Manage a large operations team supporting VA CCN Credentialing and Provider Data Loading.
Define operational strategy and align priorities with business goals for efficient, cost-effective infrastructure.
Collaborate across Provider teams and Humana Military to improve manual work, enhance data quality, and guide automation priorities.
Humana is a leading U.S. healthcare company offering insurance and healthcare services through its Humana Insurance and CenterWell brands. It is a large organization focused on improving health outcomes and supporting associates with competitive benefits.
Collaborate with health plan leaders to develop quality data strategies and reporting on HEDIS and CAHPS performance.
Oversee data ingestion, validation, and documentation to improve accuracy across EHR, HIE, and supplemental data.
Support regulatory compliance and HEDIS audit readiness while monitoring quality programs and reporting risks.
This organization is a healthcare quality partner focused on national performance initiatives, including HEDIS, CAHPS, and data analytics. It provides a highly collaborative, matrixed environment with opportunities for cross-functional exposure and remote work.
Conduct quality audits and validate provider data to ensure accuracy, integrity, and compliance with regulatory standards.
Analyze trends, investigate discrepancies, and recommend corrective actions to strengthen provider network operations.
Collaborate with cross-functional teams to document evidence, support accreditation reviews, and drive continuous improvement.
Alliance Health is a managed care organization that coordinates services for individuals with complex needs in North Carolina. They foster a collaborative, mission-driven culture focused on quality, compliance, and remote work flexibility.
Lead enterprise-wide quality strategy and compliance excellence, driving design, implementation, and continuous improvement of the PACE quality program.
Partner cross-functionally with Analytics, Compliance, and Operations to turn complex data into actionable insights and elevate quality.
Oversee Quality Operations teams, regulatory reporting, and corrective action plans to ensure participant safety and readiness.
WelbeHealth serves communities' most vulnerable seniors through PACE programs, focusing on participant-centered care. The company values pioneering spirit and offers a collaborative culture with comprehensive benefits and a commitment to diversity and inclusion.
Interpret federal and state regulations to ensure compliance and drive process improvements.
Analyze data in Excel to identify trends, savings, and process improvements.
SIHO Insurance Services provides health insurance administration and related services, focusing on payment integrity and regulatory compliance. The company operates in a managed care environment and emphasizes collaboration, professionalism, and adaptability among its employees.
Lead data governance, master and reference data initiatives that improve data quality and operational effectiveness.
Identify, assess, and resolve data-related issues and risks that could impact business operations.
Partner with business and technology teams to ensure data changes are validated and operationally ready before deployment.
Syngenta Seeds Field Crops is a global Ag Tech company shaping the future of agriculture by uniting precision breeding, advanced biotechnology, and digital platforms to help farmers mitigate risks and promote sustainable practices. The company fosters a collaborative culture that celebrates belonging, supports professional development, and strives for work-life balance.
Hire and manage a team of Oscar colleagues with direct responsibility for performance management, growth, and development.
Monitor operational KPIs, conduct root-cause analysis, and construct action plans to drive team performance.
Serve as a central communicator by leading team huddles and connecting colleagues to Oscar's mission, vision, and values.
Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. They started in 2012 to create a kind of health insurance company that behaves like a doctor in the family, fostering an inclusive culture where people can be their most authentic selves.
Manage provider data across health plans, including demographics, reimbursement rates, contracts, and key operational information.
Coordinate provider audits, credentialing activities, service and relationship processes, and contract management systems.
Oversee daily priorities for administrative teams and external vendors, using data analysis to improve provider network operations.
This healthcare organization supports provider network operations across health plans. They offer a collaborative, deadline-driven environment with a focus on independent work and analytical skills.
Oversee data extraction and de-identification across health system partners to ensure timely delivery.
Serve as primary point of contact for partners, managing day-to-day project operations and communication.
Develop and execute data extraction roadmaps, build business cases, and maintain comprehensive documentation.
Dandelion Health unlocks clinical depth by combining raw multimodal data from community health systems with validated AI models to deliver regulatory-grade scientific insights and products. The company is a mission-driven startup with a collegial, academic culture and start-up speed.
Lead strategic initiatives that advance healthcare interoperability and EHR capabilities across business, clinical, and technology teams.
Define future-state business capabilities, build business cases, and guide initiatives from planning through implementation.
