Alliance Health

The Deputy Chief Risk & Compliance Officer serves as the senior operating and governance leader for the Office of Compliance and Risk Management, translating the EVP-Chief Risk/Compliance Officer’s strategic direction into coordinated execution across Corporate Compliance, Privacy and Health Informa

The Manager - Care Management Performance Optimization is responsible for driving operational alignment and leading performance and optimization initiatives across the Care Management department. The role focuses on identifying performance gaps, streamlining processes, enhancing service delivery, an

The Care Management Performance Optimization Specialist supports Care Management operational initiatives, projects, and performance improvement efforts by coordinating data-driven reporting, analytics, quality assurance, and cross-departmental collaboration. This role strengthens member outcomes, da

The Senior Director, Community Integration and Transition develops and implements best practices for Transition to Community Living (TCL), community services and supports, and Community Health Worker models for individuals with Serious Mental Illness and co-occurring disorders. This role develops hi

The Principal 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. The Principal Clinical Inf

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

The Director of Transition to Community Living and Care Management (TCM-CM) is responsible for the leadership, operational oversight, implementation, and performance of care management services supporting members with complex behavioral health, physical health, intellectual and developmental disabil

The UM Clinical Specialist-Behavioral Health performs professional and administrative work, primarily utilization reviews, utilization management and active care management to ensure economical and effective consumer service delivery by PHIP enrolled network providers. The position is responsible fo

The Administrative Clinical Support Specialist I performs a range of administrative tasks, resolves problems and may coordinate administrative support activities that require knowledge of program operations, policies, and processes. The position will be responsible for the transferring of clinical d

The Internal Auditor II provides senior level staff advisory, consultative, and audit work to include the preparation of audit programs and independent review of various functions, policies, and programs for soundness, adequacy, and application. The Internal Auditor II ensures resources are efficien

The Implementation Specialist – Innovation and Strategy supports the planning, coordination, and implementation of strategic initiatives within the Innovation and Strategy Division. This position is primarily responsible but not limited to supporting the Rural Health Transformation Project through s

The Provider Network Evaluator I-HCBS works as part of the Provider Network Evaluation (PNE) Department on the Home and Community Based Services (HCBS) team. Home and Community Based Services provide opportunities for Medicaid beneficiaries to receive services in their own home or in community setti

The In Reach and Engagement Specialist provides an essential function of the Transition to Community Living (TCL) program by supporting members with information about, and assistance with, accessing services and community resources to improve the individual’s health outcomes and aid in successful co

The Claims Supervisor is responsible for oversight of claims data entry, payments, credits, and adjustments; training and development of Claims Research Analyst team members; claims auditing for performance; measuring and maintaining productivity; complex decision making; and information management

The Behavioral Health Clinician is primarily responsible for coverage of the 24-hour Behavioral Health Crisis line, including conducting telephonic screening, triage and referral functions for individuals seeking services. The Clinician ensures that individuals calling with service needs are safely

The PNE Targeted Reviewer I is responsible for conducting focused and targeted reviews that may include health and safety reviews, quality of care issues, intensive incident report reviews, the appropriateness of clinical services delivered by providers in the Alliance network. The PNE Targeted Revi

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 External Clinical Quality Analyst II manages the quality review process for provider-led care management programs. Incumbents conduct quality reviews and audits of provider-led care management programs and processes for quality assurance purposes and to support the effective functioning of provi

The External Clinical Quality Analyst I manages the quality review process for provider-led care management programs. Incumbents conduct quality reviews and audits of provider-led care management programs and processes for quality assurance purposes and to support the effective functioning of provid

The Data Governance Analyst supports the development, implementation, and continuous improvement of Alliance Health’s enterprise data governance framework. This role partners with business and technology stakeholders to promote effective data management, strengthen data quality, support metadata and