Alliance Health

The Director of Utilization Management (UM) for Physical Health is responsible for administering and coordinating physical health utilization management activities for Alliance. This position ensures the UM Department operates as an integrated department providing a holistic review of member’s needs

The Health Equity Specialist supports Alliance Health’s efforts to identify, reduce, and eliminate health disparities by advancing equitable access to high-quality, whole-person care for members and underserved communities. This role uses data analysis, community engagement, member outreach, quality

The Supervisor-External Clinical Quality Analyst oversees a team of licensed and non-licensed staff responsible for conducting quality assurance, compliance, and documentation reviews of provider-led Tailored Care Management records. The Supervisor-External Clinical Quality Analyst role ensures moni

The Care Manager l-Non-Waiver 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 services

The Director-Data Platform Engineering is responsible for the strategic leadership, governance, and delivery of Alliance Health’s modern cloud based data engineering platform, replacing the legacy Enterprise Data Warehouse operating model. The Director-Data Platform Engineering provides enterprise a

The Cloud Data Architect is responsible for design and implementation of scalable enterprise-wide data architecture. The Cloud Data Architect optimizes data performance and accessibility, and ensuring data quality, integrity and security. This position is full-time remote. Selected candidate must re

The CRM Solution Architect is responsible for designing, governing, and optimizing CRM solutions across the enterprise. The CRM Solution Architect ensures that CRM platform and integration capabilities are used effectively to support business operations, technology strategy, and organizational objec

The Care Manager l-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 linked to services and su

The Practice Transformation Specialist (PTS) works with Advanced Medical Homes (AMH+) and Care Management Agencies (CMA) in the Alliance Health region to improve quality of care. This position serves as a consultant to provider practice staff to improve patient outcomes by enhancing skills in proces

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 among providers of h

The Provider Support Line Specialist handles calls from providers and answers questions about joining the network, contracts, enrollment, billing, member information, navigating the EHR, claims submissions, authorization requests, onboarding into our network, troubleshooting various technology platf

The Actuarial Associate will analyze and interpret data related to cost, membership, capitation, Rate-setting, Incurred But Not Reported (IBNR) and other items as needed. They will use SQL/excel etc. to model data and assess financial risk and help develop exhibits to assist in the socialization of

The High Priority Reentry Peer Support Specialist responsible for providing re-entering individuals with Serious Mental Illness (SMI) and/or Severe and Persistent Mental Illness (SPMI), who are on the Department of Adult Correction (DAC) prioritization list, with education and support throughout the

The Care Manager Extender supports Care Managers in delivering integrated, person-centered care coordination for members enrolled in the Alliance’s Tailored Plan. This role assists with non-clinical tasks, outreach, and administrative functions to ensure timely and effective care management services

The Provider Network Evaluator II-Clinical Quality Review (PNE II-CQR) holds and maintains clinical licensure as they are responsible for conducting as well as leading Clinical Quality Reviews (CQR), Oversight Reviews, and Plan of Correction implementation reviews of service providers contracted wit

The CM Data Senior Operations Analyst position will support the design, development, and implementation of care management reporting requirements. This position also conducts quality assurance testing related to reporting, data integrity, and analyses; to include ongoing monitoring and oversight of

The Artificial Intelligence Engineer (AI Engineer) will design, develop, deploy, and integrate machine learning models, AI tools, and other analytics products into Alliance systems and workflows to improve member health, quality of services, and administrative processes. The AI Engineer will help to

The primary purpose of this position is to plan, execute, and finalize projects according to deadlines and within budget as assigned by the Manager of Project Portfolio Management. This involves establishing a team of members who can effectively complete the project based on their skills, knowledge

The Information and Communications Specialist III, under general direction, may oversee various departmental activities including creation of internal and external organization communications and marketing/informational materials and campaigns, website content maintenance, video production, and prov

The Manager of EDI Development and Support’s primary role is to oversee the development, implementation, and support of our EDI systems, processes and vendor interactions and support. The Manager of EDI Development and Support will collaborate with cross-functional teams, manage EDI projects, and en