Value Based Care Management Senior Analyst - RN - Mobile, AL jobs in United States
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CareAllies · 15 hours ago

Value Based Care Management Senior Analyst - RN - Mobile, AL

CareAllies is focused on empowering employees and fostering growth in their careers. The Value Based Care Management Senior Analyst will coordinate relationships with provider practices and ensure quality metrics are met while implementing health care services tailored to individual customer needs.

Health CareInformation Technology
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Responsibilities

Coordinating and managing relationships with participating provider practices
Maintaining detailed understanding of HEDIS / STAR performance measures
Developing and maintaining a process to ensure all customers participating in provider practices meet all quality metrics
Coordinating the delivery of cost-effective, quality-based health care services for health plan customers by development and implementation of alternative treatment plans that address individual needs of the customer, their benefit plan, and community resources
Planning, implementing, and evaluating appropriate health care services in conjunction with the physician treatment plan
Utilizing clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services to facilitate appropriate healthcare outcomes for customers

Qualification

Registered Nurse LicensureHEDIS ExperienceCMS STARs ExperienceMicrosoft Excel ProficiencyCase Management ExperienceBilingual (English/Spanish)Utilization Management ExperienceAcute-Care Experience

Required

Current Licensure as a registered nurse, in the state of residence in good standing
Associates degree, diploma, or B.S. in Nursing
Three to Five (3-5) years recent experience in an acute-care environment, case-management, or utilization management position (experience can be a combination of LVN/RN licensure)
Previous HEDIS and/or CMS STARs experience a plus

Preferred

Bilingual (English/Spanish)
Previous HEDIS and/or CMS STARs experience
Strong proficiency level using Microsoft Excel
Client-site Location: This is a field based position in Mobile, AL and surrounding towns. The individual will be onsite at provider offices 3-5 times weekly
Schedule: Monday - Friday, typical business hours
Sponsorship: Sponsorship is not available

Benefits

Health and wellness benefits
401(k) savings plan
Pension plan
A minimum of 15 days’ of paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement
Plus other incentives

Company

CareAllies

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CareAllies works side-by-side with health care providers to help improve the quality, value and experience of care for their patients, to make health care better for everyone.

Funding

Current Stage
Late Stage
Total Funding
unknown
2024-01-31Acquired

Leadership Team

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Elisabeth DelGrosso, MBA
Vice President, Strategy, Partnerships & Product
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Joe Nicholson
Chief Medical Officer
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Company data provided by crunchbase