Alliance Health Jobs in United States

The Provider Network Evaluator II conducts targeted and focused reviews to ensure providers meet clinical licensure requirements and deliver high-quality services. They review claims data, clinical documentation, and provider contracts to identify out-of-compliance findings, over ...

The Manager of Software Architecture is responsible for building and leading a Software Architecture Team and define, develop, and enforce best practices, processes, policies and system security to ensure alignment with all corporate strategy and goals. · Manage and Develop Staff ...

The Business Analyst-PN Crisis System role will develop and analyze business performance reports utilizing EDI claims and encounter data, and provider utilization data, to identify trends, anomalies, and issues that may require the attention and/or intervention of Alliance leader ...

The Community Education Specialist is responsible for advancing a System of Care approach through the identification of training needs, the development of member-focused curricula, and the coordination of education for members and stakeholders. · Implement, evaluate, and execute ...

In the desktop infrastructure technician role, you will provide routine guidance for users of the IT system and components. You will maintain a deep understanding of IT concepts and stay updated with the latest tech trends. Success in this role will be demonstrated by the quick r ...

Job Description · The Care Manager I-Non-Waiver plays a critical role in ensuring that individuals and families with special healthcare needs receive integrated whole-person care management. This involves coordinating across physical health, behavioral health, pharmacy, and unmet ...

The Care Manager assures that individuals and families with special health care needs receive integrated whole-person care management, including coordinating across physical health, behavioral health, pharmacy and unmet health-related resource needs to ensure they are linked to s ...

The Care Manager I-TCL assures that individuals and families with special health care needs receive integrated whole-person care management, including coordinating across physical health, behavioral health, pharmacy and unmet health-related resource needs to ensure they are linke ...

The Director of Waiver Care Management oversees a team of supervisors, managers, and Care Managers and/or other care management staff that perform care management activities. The Director monitors behavioral health and physical health outcomes for those served by Alliance Care Te ...

The TCL ACH Transition Supervisor provides oversight to a team of Transition Coordinators who assist high risk and often acute members transitioning from institutional settings and ensures compliance with all DHHS required transition functions as listed in the In Reach/Transition ...

The Care Manager II position leads all communication among care team members and is the primary point of contact for the member served. The Care Manager completes a comprehensive assessment and develops a unified plan of care for Tailored Plan recipients and relays communication ...

The HEDIS Data Analyst is responsible for working collaboratively with Quality Management, IT, and other teams across the organization to gather and document HEDIS data requirements for reporting, perform integrated testing for data quality assurance, support our organization's H ...

In the desktop infrastructure technician role, you will provide routine guidance for users of the IT system and components. · Support VPN and onsite laptop connection issues. · Manage and track help desk calls from start to completion in the helpdesk tracking system. · Resolve cu ...

The Practice Transformation Specialist works with Advanced Medical Homes and Care Management Agencies to improve quality of care. · Provide support to network providers · Assist providers to evolve administrative and clinical workflows · Meet with providers to review performance ...

The Senior Clinical Informatics Analyst supports the organization's clinical and operational goals by collecting, analyzing, and interpreting healthcare data. This role develops dashboards, reports, and data visualizations that inform decision-making across departments. · Analyze ...

Job Summary · The Data Integration Business Analyst role at Alliance Health requires a professional with expertise in data integration, ETL, and API management. The ideal candidate will have experience working with healthcare data formats, such as HL7 v2/FHIR and X12/EDI 837/835. ...

The Director of Accreditation is responsible for the design, development, implementation, on-going improvement and maintenance of quality initiatives necessary for attaining NCQA accreditation. · Leads the development, organization and implementation and oversees the NCQA accredi ...

The Transition Coordinator II provides Transitional Care Management and Physical Health Consultation for members with physical and/or behavioral health needs in Acute Care facilities, State Operated Developmental Centers, and Justice System settings. · Support members transitioni ...

The Supervisor II -Care Managers provides supervision and oversight to clinically licensed Care Managers, and to Qualified Professional Care Managers, who support health plan members seeking services within Alliance Health Plans catchment area. · Work with Human Resources and Uni ...

The Care Manager assures that individuals and families with special health care needs receive integrated whole-person care management, including coordinating across physical health, behavioral health, pharmacy and unmet health-related resource needs to ensure they are linked to s ...