The Program Manager serves as the primary liaison between technical teams and operational stakeholders to drive risk adjustment and Star Ratings performance. They are responsible for managing program timelines, coordinating cross-functional workgroups, and translating complex technical data into actionable business strategies.
The Care Manager is responsible for delivering person-centered care management services to Medicaid members, including conducting clinical assessments and developing individualized care plans. They coordinate care across interdisciplinary teams and manage transitions of care to improve health outcomes and reduce avoidable utilization.
The Care Manager is responsible for delivering person-centered care management services to Medicaid members with complex physical and behavioral health needs. This role involves conducting clinical assessments, developing individualized care plans, and coordinating care across interdisciplinary teams to improve health outcomes.
The Director of Affordability is responsible for owning and driving the medical expense reduction program across all markets, focusing on PMPM reduction. This includes managing vendor partnerships, deploying clinical programs for complex disease management, and establishing a KPI framework to track financial impact.
