Qureos Mentor

Alignment Healthcare

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
The position is a field based position in Las Vegas, NV. You must live in Las Vegas.<br>
<br>
The Broker Account Manager is responsible for the sales and growth of the broker channel and reports to the Vice President of Sales. The Broker Account Manager oversees all channel activity including sales production, recruitment, training and sales strategy to grow the channel while maintaining a favorable acquisition cost for the company.<p></p><p>
GENERAL DUTIES/RESPONSIBILITIES (MAY INCLUDE BUT ARE NOT LIMITED TO):<br>
In overseeing the broker channel, the Broker Manager will:<br>
1. Increases sales and meet or exceed sales expectations through existing active relationships.<br>
2. Builds new selling relationships in existing markets and expansion markets to grow the broker sales channel.<br>
3. Manages provider relationships and assign agents to partner with Medical Groups/IPA&rsquo;s for growth.<br>
4. Oversees agent sales and product training including webinars for new agents, lock-in refresher trainings, and Open Enrollment recertification training.<br>
5. Assists with broker support channels including customer service calls and email inquiries.<br>
6. Oversees interactions with external agents including commissions, discrepancies, enrollment kit fulfillment, certification and contracting/appointment requirements.<br>
7. Ensures CMS compliance with all sales, enrollment processes and events.<br>
8. Oversees compliance at all times to include secret shopping and ride-alongs<br>
9. Provides fair and objective documentation on corrective action plans and/or performance appraisals as directed by company policies and procedures.<br>
10. Provides effective and objective communication to keep managing relationships apprised of any updates and/or changes within department, CMS guidelines, company policies and procedures while keeping strong morale intact.<br>
11. Attends all mandatory management administrative, educational and/or training courses.<br>
12. Other duties as assigned</p><p><b><br>
Job Requirements:</b></p><p><b>
Experience:</b></p><ul><li>Required: Minimum of 2 years of general sales / marketing strategy experience.</li><li>Preferred: Medicare knowledge and/or health insurance background preferred.</li></ul><p><b>
Education:</b></p><ul><li>Required: High School Diploma or GED. Bachelor's degree or four years additional experience in lieu of education.</li><li>Preferred: MBA</li></ul><p><b>
Training:</b></p><ul><li>Required:</li><li>Preferred:</li></ul><p><b>
Specialized Skills:</b></p><ul><li>Required:</li></ul><ul><li>
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>
Strong knowledge and understanding of the CMS Marketing Guidelines</li><li>
Must have reliable means of transportation to get to all sales activities and appointments.</li><li>
Extremely organized, detail driven and a self-starter.</li><li>
An innovator and effective leader with the ability to motivate direct team, community affiliates and provider relationships.</li><li>
Excellent public speaking and presentation skills.</li><li>
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.</li><li>
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>
Report Analysis Skills: Comprehend and analyze statistical reports.</li></ul><p><b>
Licensure:</b></p><ul><li>Required: None</li><li>Preferred: Current and active life insurance license within respective selling state</li></ul><p></p><p>
Essential Physical Functions:</p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p>
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p><div></div>
Pay Range: $49,486.00 - $74,228.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

Broker Account Manager - Field position in Las Vegas

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
This is a hybrid position in Orange, CA.<br>
<br>
The Pharmacy Technician performs department administrative functions that do not require the Pharmacy Managers judgment. Responsible for the administrative and clerical support directly involved with the day-to-day operations of the multiple programs performed by the department. Performs assigned tasks to meet AHP HMO and Pharmacy Department goals.<p></p><p><b>
GENERAL DUTIES/RESPONSIBILITIES:</b><br>
1. Assists with the daily operations of the various Pharmacy Department programs, multiple projects and participate in Plan and regulatory agency audits, as necessary.<br>
2. Makes high volume of outbound calls to members, prescribers, and pharmacies in regard to the Adherence program.<br>
3. Assists members in refilling their medications and reaching out to the prescriber&rsquo;s office if a member requires additional refills on their maintenance medications.<br>
4. Drafts routine reports and correspondence.<br>
5. Supports all CMS required oversight processes of PBM including but not limited to: Rebates, Explanation of Benefit reports, Transition Reports, and Part B vs Part D.<br>
6. Responds to inquiries from physicians, members, and pharmacies related to formulary and prescription benefits.<br>
