The Implementation Specialist supports the planning, coordination, and execution of strategic initiatives within the Innovation and Strategy Division, specifically focusing on the Rural Health Transformation Project. They are responsible for managing project workstreams, coordinating stakeholder engagement, and ensuring operational readiness through effective communication and documentation.
The specialist supports the development and management of the provider network by analyzing network gaps, recruiting providers, and overseeing service expansion initiatives. They also provide technical assistance to providers and collaborate with internal departments to ensure compliance with performance standards.
The Care Manager II provides transitional care management and physical health consultation for members in various facility settings. They are responsible for developing post-discharge transition plans, facilitating clinical handoffs, and coordinating with care teams to ensure member integration into the community.
The CRM Engineer develops, integrates, and maintains technical components of the Salesforce platform, including Apex, LWC, and data pipelines. They ensure reliable data flow between Salesforce and other enterprise systems while supporting the full software development life cycle.
The specialist will manage the configuration, testing, and maintenance of healthcare management software while serving as a liaison between IT, business units, and vendors. They are responsible for designing workflows, performing end-to-end testing, and documenting technical characteristics to ensure system integrity.
The UM Program Integrity Specialist leads the development and implementation of a comprehensive Utilization Management training plan to ensure consistent application of workflows and clinical standards. They also support program documentation, audit readiness, and process improvement initiatives to maintain regulatory and accreditation compliance.
The Software Support Analyst serves as a subject matter expert for the Alliance Claims System, bridging the gap between end users and the application development team. Responsibilities include troubleshooting SQL Server stored procedures, managing support tickets, and assisting with system configuration and maintenance.
The role involves designing and implementing program evaluations to assess the effectiveness and cost-benefit of services delivered to recipients. It requires analyzing complex datasets and disseminating findings to promote continuous quality improvement within the organization.
Provide clinical oversight and medical expertise for physical health services, focusing on utilization management and evidence-based medical reviews. Support operational goals through committee participation and collaboration between medical and behavioral health teams.
