. Monitors performance metrics and prepares reports.
* Builds and shares knowledge and acumen through self-directed learning. Stays informed about underwriting and policy guidelines and other updates including compliance and legal requirements.
* Continues to build personal skill set by participating in in-house or outside insurance or industry related courses or seminars as deemed necessary to expand product and system knowledge.
* Stays current with relevant product(s), which includes all specialty lines.
* Champions change initiatives and fosters acceptance and support for these changes within the team.
Physical Actions
* Job is performed in-person at a Farmers office or virtually at an approved alternative work location.
* The physical work environment is indoors and climate-controlled with adequate lighting and ventilation.
* Normal and customary distractions include background noise produced by office equipment and chatter among people, as well as interruptions.
* Frequently sits for prolonged periods of time, up to a full shift.
* Occasionally moves about the workplace including, navigating stairs, ramps, and level or uneven surfaces.
* Occasionally moves, pushes, pulls, lifts, carries, and/or places objects or materials weighing up to 25 pounds without assistance.
* Frequently uses shoulders, arms, hands, and fingers to manipulate equipment, tools, and objects necessary to perform job duties.
* Frequently performs fine motor tasks such as typing, mousing, or writing, up to a full shift.
* Rarely performs movements such as bending, stooping, crouching, kneeling, twisting, and reaching overhead or below the knees.
* Possesses clear vision, with or without correction, to visually read and verify information.
* Relies on depth perception and peripheral vision to navigate the work environment visually by identifying barriers, changes in terrain and locating objects.
* Possesses adequate hearing, with or without correction, to communicate with co-workers, respond promptly to auditory signals or alarms, and discern sounds essential for maintaining safety and productivity in the workplace.
* Jobs in this category require rare, if any, travel.
Education Requirements
* High School Diploma or equivalent required.
* Property and Casualty license required. Candidates must currently hold a Property & Casualty license or be willing to obtain one. Farmers will provide support and resources to help qualified candidates earn their license.
* Ability to be appointed to sell insurance in all states required.
Experience Requirements
* 2 years of experience in insurance or related field required.
* Experience providing advanced customer support within a high-volume, complex environment preferred.
Benefits
* Farmers offers a competitive salary commensurate with experience, qualifications and location.
o DC/NJ/NY/OH Only: $27.04 - $45.90
* Bonus Opportunity (based on Company and Individual Performance)
* 401(k)
* Medical
* Dental
* Vision
* Health Savings and Flexible Spending Accounts
* Life Insurance
* Paid Time Off
* Paid Parental Leave
* Tuition Assistance
* For more information, review "What we offer" on https://*********************************/#offer
Job Location(s): US - RI - Warwick
Anticipated application deadline: At Farmers, the recruitment process is designed to ensure that we find the best talent to join our team. As part of this process, we typically close open positions within 8 to 21 days after posting. If you are interested in any of our open positions, we encourage you to submit your application promptly.
Farmers will consider for employment all qualified applicants, including those with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring Ordinance or other applicable law. Pursuant to 18 U.S.C. Section 1033, Farmers is prohibited from employing any individual who has been convicted of any criminal felony involving dishonesty or a breach of trust without prior written consent from the state Department of Insurance.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Farmers is an Equal Opportunity Employer and does not discriminate in any employer/employee relations based on race, color, religion, gender, sexual orientation, gender expression, genetic information, national origin, age, disability, marital status, military and veteran's status, or any other basis protected by applicable discrimination laws.
Want to learn more about our culture & opportunities? Check out ********************************* and be sure to follow us on Instagram, LinkedIn, and TikTok.
Spokane, WA only: Residents who prefer not to provide their address click here to submit your resume via email: *******************
$36k-43k yearly est. Easy Apply 60d+ ago
Lead Health Data Analyst
Blue Cross & Blue Shield of Rhode Island 4.7
Providence, RI job
Pay Range:
$98,100.00 - $163,400.00
Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self.
It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued.
Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We're dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
What you will do:
Lead the extraction and analysis of health care data for specific studies and corporate initiatives related to the Total Cost of Care. Lead data intensive projects related to data exchanges with contracted clinical vendors; Serve as a technical resource to department staff and management on technical issues; Develop and improve automated processes to increase the efficiency and accuracy of work products.
