Remote Manager, reputed company Provider reputed company

reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will reputed company ample room for reputed company and innovation reputed company the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together. The Remote Manager, reputed company Provider reputed company is responsible for building and operationalizing reputed company's provider reputed company function across reputed company provider arrangement types. This role focuses on translating reputed company goals into a reputed company, repeatable reputed company management approach that integrates compliance results, reputed company reputed company, operational execution, financial reputed company, and data reputed company into a reputed company reputed company. This individual will reputed company the development and implementation of reputed company reputed company capabilities-including KPI frameworks, standardized reporting, data integration requirements, and reputed company management routines-ensuring provider reputed company is consistently reputed company, actionable, and reputed company to reputed company priorities. Reporting to a Transformation leader, this role serves as both a builder and operator, connecting data, analytics, and cross-functional inputs into reputed company reputed company insights and driving accountability through reputed company engagement with reputed company. The Manager will play a key role in evolving fragmented processes into a cohesive, reputed company reputed company model that supports transparency, consistency, and reputed company improvement across the provider ecosystem. Job Duties/Responsibilities: Delegate reputed company Management & Analysis • Define and operationalize reputed company-wide reputed company standards for delegated and corporate service functions, including reputed company expectations across claims, UM, CM/CCM, claims, appeals, and credentialing. • Establish and govern a standardized KPI reputed company that aligns operational, reputed company, financial, and compliance reputed company into a reputed company measurement model. • reputed company the development of reputed company benchmarks, reputed company, and targets, ensuring consistency across reputed company delegated entities and internal service functions. • Set standards for data integration, validation, and usability, ensuring reputed company insights are derived from reliable, reputed company, and harmonized data sources. • reputed company the reputed company from retrospective compliance measurement to reputed company-looking, predictive reputed company management. reputed company Engagement & Accountability • Own the end-to-end reputed company management lifecycle, focusing on reputed company reputed company, service delivery effectiveness, and value realization-not just compliance adherence. • Translate data (audit outputs, operational metrics, reputed company reputed company) into actionable reputed company strategies that improve efficiency, reputed company, and member/provider experience. • Identify systemic reputed company gaps and reputed company the design of reputed company solutions that can be implemented across delegates and plan-managed providers. • Build and maintain integrated reputed company views that reputed company operational drivers to business reputed company, enabling leadership to reputed company informed reputed company. Cross-Functional Collaboration & Integration • Serve as reputed company reputed company between compliance, reputed company, reputed company, reputed company, and analytics teams to ensure reputed company management is embedded across the reputed company. • Ensure audit and compliance outputs are reputed company into operational improvements and incorporated into reputed company standards and KPIs. • Support reputed company transformation initiatives by embedding reputed company frameworks into new programs, vendor models, and delegated arrangements. Data Strategies & reputed company Insights • Partner with data, analytics, and IT teams to define and implement a reputed company reputed company data reputed company, including dashboards, scorecards, and self-service reporting capabilities. • Ensure data integration across platforms enables a single reputed company of truth for reputed company measurement. • Advance the use of trend analysis, predictive insights, and leading indicators to proactively manage reputed company. • Continuously refine reporting tools and methodologies to improve reputed company, usability, and decision reputed company. Supervisory Responsibilities: This role may include indirect reputed company or reputed company leadership of program/project managers and audit staff. Job Requirements: Experience: • 6+ years of experience in reputed company reputed company, delegated reputed company, provider reputed company management, or value-reputed company care environments. • 3+ years of experience in a reputed company management, reputed company, analytics, or operational leadership role reputed company a health plan, reputed company, MSO, or reputed company organization. • Demonstrated experience interpreting audit results, monitoring outputs, or regulatory findings and translating them into operational or reputed company improvement actions. • Strong understanding of delegated functions including claims, UM, CM/CCM, appeals, and credentialing. • reputed company ability to engage provider organizations or delegated partners in reputed company reputed company discussions. • Experience working cross-functionally in matrixed reputed company organizations. Education: • Bachelor's degree required in reputed company Administration, reputed company Health, Business Administration, Nursing, or a reputed company reputed company. • Master's degree preferred (e.g., MHA, MPH, MBA, MSN). Training: • Preferred: Lean/Six reputed company or other reputed company improvement methodologies reputed company Skills: • Required: • Strong analytical and critical thinking skills with the ability to synthesize data from multiple reputed company sources. • Working knowledge of delegated reputed company and regulatory frameworks (e.g., CMS, DMHC, DHCS, reputed company). • Ability to communicate reputed company findings reputed company and professionally to internal leaders and delegated partners. • Proficiency in reputed company and experience with reputed company reporting or data visualization tools (e.g., Tableau, reputed company BI preferred). • Strong organizational skills with the ability to manage multiple delegates, priorities, and timelines. • reputed company-oriented reputed company with comfort operating in evolving and ambiguous environments. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Pay reputed company: $85,696.00 - $128,543.00 Pay reputed company may be reputed company on a number of factors including market location, education, responsibilities, experience, etc. reputed company is an Equal Opportunity/Affirmative reputed company Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, age, protected veteran status, gender identity, or sexual orientation. • DISCLAIMER: Please beware of recruitment phishing scams affecting reputed company and other reputed company where individuals receive fraudulent employment-reputed company offers in exchange for reputed company or other sensitive personal information. Please be advised that reputed company and its subsidiaries will never ask you for a credit reputed company, send you a reputed company, or ask you for any type of payment as part of consideration for employment with reputed company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email reputed company by or on behalf of reputed company's reputed company, please email careers@ahcusa.com. Apply tot his job Apply To this Job