Top Tech Jobs & Startup Jobs

The role involves analyzing business needs, improving processes, coordinating efforts, and supporting business initiatives through data analysis and testing.

Manage a cross-functional team to execute business transformation initiatives, providing coaching and oversight while driving organizational change and growth.

Analyze performance data, develop and monitor quality improvement reports, and support NCQA accreditation. Requires statistical analysis experience and familiarity with HEDIS measures.

Lead Site Reliability Engineer responsible for optimizing and maintaining Microsoft 365 reliability and performance, mentoring team members, and managing monitoring systems in platforms like Splunk and Dynatrace.

Coordinate transitions of Medicaid/Medicare members from nursing facilities to the community, support care plans, and educate stakeholders about services.

Responsible for developing and implementing various training programs for clinical and non-clinical staff, including orientation and competency evaluations.

Oversee Provider Relations department, ensuring compliance with policies, develop tactical plans, manage budget, analyze reports, and train staff.

Coordinate and negotiate contracts with healthcare providers, ensuring compliance with guidelines and overseeing provider performance. Track credentialing and facilitate internal coordination.

Oversee Quality Improvement activities, manage HEDIS performance, ensure compliance, and direct risk adjustment strategies. Collaborate with other departments to enhance performance and outcomes.

The Retention Field Representative retains membership through outreach, education, resolving inquiries, and ensuring compliance with policies while building member relationships.