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

The Provider Engagement Account Manager maintains provider partnerships, resolves issues, drives performance improvement, and educates providers on various policies and procedures.

Responsible for recruiting healthcare providers and managing contracts, ensuring compliance with state guidelines and internal policies. Requires outreach and coordination with various departments.

Supervises the utilization management team, ensures compliance with standards, and monitors team performance to improve care for members.

This role leads improvements in Provider Data Excellence processes, ensuring compliance and efficiency while fostering collaboration across departments in a healthcare payer setting.

Maintain partnerships with provider networks, resolve issues, educate providers, and drive performance improvement in quality and cost utilization.

Lead all financial activities for a business unit, including analysis, forecasting, and compliance. Manage financial strategy, pricing models, and performance reviews.

Manage partnerships with provider networks, resolving issues and educating providers on policies to ensure high-quality care for members.

Manage partnerships with health providers, ensure performance and compliance, conduct education sessions, and drive quality care improvements.

The Program Manager will oversee skills strategy initiatives, manage projects, ensure regulatory compliance, and facilitate cross-functional collaboration to enhance workforce capabilities.