Telligen

This position involves conducting face-to-face assessments of members who may need skilled nurse assessment services, completing assessments using a skilled care acuity tool, and providing service recommendations based on members' health care needs. The incumbent may also serve as a mentor for new staff, complete quality assurance audits, and participate in process improvement initiatives.

Responsible for providing guidance around the clinical aspects of the program and overseeing the success of quality improvement initiatives for nursing homes, hospitals, and outpatient clinical practices. The role involves supporting a team of managers and Quality Improvement Advisors to ensure effective technical assistance and achievement of project goals. Must live in Colorado, Idaho, or Iowa.

As a Peer Reviewer -1099 Consultant, you will leverage your medical knowledge and deep understanding of mental health and substance abuse disorders, diagnosis, and standards of care to determine medical necessity and appropriate care for Medicaid beneficiaries. This role will focus on psychiatric and addiction medicine reviews. You will oversee and be responsible for the medical review activities for the assigned contract.

You will supervise analytic employee-owners, act as an analytic program manager, working with the Project Management Office, and partner with other Telligen analytic and programmatic leadership. You will support quality improvement efforts at the local, state, and national levels. You retrieve, validate, analyze, report, and visualize data.

As an Associate Program Manager will work with the Project Manager and contract leadership team to coordinate project activities, including managing education and outreach opportunities and person and family engagement efforts. You will also coordinate operational activities.