Jobs at Altais

Processes incoming medical authorizations through Tapestry Link and OnBase, verifies eligibility and benefits, reviews requests, prepares denial letters, and obtains missing clinical documentation from provider offices. Provides authorization support to internal and external customers, documents activities accurately, meets turnaround requirements, maintains confidentiality and HIPAA compliance, and cross-trains with other utilization management coordinators.

Owns month-end journal entries, accruals, reconciliations, schedules, reporting, regulatory filings, and variance analysis. Investigates accounting issues, supports audits, maintains controls and procedures, and partners with business and IT teams on system integrity and process improvements. Supports strategic projects, system implementations, and accurate financial reporting while communicating risks and recommendations to management.

Leads development and delivery of complex healthcare, clinical, provider, and financial datasets. Provides enterprise reporting, dashboards, data visualization, business intelligence, and decision support. Analyzes cost, utilization, provider, member, and clinical data to identify inefficiencies and savings opportunities. Serves as an internal analytics consultant, improves data procedures, automates reporting processes, trains team members, and ensures validation and documentation standards.

Analyzes, validates, and maintains provider data for credentialing, enrollment, health plan rosters, and regulatory submissions. The role performs data reconciliation, quality checks, reporting, exception resolution, and audit support while collaborating with credentialing, operations, compliance, contracting, enrollment, and IT teams. It also supports process improvement, automation, data governance, system testing, and documentation to improve provider data accuracy and submission timeliness.

Lead actuarial analyses for Medicare risk adjustment, pricing, and financial reporting. Extract and manage large healthcare datasets, build risk score reports (Cozeva, claims, Power BI), support forecasts/filings, advise senior management, collaborate with operations, and mentor junior analysts.

Lead physician network expansion and operations by building relationships with physicians, medical groups, and payers; implement network strategy and performance optimization; support physician services and satisfaction; collaborate with clinical and quality teams; and manage and coach a team of network development and physician relations professionals.

Lead and manage the Altais Hawaii integrated health network, setting strategy, overseeing finance, operations, clinical performance, governance, payer and hospital relations, business development, and physician engagement to grow and sustain the market.

Manage the AHS accounting department, oversee month-end close, general ledger maintenance, balance sheet reconciliations, financial reporting, budget variance analysis, and chart of accounts. Develop accounting policies, support annual budgeting, ensure internal controls to prevent fraud, and work closely with the Controller to ensure accurate financial statements for all entities.