7. Retrieves accurate, concise, applicable, and timely drug information.<br>
8. Interacts with Plan's contracted PBM to ensure communications and information to other internal Plan departments as applicable.<br>
9. Interacts with Plan&rsquo;s contracted PBM in regard to Prior Authorizations, Overrides and in resolving issues pertaining to member&rsquo;s medications.<br>
10. Makes outbound calls to pharmacies and prescribers to resolve prescription issues such as medication requires Prior Authorization, assist retail/mail order pharmacies in resolving third party rejections, and reviewing daily rejections while ensuring we are CMS compliant.<br>
11. Interacts with internal plan departments to address pharmacy related issues.<br>
12. Works closely with compliance department to make sure Pharmacy Programs meet the criteria established by CMS.<br>
13. Ensures all HMO&rsquo;s members information is kept confidential according to HIPAA.<br>
14. Other duties as assigned.</p><p><b>
Job Requirements:</b></p><p><b>
Experience:</b></p><ul><li>Required: Minimum 1 year customer experience.</li><li>Preferred: Prior Pharmacy Tech experience in a healthcare setting.</li></ul><p><b>
Education:</b></p><ul><li>Required: High School Diploma or GED.</li><li>Preferred: Associates Degree in Pharmacy Tech</li></ul><p><b>
Training:</b></p><ul><li>Required: None</li><li>Preferred: Pharmacy Tech school</li></ul><p><b>
Specialized Skills:</b></p><ul><li>Required:</li></ul><ul><li>
Knowledge of pharmacy and medical nomenclature/terminology, common medication dosages, trade &amp; generics, and medication therapy application.</li><li>
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.</li><li>
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>Preferred: Bilingual - English/Spanish or English/Chinese</li></ul><p><b>
Licensure:</b></p><ul><li>Required: Pharmacy Tech license</li><li>Preferred: Certified Pharmacy Technician</li></ul><p><b>
Work Environment:</b></p><p>
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p>
Essential Physical Functions:</p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p>
1 While performing the duties of this job, the employee is regularly required to talk, hear, and sit; use hands to manipulate office equipment.</p><p>
2 The employee regularly is required to stand, walk, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</p><p>
3 The employee frequently lifts and/or moves up to 10 pounds.</p><p>
4 Specific vision abilities required by this job include close vision and the ability to adjust focus.</p>
Pay Range: $41,472.00 - $62,208.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

Pharmacy Technician - Hybrid - Orange, CA

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
**This role is remote, but must be able to work PST hours.**<br>
<br>
The Associate Vice President (AVP), Data Science &amp; Analytics &ndash; Medicare Quality, is a senior leadership role responsible for the strategy and execution of advanced analytics that drive quality performance for the Star Ratings Program. This role is ideal for a senior-level data scientist with deep experience in healthcare quality measurement, predictive modeling, and data-driven strategy.
<br>
<br>
This individual will serve as the principal architect of the organization's Star Ratings analytics ecosystem, responsible for developing predictive models, generating actionable insights, and shaping the data strategies that directly influence quality outcomes. This role requires a leader who blends hands-on data science expertise with strategic vision, acting as both a primary technical authority and a key business advisor.
<br>
<br>
The AVP will work closely with leaders across clinical, business, and operational departments to translate complex data science findings into effective business interventions. This includes owning forecasting models, leading exploratory analysis to uncover new performance levers, and mentoring a team of analytics professionals to ensure technical and strategic excellence.<p></p><div><p>
Job Duties/Responsibilities:</p></div><div><p><b>
Data</b><b> Modeling &amp; Strategy</b>:</p></div><div><p>
Lead the design, development, and continuous refinement of advanced statistical and machine learning models to predict and optimize performance on the Star Ratings Program.</p></div><div><p>
Own the technical roadmap for the analytics platform, ensuring it supports current and future analytical needs.</p></div><div><p><b>
Actionable Insight Generation</b>:</p></div><div><p>
Translate model outputs and complex datasets into actionable member, provider, and measure-level insights.</p></div><div><p>
Partner with cross-functional teams to embed these insights into clinical outreach, population health, and member engagement workflows to guide targeted interventions.</p></div><div><p><b>
Forecasting &amp; Performance Monitoring</b>:</p></div><div><p>
Own the end-to-end development of forecasting models for the Star Ratings Program, including the design of risk-adjusted simulations.</p></div><div><p>