What you'll need to succeed:
Develop deep understanding of claims, eligibility and provider data to support clinical vendor implementations and ongoing relationships. Perform data extraction and mapping activities in alignment with vendor program specifications. Collaborate with vendors to define necessary inbound data elements and facilitate their integration into BCBSRI data structures.
Drive data discussions to ensure “minimum necessary” data is provided to fully support clinical programs. Present and defend data requirements at internal Data Governance Committee.
Triage data discrepancies and expeditiously resolve inconsistencies.
Perform complex analytical work of health care data. Utilize data to provide insights about customers and prospects to support the growth of various market segments.
Initiate and lead data intensive projects; translate quantitative findings into practical insights through the interpretation of data, trends and other sources. Prepare project results or recommendations for a wide range of audiences using written reports and presentation exhibits/graphics.
Conduct special data extraction and analysis studies. Summarize results and provide recommendations where appropriate.
Design, implement, and maintain various databases as assigned; develop reporting capabilities and ensure data quality and documentation is adequate.
Identify areas where operational efficiency can be improved through enhanced automation. Collaborate with technical staff on implementation of enhancements. Communicate necessary changes and enhancements to all internal/external customers.
Represent the organization at external meetings.
Provide recommendations and input to new contract provisions for performance guarantees. Respond to various Requests for Implementation as requested by marketing staff. Perform special studies as needed.
Perform other duties as assigned.
Bachelor's degree in Computer Science, Mathematics, Economics, or related field; or an equivalent combination of education and experience
Seven to ten years health data analysis, business analysis, software application, database design, and technical documentation experience, preferably in the health insurance industry
Successfully pass the Wolfe Spence Programmer Aptitude test
Knowledge of claims processing and membership processing for all BCBSRI lines of business
The extras:
Knowledge of applied statistics
Knowledge of econometric modeling
Knowledge of marketing analytic principles and modeling
Experience utilizing competitive intelligence
Knowledge of CPT-4 and ICD-9 coding and covered benefits
Understanding of SAS programming, spreadsheet, and database software and other application development tools
Knowledge of general mathematical principals
Working knowledge of Business Objects and Windows
Understanding of micro and mainframe computer systems
Strong business acumen and political savvy
Ability to lead and manage projects
Ability to collaborate while dealing with complex situations
Ability to think creatively and to drive innovation
Ability to motivate, lead and inspire a diverse group to a common goal/solution with multiple stakeholders
Ability to convert business strategy into action-oriented objectives and measurable results
Strong negotiating, influencing, and consensus-building skills
Ability to mentor, coach and provide guidance to others
Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
In-office: onsite 5 days per week
Hybrid: onsite 2-4 days per week
Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer.
The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.
$98.1k-163.4k yearly Auto-Apply 60d+ ago
Insurance Producer -Cranston, RI
Horace Mann 4.5
Cranston, RI job
Join Horace Mann: Empower Educators, Achieve Financial Success
Ready to Make a Difference?
Join Horace Mann today and take the first step toward achieving your career and financial goals while making a meaningful impact on the educators you serve. Together, we can help educators secure their future while empowering you to achieve your own.
As an Insurance Producer at Horace Mann, you'll receive mentorship from an experienced agent while gaining hands-on experience in the industry. Our insurance products are tailored to meet the unique needs of educators, and we provide outstanding training, competitive rates, and flexible work options. With an unparalleled compensation structure, exciting incentives, and bonus opportunities, top performers have the chance to earn all-expenses-paid trips to amazing destinations.
Why Join Us?
