Primary responsibilities include investigation of Workers Compensation claims to determine either compensability of the claim. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals.
This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Principle Duties and Responsibilities: Claims Management Manage WC caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory
and legal obligations. Monitor and ensure timely execution of all statutory deadlines or legal filings as needed. Analyze fact of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines.
Identify fraud indicators and actively pursue subrogation opportunities. Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks. Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors,
healthcare providers, outside attorneys) customers. Financial Impact Administration Manage book of claims business (up $1 million WC) with authority to settle/negotiate a single claim within their authority of up to $50,000 (Corporate Authority policy) Communicate ongoing causes of WC injuries to Safety and Brands.
Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications. Basic Qualifications: Licensed adjuster or ability to obtain license (as appropriate by jurisdiction) Bachelor's degree or 4 years WC claims experience Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation claims.
Knowledge of medical terminology involved in complex claims Strong negotiation skills. Skills and Abilities: Demonstrates -relationship building and communication skills, both written and verbal. Highly self-motivated, goal oriented, and works well under pressure. Customer focused solid understanding of WC legal procedures, processes, practices and standards in the handling of complex claims Ability to identify problems and effectuate solutions Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail Able to apply critical thinking when solving problems and making decisions.
#LI-SM1 #LI-Hybrid Retail Business Services currently provides services to five omnichannel grocery brands, including Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Retail Business Services leverages the scale of the local brands to drive synergies and provide industry-leading expertise, insights and analytics to local brands to support their strategies.
We are committed to diversity, equity and inclusion and we foster a community of belonging where everyone is valued. Retail Business Services is an equal opportunity employer. We comply with all applicable federal, state and local laws. Qualified applicants are considered without regard to interaction, race, color, ancestry, national origin, citizenship status, religion, age, marital status (including civil unions), military service, veteran status, pregnancy (including childbirth and related medical conditions), genetic information, interactionual orientation, gender identity, legally recognized disability, domestic violence victim status or any other characteristic protected by law.
We provide reasonable accommodations to applicants and employees with disabilities. As important as what we do is how we do it. Our team embodies our values of Courage, Care, Teamwork, Integrity and Humor in everything that they do. We have a culture of care that values and celebrates the qualities and perspectives that make us all unique. If you have a disability and require assistance in the application process, please contact our Talent Acquisition Department at xyz X@. For more information, visit . Job Requisition: 355603_external_USA-MA-Quincy_1292023
Primary Purpose: The Software Engineer III has a demonstrated track record delivering technically sound, high-quality, innovative, and fully functional software solutions that adhere to coding standards and technical design. This role will research, design, develop and implement new software solutions in addition to enhancing existing software capabilities.
This role will also collaborate with other Squad members, stakeholders and the Product team to ensure that products meet business, functional, and technical requirements and are scalable in nature. This will include translating business and technical requirements into well engineered, tested, and deployed technology solutions by gathering
user requirements, defining system functionality, and writing code in various languages. The Software Engineer III is responsible for projects from inception to completion including all project artifacts, executive status reports, and supervision of less experienced contributors.
This role works on problems of diverse scope where analysis of data requires evaluation of identifiable factors, deep understanding of the business strategy, operations, markets and key stakeholders. Duties & Responsibilities: Develop the technical design for solutions based on the defined scope, requirements, and functional design provided by the Product team and other stakeholders. Build and configure technical
components (interfaces, conversions, reports, workflows) so that solution design meets business needs and solution architecture standards.
Write and document programming code to meet the gathered requirements. Deliver solutions through ERP or Saa S solutions (e. g. SAP, Manhattan Active WM, Relex) Perform code reviews and quality assurance to ensure compliance to technical standards and business requirements. Collaborate with Squad to support the Product team to create and refine user stories and acceptance criteria. Prepare development and test environments, conduct test readiness to proceed with testing, and collaborate with to execute testing. Fix bugs identified during quality assurance and testing.
Continuously reduce technical debt (e. g. create technical debt stories, remove bugs) and decommission legacy applications and solutions. Perform updates and enhancements to the solution, as needed. Release software into production and perform release testing (system integration, mock conversion, parallel, regression, performance and stress, infrastructure). Develops solutions of diverse scope and solve technical problems that impact multiple areas or disciplines. Communicates with internal team members across multiple areas and client team members.