Develop and maintain performance monitoring tools and dashboards to track and measure performance at all organizational levels.</p></div><div><p><b>
Subject Matter Expertise &amp; Compliance</b>:</p></div><div><p>
Serve as the organization's senior data science subject matter expert on all Star measures (e.g., HEDIS, CAHPS, HOS, Part D).</p></div><div><p>
Translate complex CMS methodology into technical data requirements and support regulatory reporting and CMS audit readiness through rigorous data validation.</p></div><div><p><b>
Executive &amp; Cross-Functional Partnership</b>:</p></div><div><p>
Serve as the primary analytics partner to clinical, quality, and business leaders, helping them interpret data and make informed decisions.</p></div><div><p>
Present complex data science findings and model outcomes to executive audiences, clearly communicating the connection to business objectives and strategic value.</p></div><div><p><b>
Team Leadership &amp; Development</b>:</p></div><div><p>
Lead and mentor a dedicated team of data scientists and analysts.</p></div><div><p>
Promote best practices in statistical modeling, coding, data wrangling, and visualization to foster a culture of technical excellence and data-driven inquiry.</p></div><div><p><b>
Other Duties as Assigned</b></p></div><div><p>
Job Requirements:</p></div><div><p>
Experience:</p></div><div><ul><li><p>
Required:</p></li></ul></div><div><ul><li><p>
Minimum 10+ years data science, data engineering, or a related field, with a proven track record of designing and executing large-scale, complex data solutions.</p></li></ul></div><div><ul><li><p>
Significant experience in a leadership capacity, with demonstrated ability to set technical vision and manage teams.</p></li></ul></div><div><ul><li><p>
In-depth knowledge of the healthcare industry, specifically Medicare Advantage and the CMS Star Ratings System.</p></li></ul></div><div><ul><li><p>
Expert-level proficiency with modern data architecture principles, including cloud platforms (Azure), data warehousing, data lakes, and ETL/ELT processes.</p></li></ul></div><div><ul><li><p>
Demonstrated experience establishing and managing data governance and data quality programs.</p></li></ul></div><div><ul><li><p>
Strong understanding of data security and compliance requirements in a healthcare context.</p></li></ul></div><div><ul><li><p>
Preferred:</p></li></ul></div><div><ul><li><p>
10+ years&rsquo; experience in Medicare Advantage Plans</p></li></ul></div><div><ul><li><p>
10+ years&rsquo; experience in a technical leadership position in a healthcare environment</p></li></ul></div><div><p>
Education:</p></div><div><ul><li><p>
Required: Bachelor&rsquo;s degree in Health Informatics, Computer Science, Data Science, Business Analytics or related quantitative field.</p></li></ul></div><div><ul><li><p>
Preferred: Master&rsquo;s degree in one of the above fields</p></li></ul></div><p></p><div><p><br>
Specialized Skills:</p></div><div><p>
Required:</p></div><div><ul><li><p>
Technical &amp; Domain Expertise</p></li></ul></div><div><ul><li><p><b>
Healthcare &amp; Stars Domain Knowledge</b>: Required understanding of Medicare Advantage, the CMS Star Ratings Program, HEDIS measures, CAHPS/HOS surveys, and pharmacy data (PDE).</p></li></ul></div><div><ul><li><p><b>
Advanced Modeling &amp; Statistical Strategy:</b><b> </b>The ability to direct and apply sophisticated statistical and machine learning methods to solve critical business problems. This includes overseeing model selection, validation, and interpreting results to guide high-level strategic decisions.</p></li></ul></div><div><ul><li><p><b>
Analytical Data Architecture &amp; Engineering: </b>Oversight of the data preparation process, including the strategic design of datasets, advanced feature engineering, and ensuring the integrity of the data used for all modeling and reporting.</p></li></ul></div><div><ul><li><p><b>
Technical Leadership &amp; Implementation: </b>Expert-level proficiency in Python and advanced SQL, with the ability to set and enforce best practices for coding, analytical rigor, and reproducibility across the team and its projects.</p></li></ul></div><div><ul><li><p>
Leadership &amp; Communication</p></li></ul></div><div><ul><li><p><b>
Executive Translation</b>: The ability to distill highly complex data concepts, challenges, and technical jargon into clear, concise summaries. Must be able to articulate the business value and strategic implications of &lsquo;technical&rsquo; decisions to non-technical executives and stakeholders.</p></li></ul></div><div><ul><li><p><b>
Strategic Thinking: </b>Capacity to develop a long-term vision and roadmap that aligns with business objectives, anticipates future CMS regulatory changes, and scales with organizational growth.</p></li></ul></div><div><ul><li><p><b>
Stakeholder Management &amp; Influence</b>: Proven ability to build consensus and foster strong relationships with a diverse range of stakeholders, including clinical leaders, business executives, IT teams, and compliance officers.</p></li></ul></div><div><ul><li><p><b>
