The Program Manager is responsible for the assessment, development, and leadership of the Substance Use Disorder (SUD) continuum of care across various behavioral health and primary care settings. They will monitor performance metrics, provide technical assistance, and implement strategic initiatives to improve SUD services and member outcomes.
This role focuses on the design and development of complex data models, ETL specifications, and enterprise data architecture. The architect will also lead vendor coordination, establish data standards, and partner with organizational leaders to recommend data solutions.
This role involves designing and developing data models, ETL specifications, and data warehouse architectures at an intermediate level. The architect will also conduct data analysis, manage vendor relations, and ensure system compliance with established standards.
This position supervises a remote team of RNs responsible for prior authorization and benefit review processes. The supervisor ensures staff competency, manages referral workflows, and implements program changes to align with organizational goals.
This role leads large-scale, complex projects using project management and Lean principles to facilitate collaboration across internal and external stakeholders. Responsibilities include developing project plans, monitoring status, ensuring quality assurance, and managing implementation and documentation.
This role provides leadership oversight for clinical decision tools and utilization management activities while managing multiple teams. It involves developing quality assurance processes, ensuring regulatory compliance, and collaborating across departments to meet organizational goals.
The IS Security Engineer II is responsible for designing, implementing, and maintaining corporate security systems to support business strategies. This role involves managing security technologies, analyzing business needs, and ensuring compliance with established security policies and standards.
The Actuarial Services Manager is responsible for managing actuarial components of financial reporting, including IBNR estimates, trend forecasting, and cost modeling. They also provide leadership to the actuarial team, ensuring alignment with organizational goals and effective cross-functional collaboration.
The Medical Director for Behavioral Health is responsible for implementing clinical strategies, utilization review, and care management initiatives to improve behavioral health delivery systems. They will also provide psychiatric consultation, oversee quality management programs, and collaborate with network providers to ensure high-performing care outcomes.