Acts as a project/team leader regarding solution design, process and/or approaches. Acts as a subject matter expert on technology solution Delivers high quality work in cross-functional team environments - often leading technical backssments and responsibilities, often contributes and leads collaborative brainstorming sessions and technical delivery approaches and has model self-led work drive and accountability - seen often as a technical leader and subject matter expert in the space, but leads humbly through team empowerment. Qualifications: Masters Degree in Computer Science or Technical field; equivalent trainings/certifications/experience equivalency will be considered 5 or more years of equivalent experience in relevant job or field of technology.
Experience in an advanced role or technical capacity, leading teams directly or indirectly Experience in guiding, training or onboarding team members in relevant technologies, capabilities or skills Proven work experience as a Software Engineer or Software Developer Experience designing interactive applications Ability to develop software in Java, Cobol, Python, C#, Cold Fusion, C++, or other programming languages Excellent knowledge of relational databases, SQL and ORM technologies (JPA2, Hibernate) Experience developing web applications using at least one popular web framework (e.
g. Angular, Ruby, Django, , Spring, Express) Experience with test-driven development Ability to document requirements and specifications Knowledge of algorithms and data structures Proficiency in troubleshooting software issues and debugging a large codebase Skills: Programming, Testing, Analytical Thinking, Agile Development, Problem Solving, Cybersecurity Risk Management, Data Privacy, Application Security, Technical Troubleshooting Preferred Qualifications: Post graduate degree advanced training and or certifications in relevant field/s of study preferred 3 or more years experience in Agile teams and or Product/Platform based operating model.
Experience in leading teams. Experience in retail or grocery preferred. #Dice Jobs #LI-AD1 #LI-hybrid Retail Business Services currently provides services to five omnichannel grocery brands, including Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Retail Business Services leverages the scale of the local brands to drive synergies and provide industry-leading expertise, insights and analytics to local brands to support their strategies.
We are committed to diversity, equity and inclusion and we foster a community of belonging where everyone is valued. Retail Business Services is an equal opportunity employer. We comply with all applicable federal, state and local laws. Qualified applicants are considered without regard to interaction, race, color, ancestry, national origin, citizenship status, religion, age, marital status (including civil unions), military service, veteran status, pregnancy (including childbirth and related medical conditions), genetic information, interactionual orientation, gender identity, legally recognized disability, domestic violence victim status or any other characteristic protected by law.
We provide reasonable accommodations to applicants and employees with disabilities. As important as what we do is how we do it. Our team embodies our values of Courage, Care, Teamwork, Integrity and Humor in everything that they do. We have a culture of care that values and celebrates the qualities and perspectives that make us all unique. If you have a disability and require assistance in the application process, please contact our Talent Acquisition Department at xyz X@.
For more information, visit . Job Requisition: 350163_external_USA-MA-Quincy_1262023
guides of Health care EDI format. Strong experience in Test Automation and EDI, HIPAA, PHI and NCPDP Testing. Should have good experience in Claims, Eligibility, Membership, Enrollment process, diagnosis, and procedure codes. Database knowledge to run DDL, DML, and other SQL commands.
Ability to review scenarios with Business and get sign off on Testing scenarios/strategies. Experience with participating in daily Scrum, Sprint Planning and Status reports. Must have Tools: Selenium, Client Load Runner, TOAD for Oracle 12.6, Python, Oracle SQL Developer 18.2, PL/SQL, UNIX, AWS, File Zilla, Microsoft Visio, Win SCP, Java, MS Office, Atlassian JIRA, Putty, COGNOS. Prior experience working
in healthcare or government setting with a strong knowledge base in healthcare insurance principles, eligibility, and Medicaid Management Information System (MMIS).
JOB DESCRIPTION Our client seeks a highly motivated individual as a Quality Assurance Tester to join its Data Warehouse Systems Quality Assurance (SQA) team. The Quality Assurance Tester will be responsible for working on complex projects within the Healthcare Domain and applying knowledge of software testing and analysis concepts, practices, and procedures. Requires experience in all phases of software development life cycle and testing methodologies. Experience should include testing of functional/non-functional scenarios
in support of integrated multi-platform systems. The individual should work in compliance with HIPAA requirements.