Thought Leadership &amp; Mentorship</b>: The ability to lead through influence, mentor technical staff, and champion best practices to elevate the data capabilities of the entire organization.</p></li></ul></div><div><ul><li><p><b>
Problem-Solving</b>: A pragmatic approach to deconstructing complex business and operational problems and designing effective, sustainable technical solutions.</p></li></ul></div><p></p><div><p><br>
Essential Physical Functions:</p></div><div><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p></div><p></p><div><p><br>
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</p></div><div><p>
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p></div>
Pay Range: $149,882.00 - $224,823.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

AVP, Medicare Quality Analytics

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
Alignment Health is seeking a compassionate, organized, and tech-savvy medical assistant to join the Jump Start Assessment (JSA) team in El Paso, TX. In this role, you will provide both clinical and administrative support while working closely with clinicians to deliver high-quality medical services. You will play a key role in supporting patient care by assisting clinicians with examinations and treatments under the direction of a Physician, PA, or Nurse Practitioner.<br>
<br>
The medical assistant is responsible for completing all medical assistant duties with a high level of competency while also helping to manage patient flow on the floor. This role offers the opportunity to contribute beyond core responsibilities through involvement in special projects, reporting, administrative, and compliance-related tasks as needed.<br>
<br>
Schedule: 8:00 AM - 5:00 PM Mountain Time.<br>
Location: This is a field-based position requiring local travel and in-person interactions; it is not a fully remote role.<p></p><p><b>
General Duties / Responsibilities:</b></p><div><div><ul><li><p>
Hybrid, field-based role supporting telehealth, in-clinic care, and in-home member visits; requires flexibility to transition between remote, field, and onsite responsibilities based on operational needs.</p></li><li><p>
Conduct in-home member visits and field-based care delivery, with driving requirements varying (up to ~50% or more) based on business initiatives throughout the year. (Mileage reimbursement provided)</p></li><li><p>
Adapt to a dynamic weekly schedule, including a mix of remote support, in-clinic coverage, and field visits, with assignments determined by business needs.</p></li><li><p>
Complete all basic patient intake with demonstrated competency including but not limited to:</p></li></ul><p></p><ul><li>Vitals (height, weight, blood pressure, pulse, respiration, temps, etc)</li><li>Phlebotomy</li><li>Vaccine Administration</li></ul><p>
Medical History / medication collection including Jump Start Application and EMR</p><ul><li>Other machines / systems trained on by supervisor and within Medical Assistant Scope</li></ul><ul><li><p>
Complete all patient check-in functions including eligibility verification, appointment scheduling, confirmation, arrival of member within the EMR system and checkout.</p></li><li><p>
Support ongoing HEDIS and population health initiatives throughout the year, including outreach, screenings, and in-home or in-clinic interventions.</p></li><li><p>
Deliver excellent customer service for every member including assisting with care coordination needs such as referrals, enrollments in chronic disease management programs, etc.</p></li><li><p>
Facilitate member concerns, complaints or coordination needs regarding services at Alignment clinics, primary physician offices, network providers, or health plan services.</p></li><li><p>
Complete telephonic history and pre-visit planning as needed.</p></li><li><p>
Perform a high volume of outbound and inbound member calls daily to support scheduling, pre-visit preparation, and care coordination.</p></li><li><p>
Conduct in-home member visits including vitals collection, basic assessments, and assisting members with telehealth connectivity in their home environment.</p></li><li><p>
Provide real-time telehealth support, including guiding members through device setup, troubleshooting connectivity issues, and ensuring successful provider visit completion.</p></li><li><p>
Support multiple providers simultaneously (typically 3&ndash;4), including managing schedules, completing pre-visit chart preparation, and coordinating care needs.</p></li><li><p>
Facilitate referrals / authorizations for members between the member, Alignment, specialists, and primary care providers if applicable.</p></li><li><p>
Additional responsibilities, including participation in special initiatives and evolving care programs, may be assigned as needed.</p></li></ul></div><p></p><p><b>
Minimum Requirements:</b></p><p></p><p><b>
Skills and Experience:</b></p><p>
Required:</p><ul><li><p>
Minimum 3 years' experience as a medical assistant preferably in a physician office including working knowledge of managed care.
