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The role involves negotiating and managing vendor/provider contracts, performing market analysis, and overseeing financial and operational success of partnerships.

The HEDIS Program Manager II will oversee initiatives for Medicaid, ensuring integration of HEDIS and CAHPS while managing projects and collaborating with stakeholders for improved program outcomes.

The VP Corporate Compliance Investigations leads compliance-related investigations, manages the Compliance Investigation Unit, and ensures stringent adherence to compliance standards while fostering collaboration across departments.

The Provider Engagement Account Manager maintains partnerships between health plans and contracted providers, ensuring optimal performance and aligning on network opportunities for improvement. Engages with providers through visits, evaluates performance metrics, and implements strategies for better patient outcomes.

Manage compliance department functions, oversee audits, ensure regulatory compliance, develop corrective action plans, and provide training on compliance issues.

The Data Analyst III is responsible for supporting analytic data needs, handling complex data projects, and leading other Data Analysts by providing advanced analytical support in various operational areas.

Manage provider relationships for improved performance and quality care. Act as liaison, resolve issues, and engage in value-based care initiatives.

Direct provider network and contracting activities, develop strategies, manage budgeting, analyze market information, and oversee staff for network expansion and contract negotiations.

The Vice President, Marketplace Network Strategy & Management oversees provider network strategy, budget management, and collaborates with health plans and stakeholders to enhance network operations and development.

Lead clinical coding compliance nurses and non-clinical team members, ensure compliance with coding practices, oversee relationships with health plans, and manage escalated inquiries.