DETAILED LIST OF JOB DUTIES AND RESPONSIBILITIES: Create test models for release testing (plans, data, and scripts) including the identification, collection, and/or creation of test data. Lead coordination and execution of release testing as appropriate. Determine and meet time estimates and schedules for testing efforts. Define Release Test Plans and criteria for user acceptance including entry/exit criteria. Develop, update, and maintain quality testing standards and procedures. Communicate effectively with customers and software vendors as appropriate.
Assist in the planning, creation, and control of the test environment(s). Follow standard testing methodology frameworks, and testing processes as a standard. Coordinate testing specific release activities Determine and meet time estimates and schedules for testing efforts. Create test models for release testing (plans, data, and scripts), participate in structured walk-through and peer reviews. Participate in the coordination and execution of release testing. Participate in Lessons Learned as appropriate. Identify defects and questionable functionality; manage defects through to closure.
Resolve issues with unclear requirements and achieve a successful result. Triage and solve complex problems using structured troubleshooting methodologies. Work independently as well as work collaboratively in a team environment. Ability to design and develop a scalable and reliable automation test scripts. Identify areas of optimization and improvement in the testing process. Document test automation framework design. Responsible for System testing of Ad-Hoc Query Packages in Cognos which involves execution of Ad-hoc reports and corresponding test SQLs based on various join conditions and filters and calculations.
QUALIFICATIONS: REQUIRED SKILLS AND ABILITIES Hands on experience of end-to-end integration testing, Ability to Come up with the End-to-end test scenarios and test cases. Understanding of companion and implementation guides of Health care EDI format. Strong experience in Test Automation and EDI, HIPAA, PHI and NCPDP Testing. Should have good experience in Claims, Eligibility, Membership, Enrollment process, diagnosis, and procedure codes. Database knowledge to run DDL, DML, and other SQL commands. Ability to review scenarios with Business and get sign off on Testing scenarios/strategies.
Experience with participating in daily Scrum, Sprint Planning and Status reports. Must have Tools: Selenium, Client Load Runner, TOAD for Oracle 12.6, Python, Oracle SQL Developer 18.2, PL/SQL, UNIX, AWS, File Zilla, Microsoft Visio, Win SCP, Java, MS Office, Atlassian JIRA, Putty, COGNOS. Prior experience working in healthcare or government setting with a strong knowledge base in healthcare insurance principles, eligibility, and Medicaid Management Information System (MMIS). Ability to independently query transactional and Data Warehouse databases. Experience with data quality and remediation, data flows and mapping, or comparable experience (system or Data conversions, for example).
Test automation framework development using Selenium, Junit/Test NG, REST Assured tools. Programming language, preferably JAVA and good understanding of object-oriented design techniques. Proficient using XPath and CSS Selectors. Able to derive customized Xpaths. Experience in Jenkins, Maven, SVN, Git, and XL Deploy. Experience using Version controller tools like SVN / GIT Experience in test management, Build and CI/CD tools like ALM, Maven, Jenkins, and XL Deploy as preferred.
Must possess excellent verbal and written communication skills. Familiarity of testing types: black-box, white-box, functional, smoke, and regression. Strong analytical, troubleshooting, and problem-solving skills. Ability to deliver on time, while working in a semi-autonomous environment. EDUCATION AND EXPERIENCE: Bachelor of Science in Computer Science, related degree, or equivalent work experience. Knowledge of QA Methodologies and the software development lifecycle. 5 years of experience black-box, white-box, functional, smoke, and regression testing. 5 years of experience designing and maintaining test automation frameworks for web-based applications.
3 years of experience designing and maintaining web service automation test suites and frameworks. Strong analytical, troubleshooting, and problem-solving skills. Strong verbal, written and presentation skills. Proficiency in MS Office, i. e. Word, Excel, Power Point, Access, and Visio. Government and or Healthcare prior experience desired. Equal Opportunity Employer Veterans/Disabled While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations.
