Lead strategic and operational oversight for Medicaid external quality review contracts, ensuring compliance, quality, and timely deliverables.
Serve as the senior relationship manager for state Medicaid agencies and stakeholders, proactively resolving concerns and driving customer satisfaction.
Direct project planning, budgets, staffing, and team development while identifying risks and supporting business development initiatives.
Health Services Advisory Group (HSAG) is a national healthcare quality consulting organization that partners with states to improve healthcare delivery through external quality reviews and data-driven solutions. The company fosters a mission-driven, collaborative culture dedicated to making healthcare better for communities and clients.
Lead quality program management activities to ensure compliance with state, federal, and NCQA requirements.
Oversee complex quality deliverables including audits, accreditation surveys, and performance reports.
Collaborate with quality leadership and cross-functional teams to monitor performance and drive continuous improvement.
This organization partners with health plans to implement quality improvement programs and ensure compliance with regulatory standards such as NCQA and HEDIS. The culture emphasizes collaboration, regulatory excellence, and continuous improvement, with a remote work environment for professionals based in Michigan.
Oversee CMS and state audit readiness, live audit management, and corrective action plans.
Build internal monitoring, training, and reporting to foster a culture of compliance.
Collaborate with clinical and operations teams to integrate audit findings into improvements.
Habitat Health empowers older adults to experience more good days through the Program of All-Inclusive Care for the Elderly (PACE), delivering coordinated medical and social care in homes and communities. Supported by leading healthcare organizations and investors, the company is expanding its scalable model with a mission-driven culture focused on participant well-being.
Lead external customer audits and utilization management oversight activities as a subject matter expert.
Analyze complex UM data, investigate findings, and prepare evidence-based responses for regulators and accreditation organizations.
Collaborate with operational, technical, and client-facing teams to drive compliance and process improvements.
This company is a healthcare organization specializing in utilization management and regulatory compliance. It operates with a remote team across the United States, fostering a collaborative and improvement-driven culture.
Conduct clinical audits and risk assessments to identify compliance gaps.
Manage multiple client engagements and deliver accurate project results.
Build strong client relationships and present findings to leadership.
Kodiak Solutions transforms healthcare through technology-driven solutions, specializing in finance, unclaimed property, and risk management. Their innovative platform streamlines operations, allowing providers to focus on patient care.
Audit participant electronic health records to ensure complete, accurate, and timely documentation.
Identify documentation gaps and collaborate with clinical teams to improve processes and regulatory readiness.
Reconcile regulatory logs and assist with audits and investigations to maintain data integrity.
WelbeHealth is a value-based healthcare organization that provides all-inclusive care to vulnerable seniors, keeping them in their communities. The company emphasizes a supportive team culture with work-life balance and comprehensive benefits.
Oversee delegated audits related to UM, Credentialing, Claims, Enrollment, and Appeals processes to ensure compliance with payer contracts.
Educate staff, update policies and workflows, and act as a liaison between payers and local market leadership during audits.
Operationalize regulatory communications from governing bodies and document process changes for upstream and downstream teams.
Dignity Health Management Services offers integrated management and business services to healthcare providers, focusing on managed care administrative and clinical services to contain costs and improve quality. It is part of CommonSpirit Health, a large health system with a mission-driven culture centered on community and patient care.
Lead multiple concurrent projects through the full project life cycle, from requirements gathering to deployment and closure.
Identify opportunities to increase efficiency, improve service levels, and ensure regulatory compliance through enhanced operations.
Translate contracts, regulatory requirements, and business objectives into clear scope, milestones, and measurable outcomes.
Centene provides access to high-quality healthcare, innovative programs, and health solutions that help families and individuals get well, stay well, and be well. Centene is a large healthcare organization with a culture of purpose and diversity, offering comprehensive benefits and a flexible work environment.
Lead and coordinate H.R. 1 workstream activities, including schedules, deliverables, resources, risks, and project performance.
Serve as the primary liaison between Hawaiʻi Med-QUEST, BerryDunn, and key stakeholders for H.R. 1-related initiatives.
Research Medicaid policies and regulations, translate them into system requirements, and own Jira tracking and status reporting.
BerryDunn is a professional services firm providing tax, advisory, consulting, and attest services to businesses, nonprofits, and government agencies. The firm is client-centered and people-first, with a focus on learning, development, well-being, and a diverse and inclusive workplace culture.
Manage client relationships and serve as lead point of contact for assigned projects.
Oversee project implementation, quality control, and coordination with internal teams.
