Alliance Health

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 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 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 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 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

This position, overseen by the System of Care Manager, works to support local care coordination efforts through a combination of activities with various public and private agencies, development of processes and agreements to address critical community needs of individuals enrolled with the MCO and f

The Community Health Worker uses engagement strategies and strong community connections to assess and assist members to identify and seek resources that support their unmet health needs, while providing education on, and connection to their benefits. Connecting with members in the community is an es

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 Learning Business Partner I for Leadership Development (LBP-LD) will focus on the organization, planning, designing, and implementing scalable training curricula (aligned to our leadership competencies) and processes to support achieving performance and growth objectives. This role will collabor

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

The AI Operations Engineer is responsible for the operational stability, reliability, and continuous performance of deployed AI models and services. The AI Operations Engineer ensures that AI solutions built are seamlessly operationalized, monitored, and maintained in production environments. By man

The AI Quality Engineer is responsible for ensuring the reliability, accuracy, and safety of AI-driven solutions from the earliest stages of development. This role is deeply integrated into the development lifecycle, focusing on building quality products by designing sophisticated evaluation framewo

The Analytics Engineer serves as a critical technical bridge between Data Engineering and Data Analytics, applying rigorous data engineering principles to the analytics development lifecycle. This role is responsible for creating, scaling, and managing high-value data assets (including metrics store

The Care Management for High-Risk Pregnancy (CMHRP) Care Manager provides comprehensive, member-centered care management services for eligible high-risk pregnant members enrolled in Alliance Health’s Care Management for High-Risk Pregnancy program. This position supports early identification, outrea

The Care Management for High-Risk Pregnancy (CMHRP) Care Manager provides comprehensive, member-centered care management services for eligible high-risk pregnant members enrolled in Alliance Health’s Care Management for High-Risk Pregnancy program. This position supports early identification, outrea

The Care Management for High-Risk Pregnancy (CMHRP) Care Manager provides comprehensive, member-centered care management services for eligible high-risk pregnant members enrolled in Alliance Health’s Care Management for High-Risk Pregnancy program. This position supports early identification, outrea

The Manager- Integrated Health Engagement leads and supports interdisciplinary care management teams to ensure the effective delivery of integrated, whole-person care. This role is responsible for overseeing daily operational workflows, supervising frontline staff, monitoring team performance agains

The Instructional Designer works collaboratively with departments, subject matter experts, facilitators, and business partners to identify training needs, define learning outcomes, and develop effective learning solutions using proven instructional design methodologies. The Instructional Designer in