</p></li><li><p>Familiar with medical terminology</p></li><li><p>
Proficient in Microsoft Office suite (Outlook, Excel, Word)</p></li><li><p>
Proficient with the following applications: FaceTime, WhatsApp, other video applications</p></li><li><p>
Bilingual English / Spanish</p></li></ul><p></p><p>
Preferred:</p><ul><li><p>
Experience working with internal medicine offices
</p></li><li><p>Knowledge in Medicare and Medicaid benefits and resources preferred</p></li></ul><p></p><p><b>
Education / Licensure:</b></p><p>
Required</p><ul><li><p>
Completion of accredited medical assistant program.</p></li><li><p>
High school diploma.</p></li><li><p>
Current, valid, unrestricted driver's license and reliable transportation.</p></li><li><p>
CPR / First Aid Certification</p></li></ul><p></p><p>
Preferred:</p><ul><li><p>
Medical assistant certification.</p></li><li><p>
LVN / LPN or other higher nursing certifications accepted as well.</p></li></ul><p></p><p><b>
Work Environment</b></p><p>
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p>
Essential Physical Functions:</p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p>
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</p><p>
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p></div>
Pay Range: $38,569.00 - $57,853.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

Bilingual Spanish Medical Assistant (Home Visits in El Paso TX | Field Remote)

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
The Senior AI &amp; Automation Engineer is a senior individual contributor and technical leader on the Data &amp; Technology Solutions team, responsible for architecting, building, and scaling intelligent AI systems and enterprise automation solutions that directly improve care quality and operational performance across our Medicare Advantage business. You will serve as a go-to technical expert for AI Scientists, Data Engineers, Product Managers, Clinical Operations, and Application Engineering teams &mdash; driving end-to-end delivery of production AI systems that span claims processing, risk adjustment, prior authorization, revenue integrity, and member engagement. This role carries a higher degree of independent ownership and technical authority than the mid-level equivalent, with expectations to lead complex, ambiguous initiatives from concept through production and to actively elevate the engineering practices of the broader team.<p></p><div><div><p><b>
Job Duties / Responsibilities</b></p></div><div><ul><li><p><b>
Architect and deliver production-grade AI and machine learning systems.</b> Lead the end-to-end design and deployment of predictive and generative AI models &mdash; including NLP, classification, regression, and computer vision &mdash; for high-stakes Medicare Advantage workloads. Own architectural decisions related to model selection, scalability, and production readiness, and establish monitoring and drift detection standards adopted across the team.</p></li></ul></div><div><ul><li><p><b>
Lead the design and scaling of intelligent process automation.</b> Evaluate and architect enterprise-wide automation strategies using RPA platforms (e.g., UiPath, Power Automate) and orchestration tools (e.g., Airflow, Prefect). Drive automation ROI analysis, establish engineering standards for fault-tolerant workflow design, and serve as the senior technical owner for the organization's most complex automation pipelines.</p></li></ul></div><div><ul><li><p><b>
Own AI/ML data infrastructure strategy and pipeline reliability.</b> Design and govern robust ETL and feature engineering pipelines that support model training, validation, and real-time inference at scale. Define infrastructure standards for experimentation, retraining, and monitoring that ensure consistent model performance across a regulated, high-availability production environment.</p></li></ul></div><div><ul><li><p><b>
Integrate AI and automation systems into enterprise architecture.</b> Lead the integration of deployed models and automation services into enterprise products via REST APIs and microservices, setting the engineering bar for security, HIPAA compliance, and maintainability. Drive adoption of containerization (Docker, Kubernetes) and CI/CD best practices across the AI engineering team.</p></li></ul></div><div><ul><li><p><b>
Architect and implement LLM-powered and agentic AI applications.</b> Define the technical approach for integrating large language models into clinical and operational workflows &mdash; including prompt engineering, fine-tuning, RAG pipelines, and multi-agent orchestration frameworks (LangChain, LangGraph, AutoGen). Own delivery of agentic AI solutions that transform end-to-end workflows in areas such as clinical document intelligence, intelligent prior authorization, and member communication.</p></li></ul></div><div><ul><li><p><b>