Performance-Based Compensation [1099] with a 36-month incentive plan and enhanced commissions
Monthly incentives based on sales volume for the first 36 months
Quarterly production bonuses for the first 36 months
Leverage established books of business while learning the business
Access to a niche market that increases your potential for success
Value-added services to connect you with ideal clients
Simple, streamlined products and sales processes for quick success
Networking, community, and industry events to expand your connections
A comprehensive, multi-line product portfolio in a ‘One-Stop Shop' model
What You Will Do:
Solve financial challenges faced by educators through tailored solutions
Present with confidence-one-on-one or in large groups-to educate potential clients on products
Engage in community and networking events, expanding your professional connections
Stay current with industry trends and apply new knowledge to help clients
Cultivate strong market relationships and build a solid client base
Invest time and resources in ensuring the success and growth of your business
What We're Looking For:
A commitment to helping educators achieve financial prosperity
Strong interpersonal and presentation skills
Self-motivation and the ability to manage your own business
The ability to obtain or currently hold state licenses in Life & Health and Property & Casualty
Compensation and Benefits:
Sign-On Bonus
Uncapped Earnings/Commission
Structured Incentive & Bonus Pay to reward your hard work
Work Environment-work in-person, in the field, and/or from an office setting
Support and Accountability:
As an Insurance Producer, you'll be guided by a mentor agent who will support you every step of the way to ensure your success.
We make a difference!
At Horace Mann, we are driven by our mission to support the educators who shape the future of our children. We believe that educators deserve someone who looks after their financial well-being just as they do for their students. Our passion lies in providing tailored solutions that protect what educators have today and help them achieve long-term financial security and happiness.
# LI-AK1
#LI-CP1
#VIZI#
$66k-86k yearly est. Auto-Apply 11d ago
Risk Management, Modeling Analytics Lead
Travelers Insurance Company 4.4
Providence, RI job
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Data Analytics, Data Science
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$169,400.00 - $279,600.00
**Target Openings**
1
**What Is the Opportunity?**
The Travelers Catastrophe Risk Management Group is seeking a Cyber Peril Lead to join our PERILS team leading our research related to man-made perils with a focus on Cyber risk. You will be joining a group of dedicated professionals charged with leading Travelers to be in position to successfully endure catastrophic loss from natural and man-made perils.
The PERILS team is a multi-discipline group focusing on peril research, the development of next generation analytics, and event response activities. As a member of this Team, you will be an active participant in the development and implementation of peril research and strategies. The team engages in enterprise-wide complex multi-disciplinary CAT research projects with various depths of focus. The position requires an individual who can strive in an analytical, innovation-driven environment, in tune with business needs.
**What Will You Do?**
We are seeking a candidate with a solid analytical base in cyber risk management or a scientific, engineering, or related quantitative discipline. The person will have effective self-organizational and time-management skills with the ability to work independently and formulate and execute project objectives. We seek problem solving and critical thinking skills in support of the team's efforts to provide best-in-class analyses to our business partners. Some of the specific duties include:
+ Provide thought leadership and strategy support related to portfolio cyber risk
+ Validate cyber aggregation risk models and technographic scores
+ Assist the Cyber Underwriting team with subject matter technical expertise and guidance
+ Identify, select, and extract relevant data from various internal and external sources. Complete analyses and present recommendations to team members, stakeholders, and Leadership
+ Stay abreast of the latest scientific research and summarize findings for the peril, including recent trends in threat actors, techniques and vectors of attack
+ Drive innovation through new tools/technologies and capabilities (e.g., develop custom tail scenarios)
+ Monitor the Company's exposures, aggregations, and peril-specific book mix changes
+ Support our Business Units Consulting and Actuarial functions with ad-hoc research and peril strategy development
+ Create and maintain collaborative relationships with business partners
**What Will Our Ideal Candidate Have?**
+ Exposure to cyber catastrophe modeling and/or cyber hygiene technographic scanning tools is a plus
+ Proficiency with Microsoft Suite, SQL, statistical packages, or other programs used to retrieve and analyze data
+ Knowledge of insurance concepts, coverage, products, and operations preferred
+ Ability to apply emerging statistical procedures to large highly complex work
+ Working knowledge of a programming language such as Python/R/Matlab preferred
+ Works well both independently & within a team, strong organization, and time management
+ Demonstrated ability to convey technical concepts across professional fields of discipline
**What is a Must Have?**
+ Master's degree in Statistics, Mathematics, Decision Sciences, Actuarial Science or related analytical STEM field plus six years of experience or any suitable and equivalent combination of education and work experience.
