The lead is responsible for designing, building, and operationalizing Medicare Advantage Part C risk adjustment analytics to ensure accurate revenue and performance reporting. They will partner with leadership to translate complex claims and encounter data into actionable intelligence and strategic business insights.
Build and lead an enterprise-wide member journey management practice, coordinating cross-functional teams to design, deliver, measure, and continuously improve member experiences. Guide digital portal and mobile app roadmaps, sponsor the Member 360 data strategy, and align experience initiatives with healthcare quality outcomes and regulatory requirements.
Lead discovery with clinical, technical, and operational stakeholders to scope tailored solutions, assess feasibility, and demonstrate how the Tom platform can address client needs. Develop deal-specific solution blueprints and value cases, contribute to proposals, and ensure disciplined handoffs to implementation and customer success teams.
The Strategic Provider Partnerships Director is responsible for identifying, prospecting, and cultivating high-value partnerships with health systems and physician groups. This role involves developing strategic business cases, managing complex negotiations, and coordinating across internal departments to support market growth.
The Chief Medical Officer provides strategic clinical direction and oversees medical management, pharmacy management, and quality initiatives for Essence Healthcare. They are responsible for fostering physician relationships, managing medical costs, and ensuring clinical programs align with evidence-based guidelines and regulatory standards.
