12 systems programmer jobs found in Des Moines

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Job Summary Under the direction of the Director/Associate Director of Clinical Management, the Senior Clinical Study Manager is responsible for the oversight and management of Otsuka clinical studies, including coordination with other relevant parties (e.g., other Otsuka departments, external service providers (ESPs), etc.). Responsibilities include the planning, execution and completion of clinical trials according to applicable regulations and guidance; ICH Guidelines Good Clinical Practices (GCP), and Otsuka SOPs, within agreed-upon timeframes and budget. Job Description Provides oversight and management of clinical studies at Otsuka, including planning, execution, and completion of clinical trials according to all applicable regulations and guidance, ICH/GCP, and Otsuka SOPs. Contribute to the development and review of all critical clinical study documents, including clinical protocols, informed consent forms, or other study-related clinical documents....

Program Manager - Contract Lifecycle Management Implementation Anywhere Type: Contract Category: Program/Project Management Industry: Technology Workplace Type: Remote Reference ID: JN -032026-105956 Date Posted: 03/12/2026 Shortcut: http://careers.eliassen.com/ZA0OkN Description Recommended Jobs Description: Remote Our client is seeking a Program Manager to lead a Contract Lifecycle Management implementation within a broader Finance and Legal transformation. The role will own strategy, roadmap, and delivery across legal, finance, and technology stakeholders while managing risks, vendors, and change. The manager will drive process design, configuration guidance, and adoption to improve contract efficiency, visibility, compliance, and automation. This program leader will ensure alignment with the digital transformation ecosystem and deliver measurable outcomes. Due to client requirements, applicants must be willing...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: Use most up to date job description. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo...

Intern - Capacity Management Data AnalystRemote - United StatesJR012790 At Ensono, our Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients to Do Great Things! We enable our clients to achieve key business outcomes that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep up with continuous change and embrace innovation. We can Do Great Things because we have great Associates. The Ensono Core Values unify our diverse talents and are woven into how we do business. These five traits are the key to achieving our purpose: Honesty, Reliability, Collaboration, Curiosity, Passion Role Summary As an intern at Ensono, you will have a direct impact working with your team and also take part in programming provided by our Training and Development team. This will include project work, professional development, a business challenge...

Clinical Quality Management Program Manager (Part-time) Fully Remote-United States Job Type Part-time Description Overview Tanaq Management Services (TMS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TMS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders. About the Role We are seeking a part-time Clinical Quality Management Program Manager to serve as the primary point of contact for all contractual, technical, and administrative matters supporting the Clinical Quality Management (CQM) Program at the Defense Health Agency (DHA). The Clinical Quality Management Program Manager will provide day-to-day leadership, planning, coordination, and oversight of project staff and...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: As a Physician Clinical Reviewer, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a...

Company : enGen Job Description : JOB SUMMARY This pivotal role will lead the strategic transformation and optimization of workforce operations across enGen, encompassing both internal resources and external vendors. The Senior Director will be a key driver in establishing robust frameworks for tracking hours, managing financial allocations, and ensuring highly efficient resource deployment. This individual will possess a deep understanding of transformational initiatives, serving as a change expert who can intelligently engage with vendors, internal stakeholders, and senior leadership to align business operations with strategic objectives and deliver significant value. This leadership role is responsible for influencing, shaping, and executing high-impact strategies and initiatives delivering significant enterprise-level value. The Senior Director level demands a high degree of strategic leadership, independent decision-making, and accountability for fostering...

Nelnet Business Services (NBS), a division of Nelnet, Inc., provides payment technology, education services, and learning management solutions to education and faith-based organizations, serving more than 1,300 higher education institutions, 11,500 K-12 schools, 3,500 churches, and millions of individual students, families, and supporters across the globe. Our culture of service enables us to form long-lasting and trusted partnerships, while our focus on creativity and innovative solutions empowers our customer communities to thrive. As a Nelnet company, the perks at NBS go beyond our benefits package. You're part of a community, invested in you as an individual and united by our mission to create opportunities for people where they live, learn and work. The IT Service Management (ITSM) Analyst serves as the primary Major Incident Manager during assigned on-call rotations, leading real-time response to high-severity incidents and contributing to operational stability and site...

Director, Product Management: Capital One Shopping (Remote - Eligible) About Capital One Shopping Capital One Shopping is an industry-leading consumer technology business that is changing the way people buy and save online. The team operates with extreme focus to accelerate growth of the Shopping business, find best-in-market savings for shoppers, and create unique value for our merchant partners. Technology and a rapid test-and-learn methodology are applied to nearly all of our business challenges. The team has a flat organizational structure that emphasizes clear ownership, small teams, and leverage through technology. We are looking for a Product Director to join our team to improve and integrate new product and revenue opportunities with our merchant partners, and drive cross-functional execution within Shopping. This Product Director will have a demonstrated interest and aptitude for AI. While formal on-the-job experience with AI is a plus, we highly value candidates...

Location: Anywhere in Country At EY, we’re all in to shape your future with confidence. We’ll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world. Our objective is to provide clients with a unique business perspective on how to leverage SAP technology to enhance their operations. This is rooted in EY's SAP service line capabilities including Supply Chain, FICO, BPC, Data & Analytics, Customer, Tech/Arch and SuccessFactors. Our focus is on helping clients elevate performance and productivity. The opportunity EY's Agile Business Transformation enabled by SAP technology can help organizations address challenges in the digital era. Our EY SAP collaborative approach focuses on more than technology alone. We take a comprehensive, business-first view to address strategy, customer value, user experiences, processes, technology, and operational impacts in tandem. As...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...