Responsible for establishing and maintaining positive relationships with various providers.
Drives provider engagement and communication, supporting network development.
Manages provider performance, shares data, and supports the implementation of quality initiatives.
CommonSpirit Health has over 700 care sites across the U.S., offering services from clinics and hospitals to home-based and virtual care. They are committed to building healthy communities and advocating for those who are poor and vulnerable.
Own full P&L responsibility, including forecasting, budgeting, and performance reporting.
Build and develop a high-performing, mission-driven team.
Propel builds technology that strengthens the social safety net in America. They aim to improve how government benefits are delivered and have grown revenue 35% YoY, serving over 5.5 million Americans.
Lead complex projects across behavioral health care.
Oversee client projects and supervise multidisciplinary teams.
Partner with the Program Director on portfolio planning and business development.
Altarum is a nonprofit organization focused on improving the health of individuals with fewer financial resources and populations disenfranchised by the health care system. They work primarily on behalf of federal and state governments to design and implement solutions that achieve measurable results.
Lead the development, optimization, and performance of Clover’s dental provider network.
Build Clover’s dental network strategy from the ground up across markets.
Build, scale, and lead a high-impact dental network team spanning contracting, analytics, and provider relationship management.
Clover Health is committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. The company prioritizes preventive care while leveraging data and technology; they are passionate and mission-driven individuals with diverse areas of expertise.
Leads market clinical informatics plans and data analysis.
Champions clinical projects and systems for end-user efficiency.
Identifies areas for performance improvement in clinical applications.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually. They have more than 157,000 employees and are committed to creating a more just and innovative healthcare delivery system.
Coordinate all aspects of organ donation for transplant and research.
They are Oregon's only public academic health center. They care for patients, lead groundbreaking research, and train the next generation of healthcare professionals and is Portland's largest employer, providing opportunities for learning and advancement.
Responsible for establishing an infrastructure to support negotiations, implementation and oversight with all contracted vendors.
Develop metrics reporting from all vendors and have strong analytical skills to evaluate effectiveness of programs.
Serve as liaison between vendors and claims staff; audit, measure, report and evaluate all vendor’s performance.
Crum & Forster (C&F) provides specialty and standard commercial lines insurance products. They have over 2000 employees and are known for their employee-first focus and commitment to diversity, equity, and inclusion.
Lead clinicians across Texas, providing clinical leadership and support.
Drive clinical quality by overseeing QA audits and ensuring compliance.
Support onboarding, orientation, and training of new clinicians.
InHome Therapy is dedicated to driving quality care and building high-performing therapy teams. While the job posting does not mention the company size, it seems to have a culture of supporting and developing employees.
Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement.
Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers.
Collaborate with team leaders to ensure thorough review of DRG denials.
Machinify is a healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. They deploy a configurable, AI-powered platform and best-in-class expertise, serving over 85 health plans representing more than 270 million lives.
Work with internal and external teams to ensure pharmacies meet accreditation requirements.
Assist with staff training and process implementation related to meeting accreditation standards.
Prepare reports and maintain records, and participate in internal/external meetings.
VytlOne (formerly Maxor National Pharmacy Services) is a leading, independent pharmacy solutions platform that improves prescription drug affordability and outcomes. With a workforce of 1,600+ and almost a century of pharmacy experience, they offer the stability of a Fortune 500 company and the energy and innovation of a startup.