Facilitate medical-legal-regulatory review processes and ensure compliance.
Precision AQ is the top payer marketing agency that partners with global pharmaceutical and life sciences companies to make medicines accessible and affordable. The company recognizes achievements, offers mentorship opportunities, and promotes cross-functional teamwork in a supportive culture.
Manage day-to-day health plan relationships, program commitments, and client communications.
Coordinate onboarding and delivery with internal teams, monitor service levels, and resolve issues.
Lead business reviews with performance insights and maintain alignment between client expectations and deliverables.
This role is with a healthcare services company that partners with health plans to deliver clinical assessments and close care gaps. The company uses AI to review applications and is committed to fairness and transparency in hiring.
Manage multiple client-facing healthcare cybersecurity consulting engagements, ensuring alignment with scope, schedule, and budget.
Support PMO governance and develop detailed project plans to track progress and mitigate risks.
Coordinate internal resources and client communications, maintaining accurate project management and financial reporting.
Clearwater provides healthcare cybersecurity consulting services, helping clients manage risks and protect data. The company fosters a collaborative, client-focused culture guided by its CLEAR core values.
Coordinate assigned projects including planning, budgeting, and resource management.
Provide administrative support, scheduling, and data collection for project completion.
Manage communication and relationships with key stakeholders, composing and delivering reports.
Cincinnati Children's is a top-ranked children's hospital focused on improving child health through holistic care and research. They are a large employer recognized for innovation and excellence, with a culture that values teamwork and continuous improvement.
Create and manage project plans, scopes of work, timelines, and budgets to deliver projects on time and on target.
Collaborate with agency teams and clients to allocate resources, forecast work, and ensure smooth workflow across all projects.
Lead internal reviews, status meetings, and financial tracking while flagging risks and escalating issues for resolution.
Avalere Health is a healthcare company with a mission to reach every patient possible through advisory, medical, and marketing services. It fosters an inclusive culture with employee network groups, flexible work, and significant investment in professional growth.
Contribute to creation of client proposals and budgets.
Precision AQ is the leading payer marketing agency, supporting global pharmaceutical and life sciences clients in achieving commercial excellence. They are a team-driven agency focused on growth, offering opportunities for learning, mentorship, and advancement.
Support development of APD narratives, budgets, and CMS submission materials for state Medicaid agencies.
Assist with Outcomes-Based Procurement activities, including research, requirements gathering, and document development.
Collaborate with project teams to create client deliverables, presentations, and reports while tracking project milestones.
BerryDunn is a professional services firm that helps businesses, nonprofits, and government agencies solve their challenges through tax, advisory, and consulting services. The firm emphasizes a client-centered, people-first culture with a focus on learning, development, and well-being.
Provide compliance documentation and knowledge management support to the Contracts Management and Compliance Division.
Maintain the organization-wide risk register, track mitigation actions, and support sub-recipient due diligence workflows.
Coordinate compliance training, monitor U.S. government regulatory updates, and prepare compliance reports for leadership.
Jhpiego is a global health nonprofit affiliated with Johns Hopkins University, dedicated to improving the health of women and families in developing countries. The organization values diversity, equity, and inclusion, and offers a supportive, mission-driven work culture.
Leverage Medicaid program and policy skills to support clients, including developing 1915(c) waiver amendments and recommendations.
Build and maintain relationships with clients, stakeholders, and team members while communicating project status.
Support marketing and business development activities such as writing blog posts and attending conferences.
BerryDunn is a professional services firm that helps businesses, nonprofits, and government agencies solve challenges. Since 1974, the firm has grown to serve clients across the US and its territories, with a people-first culture focused on learning and well-being.
Manage customer relationships to drive utilization of GHX Managed Services and ensure retention and satisfaction.
Lead implementation of managed services solutions, coordinating with cross-functional teams for successful projects.
Monitor customer performance metrics, resolve issues, and mentor team members to improve service delivery.
GHX is a healthcare business and data automation company that helps providers, manufacturers, and distributors improve supply chain efficiency and reduce costs through cloud-based technology. Privately owned and headquartered in Colorado, GHX employs more than 1,000 people across the US, Canada, and Europe.
Leads end-to-end project planning and delivery for small to medium customer implementation projects. - Serves as primary project contact, building trust through transparent communication and proactive issue resolution. - Creates and maintains project documentation including plans, status reports, and risk assessments.
Intelerad provides medical imaging solutions to streamline healthcare information flow. With nearly 800 employees across four countries, we empower over 2,000 healthcare organizations to improve patient outcomes.