Develop and evaluate policies, procedures, and systems supporting care management, and analyze operational data and outcomes to recommend improvements. Provide subject matter expertise and staff training for special populations, identify members for population health programs, and coordinate relevant interventions and resources.
The Care Transitions Care Manager provides comprehensive care coordination to support individuals transitioning between care settings and maintaining stability. They assess needs, develop care plans, and coordinate services across providers to promote continuity of care and long-term outcomes.
The Director of Project Management leads the enterprise project delivery strategy, methodology, and capability development. They oversee complex initiatives, establish governance standards, and coordinate across functions to ensure organizational priorities are met.
The Claims Specialist II performs data analysis, auditing, and finalizes adjudication results for claims designated for pre-payment and post-payment review. They also provide technical assistance to providers and communicate with stakeholders to facilitate efficient claims resolution.
The Finance Manager leads the day-to-day operations of an assigned finance unit, overseeing financial processes, planning, and budget control. They are responsible for team performance, financial reporting to the Board and State, and ensuring budget compliance.
Manage and prioritize the applications product backlog based on changing business needs, and lead the Product Services and Project Services teams. Drive Agile Scrum delivery, facilitate Scrum ceremonies, assess team performance, and contribute to the design and maintenance of business systems that meet user and organizational needs.
The Peer Support Specialist provides peer-based support to individuals navigating care transitions by using lived experience to build trust and engagement. They also facilitate group activities and connect individuals to community resources to promote recovery and independence.
The Trainer delivers in-person and virtual training programs to staff, providers, and community stakeholders using established curricula. They are also responsible for preparing instructional materials, coordinating logistics, and evaluating the effectiveness of training sessions.
The Project Management Specialist coordinates project activities, tracks progress, and maintains schedules for the Rural Health Transformation Program. They also prepare status reports, facilitate meetings, and manage communication across internal and external stakeholders.
Develop and edit communications content for websites, publications, member materials, and digital, print, and media channels, including stories in written, video, and audio formats. Coordinate email communications and website updates while ensuring content follows brand, accessibility, readability, and messaging standards.
The Peer Support Specialist provides care coordination and support to individuals with behavioral health or intellectual/developmental disabilities transitioning from incarceration. They educate members on navigating social and justice systems while facilitating linkages to community resources like housing, employment, and treatment services.
The Licensed Supervisor oversees a team providing integrated care management for members with complex mental health, substance use, and intellectual disability needs. This role ensures regulatory compliance, provides clinical supervision, and monitors team performance metrics to maintain high-quality service delivery.
The Peer Support Specialist provides care coordination and support to individuals transitioning from incarceration back into the community. They educate members on navigating behavioral health and social service systems while facilitating linkages to housing, employment, and treatment services.
The Care Transitions Care Manager provides comprehensive care coordination to support individuals transitioning between care settings and maintaining stability. This role involves assessing needs, developing care plans, and facilitating referrals for psychological, behavioral, and community-based services.
The Quality Management Specialist II is responsible for monitoring services for members receiving Home and Community Based Services to ensure compliance with state standards and Medicaid regulations. This role involves conducting announced and unannounced visits, reviewing service documentation, and collaborating with the Care Management team to ensure quality support.
