Alliance Health

The NCQA Quality & Accreditation Specialist serves as the project management lead and subject matter expert for assigned NCQA standard areas and manages the assessment of related business functions for corresponding departments within the scope of NCQA standards (e.g. Provider and Member Services, U

Description Department Description As a specialized function of Human Resources, the Talent Acquisition (TA) Team strategically identifies, attracts, and hires highly qualified professionals to meet long-term organizational staffing goals. Role Description Alliance is seeking a Fall 2026 or Spring 2

The Grievance and Appeals Analyst responds to grievances and appeals to ensure the resolutions are consistent with organizational policies and procedures and which are compliant with state and federal guidelines and also ensures due process rights. The Analyst synthesizes and analyzes all available

The Utilization Management (UM) Clinical Specialist RN for physical health (PH) independently assesses the medical necessity of inpatient admissions, outpatient services, surgical and diagnostic procedures, and out of network services, monitors consumer treatment through ongoing and continuous revie

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 Care Management Consultant is a highly trained and experienced Clinician working in a consultive role and providing secondary Case Management as part of Alliance’s Multidisciplinary Care Management Team for members with Physical Health needs. The Care Management Consultant offers on-demand recom

This position plans, designs, implements, conducts, and reports program evaluations of services delivered to recipients, including process/implementation evaluation, outcome evaluation, and cost benefit analysis. Ensures that services delivered are consistent with funding requirements, best practice

The TCL Transition Coordinator is responsible for assisting individuals who have agreed to community living exiting an institutional care setting. This position will support a person in securing and managing appropriate services, housing and community resources and requires a high level of collabora

The TCL Transition Coordinator is responsible for assisting individuals who have agreed to community living exiting an institutional care setting. This position will support a person in securing and managing appropriate services, housing and community resources and requires a high level of collabora

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 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 Leave Specialist will provide support to the Human Resources department in benefits related leave administration for Alliance. This position will administer leave requests and accommodations that arise under the Family and Medical Leave Act (FMLA), the Americans with Disabilities Act (ADA), paid

The HEDIS Clinical Quality Analyst provides clinical direction, guidance, training, and quality oversight for all things related to the clinical aspect of Healthcare Effectiveness Data and Information Set (HEDIS). This position would oversee abstraction, overreads and quality analysis of HEDIS for b

The Grievance and Appeals Analyst responds to grievances and appeals to ensure the resolutions are consistent with organizational policies and procedures and which are compliant with state and federal guidelines and also ensures due process rights. The Analyst synthesizes and analyzes all available

The Physical Health Medical Director plays a key role within the Physical Health Medical Management Team, providing clinical oversight, medical expertise, and operational support for physical health services. This position ensures high quality, evidence based medical review processes and supports or

The Health Promotion and Outreach specialist conducts targeted member outreach related to health promotion, wellness, chronic condition management, maternal and child health, substance use, tobacco prevention and other population health initiatives using telephone, member portal, text, email, mail,

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 Clinical Quality Analyst manages the quality review process for care management programs. Incumbents conduct quality reviews of internal data and processes to identify trends/patterns that impact service/system quality and may require interventions. This position is fulltime remote. Selected can

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 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