The Healthcare Reclamation Analyst reviews assigned client data and payer correspondence, investigates coverage to determine eligibility and primacy, and gathers and interprets explanation of benefits and payer feedback in order to recover funds for clients who have paid in error.
As a Quality Improvement Advisor, you will serve as the primary liaison and coach for healthcare facilities within your state, focusing on implementing strategic priorities and healthcare goals. You will collaborate with state healthcare partners, systems, and providers to drive measurable improvements in patient outcomes, while addressing unique state challenges. You will analyze state- and provider-level quality data, facilitate learning collaboratives, and provide technical assistance to facilities as they implement evidence-based practices.
This vital leadership role is focused on optimizing performance across specialty clinical departments, where you will oversee teams in Movement Disorders, Cognitive Neurology, and other key neurological specialties, driving clinical excellence, provider productivity, operational efficiency, and accountability across the telehealth platform.
The SVP & Head of Payor Solutions will lead the development, implementation, and growth of Mindoula's programs and partnerships with health plans and managed care organizations. This leader will ensure operational excellence, scalable growth, and optimal outcomes for payor-driven programs while collaborating closely with internal teams and external partners to advance Mindoula's mission, deliver measurable ROI, and improve health outcomes for complex populations.
The Director, Physician Activation is responsible for ensuring physicians in contracted groups refer patients to the CCP program. The Director works with a team of high-performing Clinical Partnership Managers (CPMs) who are assigned to specific physician groups/accounts/practices. The Director will establish and refine goals around referral volume and hold team members accountable to these goals.
Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Provides medical leadership for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review and medical review of complex medical services, ensuring timely and quality decision making.
The Sr. Medicare Program Analyst will work cross functionally within the team, helping develop a purpose-driven analytics platform to maximize the health of our patients and the performance of our physicians using proprietary applications. Primary emphasis for this role is tracking Privia Health’s performance in the Medicare Primary Care Program in Maryland (MDPCP).
Reporting to the Analytics Consulting leadership team, the Collections Optimization Consultant will provide Experian Health clients with analytics-based best practices and consulting services. Specifically, you will thoroughly assess our client's use of Experian's Collections Optimization Manager solution's systems and financial performance. Make recommendations to optimize patient collections by leveraging analytics to streamline and enhance revenue cycle self-pay operations and fulfillment strategies.
The Senior Manager, Health Plan Performance will play a pivotal role in advancing key business objectives for Aledade’s Health Plan Performance portfolio. This role will be responsible for executing the overall HPP strategy and facilitating the effectiveness of the HPP team. Translate contract terms and performance data into actionable approaches to achieve contract, market, and company-level savings and quality targets.