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Designs and implements complex enterprise software solutions, collaborating with various roles to meet business and technical needs while ensuring compliance with standards.

Responsible for NCQA accreditation and HEDIS performance, managing quality improvement activities, formulating policies, and ensuring compliance within healthcare operations.

Leads IAM systems and solutions, designs and maintains software applications, enforces IAM policies, and troubleshoots IAM security issues.

The Provider Engagement Account Manager is responsible for maintaining partnerships between a health plan and provider networks, ensuring high-quality care delivery. Key responsibilities include secondary contact for providers, resolving claims issues, educating providers, and managing network performance. The role involves local travel for provider visits and completing special projects as needed.

Analyze performance data to improve business processes and member outcomes, develop reports for accreditation and quality measures, and support performance improvement efforts.

Responsible for auditing systems and processes, compiling audit findings, coordinating outcomes, and ensuring compliance with requirements for improvement in operations.

Lead complex data analysis projects, strategic planning and execution of business strategies while overseeing data analysts. Analyze competitor data and provide recommendations to leadership. Foster relationships to support strategic and corporate initiatives.