+ Heavy concentration in mathematics, including statistics and programming, business intelligence/analytics, as well as data science tools and research using large data sets. Additional verification of specific coursework will be required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
$169.4k-279.6k yearly 60d+ ago
Pharmacy Technician (43532)
Neighborhood Health Plan of Rhode Island 4.4
Smithfield, RI job
Under the direct supervision of the Manager of Pharmacy Operations, the Pharmacy Technician will perform various, assigned administrative operational functions within the Pharmacy department. This position is directly involved with day-to-day operations of the department and is responsible for conducting and coordinating multiple facets of the prescription drug prior authorization (PA) process. The duties associated with this position include PA order entry, updating PAs within the pharmacy claims system, tracking and reporting PA activity and processing PA notifications to members and providers. The position requires a working knowledge and familiarity with prescription drugs. The position works closely with Neighborhoods Medical Management, Grievance & Appeals Unit, claims department, vendors, and Member and Provider service teams. The position requires excellent verbal communication skills and a demonstrated ability to work in an organized, timely, efficient and thorough manner.
Duties and Responsibilities:
Responsibilities include, but are not limited to the following:
* Independently coordinates and processes pharmacy prior authorizations (PA) taking into consideration pharmacy benefits, medication utilization policies, information submitted by prescriber accurately and in a timely manner and in accordance with departmental policy and procedures.
* Triage, document and prioritize incoming calls and requests while following established protocols Utilize plans reporting capabilities to collect and analyze claims and drug utilization data.
* Interacts with internal plan departments to address pharmacy related issues.
* Researches pended claims and authorizations and corrects issues when applicable.
* Responds to inquiries from physicians, members, and pharmacies related to formulary and prescription benefits.
* Audits processed pharmacy claims to ensure appropriate adjudication while verifying compliance with benefit design and regulatory requirements for all lines of business.
* Demonstrates proficiency in all pharmacy claims systems.
* Collaborates with Plans contracted PBM in regards to PAs, overrides, and issue resolution.
* Conducts outbound calls to resolve prescription issues pertaining to prescription coverage, claim rejections, etc.
* Ensures all member information is kept confidential according to HIPAA regulations.
* Conducts quality assurance measures as assigned.
* Participates in onboarding and training activities of new employees.
* Other duties as assigned by the Vice President of Pharmacy or Pharmacy Management.
* Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents
$30k-37k yearly est. 10d ago
Manager, Alternative Distribution Product Management - Small Commercial
Travelers Insurance Company 4.4
Providence, RI job
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Product
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$101,300.00 - $167,000.00
**Target Openings**
1
**What Is the Opportunity?**
Within the Product team at Travelers, you will have the opportunity to regularly engage in unique and intellectually stimulating business problems. As a Manager, Product Management, you will manage the growth and profitability for a state(s), product, or line of business. You will analyze complex business problems and propose fact-based solutions with consideration of internal and external trends to achieve business objectives. By collaborating and influencing key stakeholders across the organization you will also ensure strategic direction and alignment for successful execution. You will coach and lead cross functional team(s) on growth strategies, products, and objectives.
**What Will You Do?**
+ Lead and guide the data analysis of business results including product refreshes, performance expectations and identifying root cause.
+ Develop and influence recommendations to drive desired growth & profitability impacts that demonstrate a holistic view of short- and long-term strategy with consideration for local regulatory nuances and broader marketplace dynamics.
+ Present, inform and influence recommendations to key leadership stakeholders including proposed product/pricing changes or new product builds.
+ Act as a senior resource in key strategic initiatives to support the goals and objectives of the broader organization.
+ Manage, coach, and/or guide analysts.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's degree in Business Management/Administration, Mathematics, Finance, Actuarial Science, Economics, or other analytics related field.
+ Five years' experience working in a mathematical, analytical, or data related role preferably in the financial services industry.
+ Experience developing techniques and procedures used to forecast insurance financials.
+ Has deep understanding of Travelers' business strategy and plan objectives to align with enterprise goals.
+ Excellent communication skills with the ability to interact and influence management.
+ Excellent analytical skills with the ability to evaluate and understand current data and systems, find deficiencies/opportunities, recommend changes, and translate into business impacts.
