Primarily responsible for performing compliance reporting reviews and audits to ensure compliance with federal and state regulations, NCQA, URAC and client contractual requirements.
Assist with data collection, analysis and reporting for process improvement efforts.
Plan, coordinate, and conduct compliance reporting audits at the direction of the Manager, Compliance Programs, the Chief Compliance Officer and the Quality, Security and Compliance Committee.
Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health has a supportive, growth-oriented environment and diverse, inclusive teams.
Collaborate with business partners to gather business reporting and analytics requirements.
Understand and validate the accuracy and quality of the data.
Utilize visualization tools to design and create analytics dashboards and operational reports.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach. They are committed to improving patient outcomes and quality of life by delaying disease progression and shifting care to the home.
Prepare materials for ACO board meetings and assist in coordinating key events like retreats and kick-offs.
Design and implement key financial and KPI reports using business intelligence and customer relationship management tools.
Monitor compliance activities and support leadership on special projects and data requests in a rapidly changing startup environment.
Aledade is a public benefit corporation that empowers independent primary care practices to thrive in value-based care. The company is the largest network of independent primary care in the United States, operating with a collaborative, inclusive, and remote-first culture.
Lead business readiness and enablement activities for service and operations teams aligned to the Product Development Lifecycle (PDLC).
Define and execute internal communication strategies, create content for internal channels, and project manage User Acceptance Testing (UAT) readiness.
Partner with cross-functional stakeholders to coordinate training, reinforcement activities, and support adoption and post-launch feedback and metrics tracking.
HealthEquity's mission is to save and improve lives by empowering healthcare consumers, with a vision to make Health Savings Accounts (HSAs) as widespread as retirement accounts by 2030. The company fosters a culture where the person is valued more than the position, emphasizing teamwork and inclusion in a fast-paced, service-driven environment.
Execute data analysis of trends and strategic opportunities for quality improvement across Affordability Initiatives portfolio.
Track project milestones, timelines, and deliverables from live and asynchronous engagements - ensuring alignment with initiative-specific program goals.
Maintain and provide consistent tracking of KPIs and other performance metrics to enable measurement of programs and project outcomes
Aledade empowers the most transformational part of our health care landscape - independent primary care. Since being founded in 2014, Aledade has become the largest network of independent primary care in the country, helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. They foster a collaborative, inclusive and remote-first culture.
Lead program operations including onboarding, scheduling, communication, and documentation to meet CARF standards.
Track and support residents' supervision hours, training progress, and licensure milestones while coordinating with clinical, HR, and compliance teams.
Maintain a small clinical therapy caseload, providing direct client care and assisting with client coordination such as referrals.
Backpack Health delivers behavioral health care with a focus on youth and families. It is a collaborative, mission-driven team that offers a supportive culture and values diversity and inclusion.
Support the implementation, monitoring, and reporting of quality improvement activities for a national maternal mental health hotline.
Track program performance, maintain compliance documentation, and contribute to quality reports for federal stakeholders.
Assist in coordinating meetings, developing training materials, and building a culture of continuous quality improvement across a remote team.
Postpartum Support International works to promote awareness, prevention, and treatment of mental health issues related to childbearing. The organization is composed of dedicated and passionate individuals and operates a federally funded national hotline.
Own problem discovery, solution design, and delivery for prescriber onboarding & core experience.
Ensure a high standard of care by optimizing the therapist and client experience, focusing on quality & client outcomes.
Initiate, evaluate, and prioritize ideas, gather requirements, and create specifications for all product changes.
BetterHelp's mission is to remove the traditional barriers to therapy and make mental health care more accessible. They are the world’s largest online therapy service with over 30,000 licensed therapists helping millions globally, and they deeply invest in their team’s well-being and professional development.
Perform ongoing synthesis and analysis of health care quality metric performance and other key performance indicators.
Develop dashboards and visual assessments of health care quality metric performance and key performance indicators using claims, administrative, and/or program data.
Provide data and analysis to leaders to inform strategic recommendations on health care quality.
