Oversee healthcare operational performance and drive continuous improvement across multiple markets in a senior leadership role.
Compensation
Annual compensation ranging from $129,700 to $162,100, depending on experience, qualifications, and relevant skills.
Responsibilities
Lead and oversee Risk Adjustment (BOI), Quality (HEDIS), and Cost of Care operational programs across at least three markets
Develop, implement, and maintain standard operating procedures (SOPs), service-level agreements (SLAs), and responsibility frameworks (RACI)
Collaborate with Central Operations to manage and optimize pre-visit medical record reviews, post-visit coding reviews, medical chart collection, query workflows, and provider engagement processes
Partner with Market Leaders and local operations teams to monitor performance, identify operational challenges, and implement corrective actions and improvement plans
Define and monitor key performance indicators (KPIs), conduct root cause analyses, and lead continuous improvement initiatives to standardize best practices across markets
Requirements
Bachelor's degree in Business Administration, Healthcare Management, Public Health, or a related field
Nice to have: Master's degree in healthcare administration, business, or a related discipline
Lead US forecasting for a dynamic portfolio in the respiratory sector, translating data into actionable insights for commercial strategy.
Compensation
The annual base pay (or hourly rate of compensation) for this position ranges from $155,516.80 to $233,275.20. Our positions offer eligibility for various incentives—an opportunity to receive short-term incentive bonuses, equity-based awards for salaried roles and commissions for sales roles.
Responsibilities
Lead the development and delivery of robust US forecasts across annual planning, long‑range planning, forecast updates and business reviews
Serve as the forecasting authority for prioritized markets and disease areas
Build patient‑based models in Excel using credible assumptions
Develop scenarios that reflect business ambition and constraints
Monitor actuals versus forecast and recommend updates
Requirements
Bachelor’s degree from an accredited college or university
Supports the administration, integrity, and performance of the agency's SQL Server environments and the clinical, billing, and human resources data they hold.
Responsibilities
Support the administration, security, backup monitoring, and performance of production SQL Server databases.
Assist with approved production data changes using documented change-control procedures.
Develop and maintain SQL queries, stored procedures, ETL processes, and data migration tasks.
Support EDI billing workflows (837) for county and Medi-Cal payers, including claims data validation and reconciliation.
Support EHR integrations, system migrations, upgrades, testing, and related data interfaces.
Requirements
Bachelor's degree in Computer Science, Information Systems, Data Analytics, or a related field
Key Responsibilities:
Strong experience in Snowflake, SQL, Python, and Snowpark.
Hands-on experience with Snowflake Streams, Tasks, Dynamic Tables, and Secure Data Sharing.
Healthcare domain knowledge, including EHR/EMR, patient, provider, claims, and clinical data.
Knowledge of healthcare standards such as HL7, FHIR, CCD/CCDA, ICD, and CPT.
Experience in ETL/ELT pipelines, data integration, transformation, and validation.
Experience with AWS/Azure, Git, and CI/CD.
Exposure to DBT, Power BI, or Tableau.
Knowledge of HIPAA compliance, PHI handling, and healthcare data security.
Strong understanding of data modeling, performance tuning, and cost optimization.
The Operations Data Manager is responsible for the accuracy, integrity, and operational use of data across the organization’s Independent Practice Association (IPA) and group practice sites.
Locations (4)
California, United States
Rhode Island, United States
New York, United States
Los Angeles, California, United States
Responsibilities
Own the collection, validation, and reporting of operational, quality, and utilization data for all IPA and group sites.
Ensure data accuracy, completeness, and consistency across the EHR, payer files, and internal tracking systems.
Serves as a strategic subject matter expert (SME) for Encounters Submissions, driving product value realization, strengthening client partnerships, and advancing alignment with clients’ strategic goals.
Compensation
Compensation Range: $92,972-$129,231
Responsibilities
Leads projects involving Strategic Account Managers, Client Success Managers, and product teams to drive product adoption, client satisfaction, and value delivery.
Serves as a trusted advisor and product SME to strategic clients, connecting solution capabilities—including encounters submission workflows—with client objectives, performance goals, and quality outcomes.
Analyzes client feedback, market trends, and product performance data to identify patterns, gaps, and opportunities for innovation or optimization.
Leads initiatives with Product Management and Development to guide product roadmap, usability improvements, and future enhancements based on real-world client needs.
Supports strategic client discussions, executive business reviews, and renewal planning by providing product expertise and thought leadership.
Requirements
Bachelor’s Degree or equivalent Technical/Business experience
BI/Data Analytics Developer responsible for designing and developing enterprise reporting and analytics solutions, building dashboards, scorecards, data visualizations, and web-based reporting portals using Tableau, Power BI, SQL, Teradata, and React.
Compensation
The pay range for this position is $60.00 - $62.00/hr.
Responsibilities
Build dashboards, scorecards, reports, and data visualizations
Create and maintain a web-based portal using React
Develop complex SQL queries and scripts for data marts in Teradata
Support data strategy and analytics for Medicaid, claims, provider, and enrollment data
A P&C Insurance Product Specialist role bridging the gap between technical insurance mechanics and operational delivery, handling policy documentation, claims analysis, and underwriting.
Responsibilities
Review policy documentation, support quoting workflows, and ensure accurate enrollment verifications and coverage determinations across all active programs.
Serve as an internal escalation point for complex coverage questions, claims reviews, and nuanced loss scenarios, ensuring fast, fair, and accurate resolutions.
Dive into loss runs, claims data, and client inquiries to spot coverage gaps, emerging risk trends, and opportunities to enhance existing products or launch new ones.
Deliver high-touch, consultative support for insureds, claimants, and distribution partners on technical policy matters.
Partner with Product, Operations, and Customer Support teams to streamline information flow, automate recurring checks, and refine documentation.
Develop and maintain standardized dashboards, scorecards, and recurring reports for leadership, site managers, and providers.
Monitor operational performance against established standards, including task completion timelines, outreach and documentation compliance, and care gap closure.
Manage payer and IPA data feeds, including eligibility, attribution, roster, claims, and quality files, and reconcile discrepancies.
Consultant II – US RWE, Evidence & StrategyNewAvalere Health · Remote, US
Regional Director, OperationsNewJobgether · Remote, US
US Forecasting Leader – R&IAstraZeneca · Wilmington, US
Data and Systems Integration SpecialistVista Del Mar · Los Angeles, US.png?1666363748)
Operational Data ManagerAkido · US+3 more
BI DeveloperTEKsystems · Remote, US
Insurance Product SpecialistGet Covered · Remote, US