Establish reliability standards and drive continuous system improvement.</b> Own the performance, reliability, and scalability posture of AI and automation systems across the team. Define alerting, testing, and tuning frameworks that proactively surface degradation before it affects member outcomes, and lead post-incident reviews to build organizational resilience.</p></li></ul></div><div><ul><li><p><b>
Mentor engineers and shape AI engineering culture.</b> Provide senior technical mentorship to mid-level and junior engineers through hands-on code reviews, design critiques, and paired problem-solving. Contribute to hiring, technical interviews, and the establishment of team-wide engineering standards &mdash; including responsible AI practices such as bias detection, model explainability, and governance in high-stakes healthcare contexts.</p></li></ul></div><p></p><div><p><b><br>
Supervisory Responsibilities</b></p></div><div><p>
This role is structured as a senior individual contributor with no formal direct reports. The Senior AI &amp; Automation Engineer is expected to function as an informal technical lead &mdash; providing mentorship, conducting code reviews, participating in hiring panels, and guiding the technical direction of junior and mid-level engineers on project teams.</p></div><p></p><div><p><b><br>
Job Requirements</b></p></div><div><p><b>
Experience</b></p></div></div><div><div><p><i>
Required:</i></p></div><div><ul><li><p>
5&ndash;8 years of professional experience in software engineering with a demonstrated, progressive focus on AI/ML, data science, or intelligent process automation</p></li></ul></div><div><ul><li><p>
Proven track record of independently owning and delivering complex, production-grade AI/ML systems from design through deployment and ongoing operations</p></li></ul></div><div><ul><li><p>
Demonstrated experience with the full AI/ML model lifecycle at scale: data architecture, model design, training, validation, deployment, monitoring, and retraining</p></li></ul></div><div><ul><li><p>
Experience in a regulated industry (healthcare, insurance, or financial services) with deep working knowledge of compliance and security requirements in production AI environments</p></li></ul></div><div><ul><li><p>
Experience architecting and scaling automation solutions using RPA platforms and workflow orchestration tools, including cross-functional stakeholder engagement and ROI governance</p></li></ul></div><div><p><i>
Preferred:</i></p></div><div><ul><li><p>
Experience applying AI, NLP, or ML to complex healthcare data including claims processing, revenue cycle management, prior authorization, medical coding, or clinical text understanding</p></li></ul></div><div><ul><li><p>
Demonstrated knowledge of healthcare data standards including HL7 FHIR, ICD-10/CPT codes, or DICOM</p></li></ul></div><div><ul><li><p>
Experience in a Medicare Advantage, managed care, or payer environment at a senior engineering level</p></li></ul></div><div><ul><li><p>
Prior experience as an informal technical lead, principal engineer, or engineering lead on an AI/ML team</p></li></ul></div><div><p><b>
Education</b></p></div><div><p><i>
Required:</i></p></div><div><ul><li><p>
Bachelor's degree in Computer Science, Engineering, Mathematics, Data Science, or a related quantitative field</p></li></ul></div><div><ul><li><p>
Equivalent combination of education and demonstrated, progressive senior-level hands-on experience will be considered</p></li></ul></div><div><p><i>
Preferred:</i></p></div><div><ul><li><p>
Master's degree in Computer Science, AI/ML, or a related quantitative discipline</p></li></ul></div><div><p><b>
Training</b></p></div><div><p><i>
Required:</i></p></div><div><ul><li><p>
Advanced, demonstrated proficiency with Python and ML frameworks through professional work experience at a senior level; formal training or equivalent self-directed mastery accepted</p></li></ul></div></div><div><div><ul><li><p>
Hands-on experience with cloud AI/ML platforms (AWS SageMaker, Azure AI, or Google Vertex AI) at an architecture or senior engineering level; certification or equivalent experience accepted</p></li></ul></div><div><p><i>
Preferred:</i></p></div><div><ul><li><p>
Formal certification or coursework in MLOps, cloud AI platforms (AWS, Azure, or GCP), responsible AI, or agentic AI development</p></li></ul></div><div><ul><li><p>
Certification in RPA platforms (UiPath, Automation Anywhere, or Microsoft Power Automate)</p></li></ul></div><div><ul><li><p>
Participation in advanced AI/ML communities, conferences, or open-source contributions demonstrating technical depth</p></li></ul></div><p></p><div><p><b><br>
Skills &amp; Competencies</b></p></div><div><p><b>
Technical / Role-Specific Skills</b></p></div><div><ul><li><p><b>
AI/ML Engineering:</b> Expert-level Python proficiency with deep command of ML frameworks including PyTorch, TensorFlow, scikit-learn, and Hugging Face Transformers; advanced experience designing LLM-based systems including RAG pipelines, vector databases, and multi-agent orchestration frameworks (LangChain, LangGraph, AutoGen, CrewAI)</p></li></ul></div><div><ul><li><p><b>