Benefits offered include medical, dental and vision benefits; dependent care flexible spending account; 401(k) plan; voluntary life/short term disability/whole life/term life/accident and critical illness coverage; employee assistance program; sick leave in accordance with regulation. Benefits may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions.
PDN-9acbae37-fa61-4db2-ae16-7f011277d0f0
Purpose This role will build teams to deliver highly performant and scalable data products and platforms to drive consumption of data from our enterprise data ecosystem, while driving data engineering best practices; lead, manage, and grow multiple high performing teams of product focused software & data engineers.
Embrace and incubate emerging technology and open-source products across all platforms. This individual will be accountable to drive a cohesive data strategy in collaboration with multiple enterprise partners and lead the work to modernize our existing tech stacks and data platforms. They will collaborate with internal teams to find areas of opportunities for automation and
machine learning while partnering with architects, product owners, data professionals, and software & data engineers to drive the implementation of new applications.
Duties & Responsibilities Responsible for leading the design, configuration, engineering, integration, and implementation of data platforms components and services and advise the engineering teams that work across Agile teams to design, develop, test, implement and support technical solutions across full-stack development tools and technologies. Deliver data-driven solutions that are customer focused, easy to consume and create sustained business value Develop and operationalize new program within each capability areas
from RFP, to testing, to deployment, to backssments Drive centralized and actionable views to build research, monitoring, and reporting capabilities Leverage experience to build efficient and scalable data platforms utilizing best in class tools and services Build and maintain optimized and highly available data pipelines for both real-time and batch data processing Deliver end-to-end data solutions that are highly available, scalable, stable, secure, and cost effective Design and customize complex data models, search queries, dashboards, and promote data-driven solutions in support of our technology strategies Provide expert level technical expertise to drive towards the right and practical solutions that meet the business needs within the required timelines Serve as the ambassador for all things data including data processing, cleansing, data platform engineering, data presentation, data architecture and analytics Effectively drive the teams to focus on the task at hand and align team objectives to corporate goals Define Objectives and Key Results, strategic risk indicators, and metrics/scorecards to understand current health and drive insights into focus future focus areas for the team/division before issues occur/risks are realized Surface insights to executive leadership, as needed, to update and influence Lead the evaluation of emerging data science technologies including testing and integration of new solutions Monitor and evaluates internal and external technology trends and changes that could impact data driven security programs and capabilities Additional job duties may be assigned as needed to meet the needs of the business and support our Values.
Qualifications Master's Degree in Computer Science or Technical field and Master's Degree in Technology and/or Business related field; equivalent trainings/certifications/experience equivalency will be considered 8 or more years of equivalent experience in relevant job or field of technology.
5 or more years of equivalent experience in an advanced role or technical capacity, leading teams directly or indirectly 5 or more years' experience directly responsible for guiding, training or onboarding team members in relevant technologies, capabilities or skills Preferred Qualifications Post graduate degree advanced training and or certifications in relevant field/s of study preferred 5 or more years' experience in Agile teams and Product/Platform based operating model. 5 or more years' experience in leading teams or advancing technical capability in teams.
Experience in retail or grocery preferred. #li-mm1 #li-hybrid Retail Business Services currently provides services to five omnichannel grocery brands, including Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Retail Business Services leverages the scale of the local brands to drive synergies and provide industry-leading expertise, insights and analytics to local brands to support their strategies. We are committed to diversity, equity and inclusion and we foster a community of belonging where everyone is valued.
Retail Business Services is an equal opportunity employer. We comply with all applicable federal, state and local laws. Qualified applicants are considered without regard to interaction, race, color, ancestry, national origin, citizenship status, religion, age, marital status (including civil unions), military service, veteran status, pregnancy (including childbirth and related medical conditions), genetic information, interactionual orientation, gender identity, legally recognized disability, domestic violence victim status or any other characteristic protected by law.
We provide reasonable accommodations to applicants and employees with disabilities. As important as what we do is how we do it. Our team embodies our values of Courage, Care, Teamwork, Integrity and Humor in everything that they do. We have a culture of care that values and celebrates the qualities and perspectives that make us all unique. If you have a disability and require assistance in the application process, please contact our Talent Acquisition Department at xyz X@. For more information, visit . Job Requisition: 354489_external_USA-MA-Quincy_1242023