+ Demonstrated knowledge of pricing and actuarial techniques and understanding of actuarial concepts such as loss development and trending.
+ Understand the workflow and terminology of insurance products and processes and their impact on profit and loss.
**What is a Must Have?**
+ Bachelor's Degree or equivalent combination of education and experience.
+ Three years of experience in data analytics or similar work experience.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
$101.3k-167k yearly 20d ago
Bilingual Customer Benefit Advisor I
Unum Group 4.4
Providence, RI job
When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:
+ Award-winning culture
+ Inclusion and diversity as a priority
+ Performance Based Incentive Plans
+ Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability
+ Generous PTO (including paid time to volunteer!)
+ Up to 9.5% 401(k) employer contribution
+ Mental health support
+ Career advancement opportunities
+ Student loan repayment options
+ Tuition reimbursement
+ Flexible work environments
**_*All the benefits listed above are subject to the terms of their individual Plans_** **.**
And that's just the beginning...
With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today!
**General Summary:**
Minimum starting hourly rate is $22.00
The Customer Benefit Advisor (CBA) I is the entry level in a three-level career path. A CBA I is a critical first point of contact for our customers.
To be successful in this role, the incumbent is responsible for demonstrating exceptional customer service for business serviced by Unum/Colonial Life. It is critical to provide accurate information on benefits, claims, and or policy administration with minimal operational oversight. Incumbents in this role will be tasked with compiling information for multiple product types, from multiple systems, and providing responses to customers that are thorough, clear, and concise. All work is carefully performed according to established protocols/procedures.
In this role, incumbents must demonstrate a willingness to provide strong customer service - providing accurate information to customers, expressing appropriate empathy, and resolving customer issues where appropriate. This position requires the use of multiple system applications and administrative processes. While service is focused on our external customers, this position is responsible for creating detailed/appropriate documentation for our internal cross-functional business partners.
In addition to providing excellent customer service in accordance with established standards, incumbents will need to demonstrate proficiency in individual metrics (i.e. accuracy, post-interaction surveys, average handle time, after call work, schedule adherence, etc.) that are in line with pre-set expectations and drive results for the Customer Contact Center.
**Principal Duties and Responsibilities**
+ Be the customers' first line of sight (advisor) by being available to assist via multiple avenues of communication with timely and accurate information regarding policy and coverage-related questions.
+ Meet or exceed company goals and metrics to guarantee the best experience for customers.
+ Be open and motivated by feedback and guidance to be at your best for customers.
+ Protect customers' privacy (both internal and external) and reassure them with empathy and professionalism.
+ Be available to work a regularly assigned shift between the hours of 8:00 am and 8:00 pm Eastern time Monday-Friday.
+ Reliable attendance in accordance with contact center attendance guidelines.
+ Successfully complete all required training and associated support periods.
+ Ability to obtain information from multiple systems and relay to customers in a seamless manner.
+ Follow all documented processes/workflow to enhance customer service and reduce customer effort/operating efficiency.
+ Utilize resources and tools to accurately respond to customer inquiries.
+ Demonstrate a passion for the values outlined in value statements.
+ May perform other duties as assigned.
**Job Specifications**
+ 1 year customer service experience preferred, with a strong preference that the experience be in the insurance/healthcare/medical/financial field or equivalent area.
+ Highschool diploma or GED required.
+ Successful completion of Contact Center training program, including demonstrating phone proficiency and passing required knowledge checks.
+ A passion for helping customers and exceeding their expectations with high integrity.
+ Answering customer inquiries, translating documents and acting as an interpreter for English and Spanish languages.
+ Excellent verbal and written communication skills with the ability to flex your communication style to best meet the needs of customers, both in English and Spanish.
+ Enthusiasm for working in a fast-paced, structured environment, answering numerous inquiries for customers at their greatest time of need.
+ Strong computer and multi-tasking skills as well as the ability to confidently work in multiple systems with dual monitors.
+ Familiarity with Microsoft applications such as Outlook, Word, and Excel.
+ Intellectual curiosity and a desire to continually learn and grow.
+ An excellent work ethic and ability to adapt and work successfully in a continually changing environment.