Intelligent Process Automation &mdash; Architecture &amp; Governance :</b> Proven ability to architect enterprise-scale automation strategies using RPA platforms (UiPath, Power Automate, Automation Anywhere) and orchestration tools (Apache Airflow, Prefect, or n8n); experience setting engineering standards, conducting automation ROI governance, and leading complex, cross-functional automation programs</p></li></ul></div><div><ul><li><p><b>
Cloud AI Platforms &amp;</b><b> </b><b>MLOps</b><b>:</b> Expert-level experience with AWS SageMaker, Azure AI / Document Intelligence, Google Cloud Vertex AI, or Databricks; mastery of containerization (Docker, Kubernetes), CI/CD pipelines, and MLOps tooling (MLflow, Kubeflow, or equivalent) at an architecture and governance level</p></li></ul></div><div><ul><li><p><b>
Data Engineering &amp; AI Infrastructure:</b> Ability to design, govern, and scale ETL and feature pipelines across complex, high-availability healthcare environments; deep proficiency in SQL, data architecture patterns, and real-time inference infrastructure</p></li></ul></div><div><ul><li><p><b>
Healthcare &amp; Regulatory Expertise:</b> Deep working knowledge of HIPAA compliance, data security requirements, and data governance in regulated healthcare environments; advanced familiarity with healthcare data standards including HL7 FHIR and ICD-10/CPT as applied to production AI and automation systems</p></li></ul></div><div><ul><li><p><b>
Technical Leadership &amp; AI Innovation:</b> Demonstrated ability to drive architectural decisions, mentor engineers, lead design reviews, and shape engineering standards across a team; track record of identifying and delivering high-ROI AI and automation innovations in an enterprise healthcare context</p></li></ul></div><div><ul><li><p><b>
Responsible AI &amp;</b><b> </b><b>Governance :</b> Applied experience with ethical AI frameworks including bias detection, model explainability (SHAP, LIME, or equivalent), and AI governance practices; ability to embed responsible AI standards into team workflows where AI outputs directly influence member care and financial decisions</p></li></ul></div><div><p><b>
License</b></p></div><div><p><i>
Required:</i> None at this time.</p></div><div><p><i>
Preferred:</i></p></div><div><ul><li><p>
Cloud certification from AWS, Microsoft Azure, or Google Cloud at an advanced or specialty level (AI/ML or data engineering track)</p></li></ul></div><div><ul><li><p>
RPA platform certification (UiPath, Automation Anywhere, or Microsoft Power Automate)</p></li></ul><p></p><p><b>
Essential Physical Functions:</b></p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p>
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</p><p>
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p></div></div>
Pay Range: $172,364.00 - $258,547.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

Senior AI Automation Engineer

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
Alignment Health is seeking a compassionate and detail oriented patient navigator to join their Access Primary Care Physicians clinic on Smoke Ranch Road in Las Vegas, NV. As a patient navigator, you will provide outreach and support to ensure all our members have access to the care they deserve. You will navigate our members through their health care and benefits, and connect the dots between our provider network, health plan operations, and supplemental vendors. You will be alongside our members every step of the way to ensure they are never alone in their healthcare journey and have the highest level of coordinated care. Patient navigators are active members of the health care team, addressing immediate needs and laying the groundwork for future and ongoing member support. This is a role for a passionate and experienced healthcare professional who understands the meaningful contribution they make to our members&rsquo; healthcare outcomes.<br>
<br>
Individuals with front and back office medical assistant experience and care coordination experience highly encouraged to apply!<br>
<br>
Location: Smoke Ranch Clinic<br>
Schedule: Monday - Friday, 7:30 AM - 4:00 PM<p></p><p><b>
General Duties / Responsibilities</b></p><ul><li><p>
Conduct patient outreach for new, termed, and transitioned patients</p></li><li><p>
Ensure member has access to PCP and specialists to coordinate care</p></li><li><p>
Educates member on gaps in care and assist with scheduling provider appointments</p></li><li><p>
Serve as the patient's liaison throughout the life cycle of the program by addressing program specific quality measures and adhering to company guidelines/standard operating procedures</p></li><li><p>
Make patient welcome calls on date of notification of assignment and/or discharge</p></li><li><p>
Mail letters and correspondence as needed</p></li><li><p>
Make appropriate and timely patient appointments, reminders, and confirmations</p></li><li><p>
Place regular / consistent outreaches to the patient</p></li><li><p>