Oversee governance, communication, and value realization to ensure secure data exchange and adoption of new capabilities.
eviCore is a healthcare solutions company focused on advancing interoperability and electronic health record capabilities between payers and providers. The organization supports a remote-first environment and is committed to improving healthcare delivery through strategic technology initiatives.
Own end-to-end NCQA Utilization Management reporting across Medicaid markets.
Collaborate with clinical, operational, and compliance teams to ensure accurate, timely deliverables.
Support governance committees, corrective actions, and accreditation activities.
Healthcare operations company specializing in Medicaid utilization management, regulatory compliance, and policy governance. It operates across multiple markets with a collaborative, multidisciplinary team culture.
Lead a production-focused pod of Operations Analysts and Credentialing Specialists, owning day-to-day credentialing operations.
Drive team performance by monitoring speed, quality, and efficiency metrics, ensuring SLAs are consistently met.
Coach, mentor, and train team members, conducting daily standups and weekly performance reviews.
CertifyOS builds the data infrastructure for modern healthcare, automating provider licensing, credentialing, and network monitoring. It is backed by leading investors and values authenticity, accountability, collaboration, results, and openness to feedback.
Design, build, and manage the presentation layer for reporting & analytics, data science, and consuming applications.
Mentor and grow a team of data engineers while collaborating with IT and business stakeholders on data sourcing.
Deliver technical data solutions, automate pipelines, and ensure data quality and governance across the platform.
Curana Health is a national leader in value-based care for older adults, offering on-site primary care and other solutions to senior living communities and skilled nursing facilities. Founded in 2021, the company serves 200,000+ seniors in 1,500+ communities across 32 states with a team of over 1,000 clinicians and professionals.
Design and govern enterprise data architecture, cloud data platforms, and semantic layers.
Define standards for data modeling, integration, governance, and master data management.
Enable analytics, AI, and self-service through reusable data products and ontologies.
Emory Healthcare is a comprehensive healthcare system that provides medical services and patient care. It fosters a supportive culture with comprehensive benefits, mentorship, and leadership programs for employees.
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.
End-to-end credentialing and payer enrollment for multi-state providers across commercial and Medicaid plans.
Vendor governance and SLA performance management to ensure timely provider onboarding.
Delegated credentialing and audit readiness, including NCQA and MCO compliance.
Blackbird Health provides virtual and in-person mental health services for children across Pennsylvania, Virginia, New Jersey, and Maryland, focusing on a whole-child approach that integrates brain, body, and behavior. The company is clinician-founded and owned, with a collaborative, supportive, and innovative team that is expanding into new markets in 2027.
Build and lead the data analytics and outcomes research function, owning architecture through client-facing reporting.
Partner with engineering and product on implementation and delivery, and translate member and clinical data into actionable conviction.
Manage a small growing team and produce health economics evidence that demonstrates value to payer clients.
Nadia Care is a maternal health company reimagining pregnancy, birth, and postpartum care for underserved communities through doula support, care navigation, and virtual engagement. It is an early-stage, lean team that values empathy, collaboration, and resilience in a fast-paced environment.
Analyze data from multiple sources to identify and correct errors, ensuring accuracy, completeness, and reliability.
Develop and implement data quality processes, policies, and standards while using SQL, Python, and Excel.
Collaborate with teams in a SAFe Agile environment to deliver automated reporting and dashboard solutions.
Sparksoft is a technology company providing IT solutions and services to government clients, including the Centers for Medicare & Medicaid Services. The company emphasizes innovation and collaboration, with a culture recognized as a Great Place to Work.
Analyze high-value and complex claims, ensuring alignment with carrier guidelines and regulatory requirements.
Oversee delegated claims operations and third-party administrators, monitoring compliance and quality.
Provide subject matter expertise and process improvements to strengthen claims governance and outcomes.
They are an insurance organization focused on claims governance, compliance, and operational performance. They are a growing company that prioritizes accountability, service quality, and effective risk management.
Own product strategy, roadmap, and day-to-day operations for a self-service healthcare data warehousing and reporting solution.
Lead complex feature discovery and delivery, using SQL, JIRA, and AI techniques to drive product decisions.
Engage directly with clients, manage escalations, and partner with engineering to plan releases and rollouts.
The partner company builds data products that make complex healthcare data accessible and actionable for organizations. It operates as a fully remote, collaborative team focused on high-impact solutions with significant ownership and autonomy.