+ Dependability - being available when needed by teammates and customers.
+ Comfortable with video communications via MS Teams throughout the day to communicate with teammates and leadership face to (virtual) face.
+ Must meet attendance requirements and in office expectations when applicable.
~IN3
\#LI-LM2022
Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.
Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status.
The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience.
$36,000.00-$62,400.00
Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans.
Company:
Unum
$36k-62.4k yearly 59d ago
Senior Business Analyst - Strategic Analytics
Amica Mutual Insurance 4.5
Lincoln, RI job
Senior Business Analyst - Strategic Analytics (Corporate Strategy) 25 Amica Way, Lincoln, RI 02865 Thank you for considering Amica as part of your career journey, where your future is our business. At Amica, we strive to build a culture of belonging where employees are encouraged to share their unique experience to enrich our workplace, strengthen our company's mission and broaden our vision of what's possible. We're focused on creating a workplace that works for all. We'll continue to provide training, guidance, and resources to make Amica a true place of belonging for all employees. Want to learn more about our commitment to diversity, equity, and inclusion? Visit our DEI page to read about it!
As a mutual company, our people are our priority. We seek differences of opinion, life experience and perspective to represent the diversity of our policyholders and achieve the best possible outcomes.
This position is hybrid and requires onsite days at our Lincoln, RI campus.
This role does not currently offer employment visa sponsorship.
Job Overview:
The Senior Business Analyst will play a pivotal role in shaping enterprise-level insights and driving strategic decision-making. Reporting to the Assistant Vice President in Strategic Analytics, this role partners with all functional areas to develop a comprehensive narrative of business performance and recommend actions to improve outcomes. The ideal candidate combines strong analytical capabilities with business acumen and a passion for using modern tools to accelerate insight generation.
Responsibilities:
* Analyze internal and external business trends to identify performance drivers and improvement opportunities.
* Collaborate across departments to gather context, align on KPIs, and develop a full story of enterprise results.
* Translate complex data into clear, compelling narratives and visualizations for executive audiences.
* Recommend data-driven actions to improve business performance and track the impact of implemented changes.
* Partner with Finance and operational leaders to quantify the financial impact of proposed strategic actions, ensuring recommendations are assessed based on a clear ROI.
* Develop and maintain dashboards, reports, and models that support strategic planning and operational decision-making.
* Leverage AI tools such as ChatGPT, Gemini, and Microsoft Copilot to enhance research, analysis, and productivity.
* Ensure data quality and integrity through validation, profiling, and adherence to best practices.
* Contribute to a culture of data literacy and insight-driven decision-making across the enterprise.
Requirements:
* Bachelor's degree in business Analytics, Economics, Statistics, Data Science, or a related field (master's preferred).
* 4-6 years of experience in a business analyst or data analyst role, preferably within insurance or financial services.
* Proficiency in SQL and data visualization tools (e.g., Tableau, Power BI).
* Strong analytical thinking, problem-solving, and communication skills.
* Proven ability to influence senior stakeholders, build strong collaborative relationships, and drive alignment on data-driven recommendations.
* Demonstrated ability to work independently and collaboratively across functions.
* Experience identifying and analyzing trends and their business implications.
Preferred Skills:
* Familiarity with Snowflake and Python.
* Experience with executive reporting and strategic performance analysis.
* Expert in Business Intelligence tools (e.g., Power BI, Microstrategy, Tableau)
* Ability to mentor peers and promote best practices in data storytelling and analytics.
* Understanding of enterprise data governance and reporting standards.
* Active user of AI tools (e.g., ChatGPT, Gemini, Microsoft Copilot) to drive efficiency and conduct deep research and analysis.
Total Rewards:
* Medical, dental, vision coverage, short- and long-term disability, and life insurance
* Paid Vacation - you will receive at least 13 vacation days in the first 12 months, amounts could be greater depending on the role. While able to use prior to accrual, vacation time will accrue monthly.
