The Project Manager, Medical Management is responsible for the ongoing project management and support of the various medical management projects at Allied. This position works directly with Allied's Case Management, Enhanced Case Management, and Allied Advocate departments, vendor partners, and consultants to facilitate change. The position will work with internal and ext

This position acts as a liaison between the retail and specialty pharmacy and the prescribers to document, submit, communicate outcomes and appeals. In addition, they will direct specialty pharmacy claims efficiently to provide the highest level of coordinated care to our patients and provide recommendations to non pharmacy peers. ESSENTIAL FUNCTIONS Review and manage all

The Software Engineer I is responsible for maintaining and developing software applications. This position will also be responsible for problem solving, coding, debugging, testing, and troubleshooting through the application development process. This role requires technical expertise and gives you the opportunity to engineer systems and build reliable and secure services

The Allied Advocate Quality and Training Specialist will be responsible for ensuring the continued quality of department workflows and processes and continuing training and development of best practices. ESSENTIAL FUNCTIONS Work closely with the individual teams and department leadership to determine ongoing training needs. Design and assist in developing training materia

The Supervisor, Rapid Response Team (RRT) and Refund is responsible for the timely assisting the management team with monitoring and management of the daily work and other functions within the RRT and Refund Departments. Provides guidance and direction to team members. Develops and implements workflows as needed. The supervisor is the primary contact for handling and prio

Working independently and in groups the Quality Assurance Auditor will be responsible for the completion of multiple audit tasks including but not limited to auditing the builds of plan coders as needed for all new and existing revisions, along with compiling and reporting results and trends accurately. The QA Auditor is also responsible for auditing outgoing corresponden

CLIENT RELATIONSHIP MANAGER POSITION SUMMARY The Client Relationship Manager has full command of their aligned market, serving as a direct resource for Key Business Partner Account Management Teams. Responsibilities include but are not limited to providing a highly personalized client and broker experience dedicated to educating contacts and brokers on coverage and the to

The Implementation Success Manager will manage implementation of new business sales. This position is responsible for leading and managing tasks from post sale tasks to an active client. The Implementation Success Manager will focus on completing setup milestones, leading weekly group calls, and overall project management for the success related to a new Allied client. Th

PLAN BUILDING ANALYST Position Summary Analyze plan documents to accurately build and maintain group set up in the Qiclink System. Essential Functions Accurately code self funded and fully insured groups based on the plan document. Accurately update coding for all plan changes. Set up and maintain HRA processing plans. Maintain applicable programs to ensure the appropriat

The Client Service Representative is responsible for providing excellent client service to Allied members, including HR representatives, brokers, and other various clients. They are the main point of contact for all inquiries and issues and must provide resolution in a timely, professional, and courteous manner. ESSENTIAL FUNCTIONS Act as the liaison between the client/br

The Database Engineer will be responsible for maintaining existing database and designing new stored procedure, triggers, and views for internal and external products. This position will also be responsible for problem solving and finding ways to create performant back end processes. As a Database engineer you will be working closely with the Database Administrator to res

The Billing Coordinator is responsible for managing all aspects of the billing process, including establishing, changing, and auditing client accounts, creating, and issuing invoices, processing payments, and reconciling accounts. In this role, you will work closely with clients, internal teams, and external partners to ensure timely and accurate billing. You will also be

The claims auditor will be responsible for coordinating and completing audits as well as compiling and reporting results and trends accurately, appropriately, and timely. ESSENTIAL FUNCTIONS Logging/Tracking all Claims/Tasks to be audited Audit for accuracy as well as workflow compliance; Release of appropriate claims using established workflows Assist with all audit prog

The position is responsible for the overall BPO Operations reporting and quality assurance through collaboration with various BPO department managers. Including, but not limited to, the ongoing oversight of Key Performance Indicator (KPI) reporting, ensuring all executive and external facing materials meet Allied's brand standards, assess current workflows and processes t

The Repricing Specialist I is responsible for re pricing medical (CMS1500, UB04) and dental claims using multiple applications to obtain discounted rates. ESSENTIAL FUNCTIONS Complete repricing of CMS1500 and UB04 forms for various PPO networks Ability to use multiple computer applications to obtain the information needed to correctly re price a claim Accurately key claim