CareOregon is a nonprofit, mission-driven health plan focused on providing care to low-income Oregonians. They include Columbia Pacific CCO, Jackson Care Connect, Housecall Providers and their work as part of Health Share of Oregon and they are committed to quality. CareOregon is an equal opportunity employer.
Drive implementation from end to end, both internally and externally with client teams
Partner with health plan and risk bearing provider clients to successfully launch Cohere Health products within their organization
Act as the key liaison between client implementation team and cross functional teams at Cohere to drive day to day implementation activities
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. The company works with over 660,000 providers and handles over 12 million prior authorization requests annually, and is backed by leading investors such as Deerfield Management. The Coherenauts who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles.
Monitor compliance with assigned responsibilities and coordinate with patient financial services.
Conduct initial and continued clinical authorization reviews.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Champion incremental innovation and improvement of payment products based on the product vision and roadmap, ensuring a scalable, API-driven architecture with strong security and compliance.
Collaborate with Product Managers, Development, and cross-functional teams to manage backlogs, prioritize features, and translate business needs into user stories and acceptance criteria.
Participate in Agile ceremonies, support product launches, gather user feedback, and use SQL for data exploration to ensure product features comply with healthcare regulations like HIPAA.
Experian is a global data and technology company that uses data, analytics, and software to power opportunities for people and businesses, such as redefining lending and preventing fraud across industries like financial services and healthcare. It is a large FTSE 100 company with a team of approximately 23,300 people operating across 32 countries, fostering a people-first culture focused on inclusion and work/life balance.
Conduct proactive patient outreach initiatives to identify and address quality gaps.
Collect quality data using various methods of data sourcing-EMR, claims, provider outreach.
Communicate quality performances, barriers and improvement strategies both internally and with customers.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.
Support cross-functional teams with program planning, tracking, and execution.
Build and manage dashboards, KPIs, and reports for leadership.
Turn data into clear insights and actionable recommendations.
Tarsus is dedicated to advancing a growing pipeline across early- and late-stage development. They foster a culture of commitment to patients, empowerment to champion innovation, and teamwork to amplify impact supporting a hybrid work environment.
Serve as the Contractor's primary lead for all assigned HEFP portfolio program areas.
Supervise and mentor contractor personnel across assigned programs.
Lead senior management briefings and executive-level communications for VA leadership.
Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, they support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation.
Collaborate with internal and external partners to improve data quality, streamline concept development, and optimize workflows.
Translate business needs into analysis by providing healthcare business knowledge with data, technical, and analytical expertise.
Perform data analysis and ensure implementation meets client and business requirements, functioning as a consultant to translate information needs into specifications.
TREND Health Partners is a tech-enabled payment integrity company facilitating collaboration between payers and providers to reduce waste and improve healthcare access. It is a dynamic and growing organization that promotes a collaborative and innovative work environment.
Diagnose, prioritize, and drive security program maturity.
Translate security requirements into engineering practice.
Own the compliance surface without losing sight of real risk.
Aledade helps independent primary care practices survive and thrive, aiming to bend the healthcare cost curve. They are the largest network of independent primary care in the country.
Participate in the planning and execution of the team’s work to maximize the impact of QuestBridge’s programs for high school students.
Provide operational support to college partners enabling their participation in QuestBridge programs.
Develop communications and resources for college partners, ensuring messaging is presented in a clear and concise way.
QuestBridge connects high-achieving students from low-income backgrounds with educational and career opportunities. From its founding over 30 years ago, QuestBridge has always been an organization focused on creating opportunities for students from low-income backgrounds.
Support development and submission of Monthly Progress Reports and other contract deliverables.
Track Performance Requirements Summary metrics and assist with compliance monitoring.
Maintain Integrated Master Schedule updates and documentation repositories.
Nakupuna Services supports the Defense Health Agency. They likely have a collaborative and structured culture, as they require strong organizational skills.
Own a portfolio of jurisdictions and act as the operational lead for everything regulatory that happens in those geos.
Partner closely with engineering and product to drive requirements development and shape how registration and compliance products are customized per market.
Translate policy and legal direction into operational playbooks and translate field signal back into product priorities.
Breezy is a global, two-sided marketplace company.