* Holidays - 14 paid holidays observed
* Sick time - 6 days sick time at hire, 6 additional days sick time at 90 days of employment
* Generous 401k with company match and immediate vesting. Additionally, annual 3% non-elective employer contribution
* Annual Success Sharing Plan - Paid to eligible employees if company meets or exceeds combined ratio, growth and/or service goals
* Generous leave programs, including paid parental bonding leave
* Student Loan Repayment and Tuition Reimbursement programs
* Generous fitness and wellness reimbursement
* Employee community involvement
* Strong relationships, lifelong friendships
* Opportunities for advancement in a successful and growing company
Amica conducts background checks which includes a review of criminal, educational, employment and social media histories, and if the role involves use of a company vehicle, a motor vehicle or driving history report. The background check will not be initiated until after a conditional offer of employment is made and the candidate accepts the offer. Qualified applicants with arrest or conviction records will be considered for employment.
The safety and security of our employees and our customers is a top priority. Employees may have access to employees' and customers' personal and financial information in order to perform their job duties. Candidates with a criminal history that imposes a direct or indirect threat to our employees' or customers' physical, mental or financial well-being may result in the withdrawal of the conditional offer of employment.
About Amica
Amica Mutual Insurance Company is America's oldest mutual insurer of automobiles. A direct national writer, Amica also offers home, marine and umbrella insurance. Amica Life Insurance Company, a wholly owned subsidiary, provides life insurance and retirement solutions. Amica was founded on the principles of creating peace of mind and building enduring relationships for and with our exceptionally loyal policyholders, a mission that thousands of employees in offices nationwide share and support.
Equal Opportunity Policy: All qualified applicants who are authorized to work in the United States will receive consideration for employment without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, family status, ethnicity, age, national origin, ancestry, physical and/or mental disability, mental condition, military status, genetic information or any other class protected by law. The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are 40 years of age or older. Employees are subject to the provisions of the Workers' Compensation Act.
Amica Mutual Insurance Company is committed to protecting job seekers from recruitment fraud. We never request sensitive personal information or payment during the interview process. All legitimate job opportunities are listed on our official careers site: ************************** Learn more in the "Is Amica hiring?" section of our FAQ.
rp
$80k-104k yearly est. 59d ago
Senior Contract Administrator (36662)
Neighborhood Health Plan of Rhode Island 4.4
Smithfield, RI job
The Senior Contract Administrator is responsible for the end-to-end contracting process including, contract strategy development and negotiation through to execution with an emphasis on complex, high profile negotiations. This position develops, facilitates and implements provider negotiation strategies that support strategic and corporate goals. This position is responsible for the ongoing monitoring and management of contract terms including claims system configuration, contract oversight and adherence to all managed care health plan requirements. Provides support in the absence of a manager.
Duties and Responsibilities:
Responsibilities include, but are not limited to:
* Responsible for complex, high profile negotiations, including the development, proposal and implementation of contractual terms as approved
* Leads negotiations to completion and execute contractual relationships to align with specific corporate and department initiatives, strategic goals and objectives. Responsible for the accuracy of all contract and rate proposals and final contracts. Ensuring reimbursement is accurately defined, communicated and configured while maintaining network adequacy and member access to care standards and all Plan contractual requirements
* Monitoring of contractual requirements through the ongoing management of contract terms including claims system configuration, contract oversight and adherence to all managed care health plan requirements
* Assists in the development of the vision and strategy for the department and assigned functions including the identification, recommendation and recruitment of providers
* Cultivates strong business relationships internally and externally
* Ensures that providers receive appropriate and timely responses
* Identifies and implements medical expense savings opportunities
* Leads and collaborates departmentally and cross-organizationally in the development and planning of provider contracting initiatives and efficient business processes including recommending modifications to policy and procedures, processes, workflows and communication strategies
* Provides assistance and mentorship to the Contract Administrator and support in the absence of the Manager
* Provides reporting to internal and external parties
* Represents the organization in appropriate internal and external committees and meetings and facilitate internal and external meetings, as required
* Serves as the lead subject matter expert ensuring optimal efficiency in area of responsibility
* Understands, proposes and implements various industry standard reimbursement methodologies as approved
* Works collaboratively with provider relations to understand operational issues, providing assistance in the satisfactory resolutions as needed
* Maintains professional growth and development
* Works on special projects and other duties as assigned
* Responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents