The Behavioral Health Medical Director provides medical guidance and leadership for the behavioral health program, including conducting coverage reviews and rendering medical necessity determinations. They also collaborate with providers and support organizational accreditation efforts, regulatory reviews, and vendor relationships.
The Network Contract Analyst performs contract administration, including preparing settlements and ensuring accurate provider payments. They also conduct research and data analysis to support provider contracting initiatives and reimbursement strategies.
The Software Engineer III will build, maintain, and enhance a proprietary clinical data analytics repository while overseeing projects to ensure they meet budget and timeline requirements. They will also design innovative technical solutions, conduct system testing, and act as a focal point for problem resolution and customer inquiries.
The Network Process Manager organizes teams, develops plans, and facilitates project execution to achieve organizational goals across various departments. They are responsible for managing project budgets, mitigating risks, and ensuring continuous process improvement while collaborating with stakeholders.
The Care Manager coordinates services for members with complex medical and behavioral needs, focusing on education, self-management, and quality care outcomes. They act as a liaison between patients, families, and healthcare providers to develop and implement individualized care plans.
The Care Management Team Lead oversees daily operations of the unit, including case management, disease management, and social work services. They are responsible for staff supervision, professional development, performance metric evaluation, and ensuring regulatory compliance.
The Value Delivery Manager leads Agile product teams to drive business value, optimize delivery performance, and support the transition to a product-centric operating model. They partner with business and technology leaders to manage dependencies, facilitate planning, and coach teams on Agile and Lean practices.
Leads architecture for a specific business domain and guides Agile PODs to deliver secure, scalable solutions. Drives application rationalization and adoption of reference patterns in Azure.
