Jobs at GlobalHealth Holdings, LLC

Manages Medicare Advantage member experience and quality improvement initiatives to achieve and maintain strong CMS STAR ratings and NCQA accreditation. Oversees CAHPS and HOS surveys, vendor performance, provider outreach, AWV/HRA programs, training, reporting, and cross-functional improvement efforts. Develops educational and wellness materials, monitors quality measures, presents updates to provider groups, and supports compliance with HIPAA and healthcare quality standards.

Manages the organization’s server, network, cloud, and systems infrastructure. Responsibilities include infrastructure architecture, implementation, maintenance, monitoring, troubleshooting, disaster recovery, security remediation, capacity planning, vendor management, budgeting, and Tier 3 technical support. The role leads infrastructure personnel, recommends hardware and software upgrades, manages ITIL processes and SLAs, supports Windows, Linux, virtualization, Cisco networking, and cloud environments, and ensures HIPAA-compliant handling of protected health information.

Maintains provider data integrity and directories, evaluates network access, resolves provider inquiries, supports provider onboarding and education, and collaborates with internal and external stakeholders. The role also assists with CMS guidelines and NCQA accreditation standards while protecting confidential business information and PHI. It is remote, requires strong Microsoft Office and NPPES data skills, and involves no travel or supervisory duties.

Supports healthcare quality initiatives by managing care gaps, conducting member and provider outreach, educating providers on quality measures, entering data, reviewing medical records, tracking referrals, documenting coding, and auditing provider records. Requires knowledge of HEDIS, CAHPS, HOS, Meaningful Use, CMS standards, HIPAA, and electronic health records. The role requires extensive travel during audit season and occasional overnight stays.