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The Quality Improvement Specialist conducts on-site audits for healthcare providers, documenting compliance with regulatory standards and assisting with data management and report generation. Responsibilities include conducting training sessions, managing audit schedules, and ensuring providers meet accessibility requirements while maintaining HIPAA confidentiality.
The Technical Product Manager will translate business problems into technical solutions, develop product roadmaps, and engage stakeholders to shape product design and implementation. This role involves collaborating with architects for data integration, conducting research to improve processes, and overseeing project planning for complex customer environments.
The Provider Engagement Account Manager maintains partnerships with provider networks, ensuring high care delivery levels. Responsibilities include managing provider issues, educating providers on policies and procedures, and driving performance improvement in quality and cost utilization metrics. The role requires frequent travel and project management experience within a healthcare setting.
The Quality Improvement Specialist conducts audits of Primary Care Physicians and associated facilities to ensure compliance with regulatory standards. The role involves managing scheduling, documenting findings, developing reports, and providing training and technical assistance to improve accessibility for members, while maintaining confidentiality and adhering to policies.
The Community Relations Specialist leads activities to achieve membership and enrollment goals through marketing, community activities, and outreach. Responsibilities include planning events, developing business relationships, conducting internal and external meetings, and coordinating with sales teams for market execution, all while ensuring compliance with policies and procedures.
The Retention Field Representative is responsible for retaining membership, conducting outreach, and providing product education to new and existing members. They maintain relationships with members, document interactions in systems like Sales Force, and ensure compliance with corporate policies. Fluency in Cantonese and Mandarin is required.
The Community Relations Coordinator is responsible for developing and implementing the community outreach plan for the Health Plan. This role involves engaging with community contacts, attending health events, organizing outreach activities, and supporting health education presentations. A strong focus is placed on member growth goals and complying with regulatory guidelines in healthcare marketing.
The Senior QA Automation Test Engineer designs and develops automated test scripts, conducts code reviews, and enforces quality standards. They also execute manual and automated tests, mentor junior engineers, analyze product quality, and ensure compliance with industry standards while integrating automated suites with CI/CD platforms.
The Manager, Provider Network Operations oversees provider network activities ensuring compliance with health standards and regulatory requirements. Responsibilities include managing operational functions like credentialing and contract processing, monitoring onboarding processes, leading initiatives for process improvement, and ensuring compliance with internal and external standards.
The Manager, Provider Relations & Contracting will lead recruitment, contracting, and retention efforts for behavioral health providers, manage contract compliance, negotiate agreements, and oversee business processes associated with provider contracting. This role includes fostering relationships with providers and monitoring operational and financial performance to guide negotiations.
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