Prepare, communicate, and follow through on patient flagpole/escalation communications to management</p></li><li><p>
Communicate with PCP with any member updates and requests</p></li><li><p>
Assist with obtaining medical records from any healthcare providers involved in care or hospitals</p></li><li><p>
Help members with any authorizations and referrals involved in their care plan</p></li><li><p>
Resolve incoming calls concerning members&rsquo; eligibility, benefits, provider information, clinical, and pharmacy needs; coordinate membership changes such as member&rsquo;s primary care physician and proactively engage member with their wellness plan options.</p></li></ul><p></p><p><b>
SUPERVISORY RESPONSIBILITIES:
</b></p><p>N/A</p><p></p><p><b>
Minimum Requirements:</b></p><p>
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p><b>
Minimum Experience:</b></p><ul><li><p>
Medical assistant front and back office experience.</p></li><li><p>
Experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations</p></li><li><p>
High-volume inbound customer service experience, particularly for health plan or Medicare &ldquo;Member Services&rdquo; roles in health plan and supplemental benefits preferred</p></li><li><p>
Telemarketing and / or member outreach experience preferred</p></li><li><p>
Specialized experience in escalation or resolution units preferred</p></li></ul><p></p><p>
Education/Licensure:</p><ul><li><p>
High school diploma or general education degree (GED).</p></li><li><p>
Completion of an accredited medical assistant program.</p></li></ul><p></p><p>
Other Skills and Abilities:</p><ul><li><p>
Independently motivated self-starter who can prioritize work assignments and make every day a productive day</p></li><li><p>
Team player willing to help and support colleagues, and do their part to support us all reaching our organizational goals</p></li><li><p>
Natural &ldquo;teacher&rdquo; with the ability to learn plans and describe / explain / educate healthcare coverage and services to our members</p></li><li><p>
Genuine passion for customer service</p></li><li><p>
Knowledge of ICD-10 and CPT codes.</p></li><li><p>
Computer proficient, able to type minimum 35 words per minute (WPM) by 10-key touch.</p></li><li><p>
Excellent written (email) and verbal (in-person and over the phone) communication skills.</p></li><li><p>
Language Skills: Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Able to speak effectively before groups of customers or employees of the organization.</p></li><li><p>
Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or verbal instructions. Able to deal with problems involving a few concrete variables in standardized situations.</p></li><li><p>
Computer Skills: Strong computer skills.</p></li></ul><p></p><p>
Preferred:</p><ul><li><p>
Bilingual written and verbal fluency in English and Spanish, Korean, or Vietnamese.</p></li></ul><p></p><p>
Work Environment</p><p>
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p><b>
Essential Physical Functions:</b></p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p><br>
</p><p>While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p>
Pay Range: $44,987.00 - $67,480.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

Patient Navigator (Medical Assistant Program Completion Required)

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
This is a remote position.<br>
The MRA Coding Auditor supports departmental Quality Assessment audits of internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) audits to identify areas of opportunity for improvement (training, data integrity, chart reviews).<p></p><p><b>
GENERAL DUTIES/RESPONSIBILITIES:</b><br>
1. Supports regular quality assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding &amp; abstracting quality (95% HCC accuracy). These ongoing audits ensure coding quality &amp; performance improvement standards are maintained, achieved &amp; improved per department policies and procedures.<br>
2. Tracks and reports progress of QA audits performed on the coding vendors to verify the coding accuracy and quality of the data submitted to AHP is accurate for submission to CMS.<br>
3. Works with Risk Adjustment Management on any MRA data validation / coding audit to ensure completeness and coding accuracy of all submissions to CMS. This work may encompass reviews of data for reconciliation, data flow integrity, UAT testing, high cost / low risk score members, retrospective chart reviews, or other risk adjustment related data review as directed by Manager.<br>
4. Analyzes and shares audit results with Manager. This information may be used for training physicians and clinical staff, documentation improvement, and system / process improvement.<br>
5. Utilizes, protects, and discloses Alignment Healthcare patients&rsquo; protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.<br>
6. Ensures compliance with all applicable federal, state &amp;local regulations, as well as with institutional/organizational standards, practices, policies &amp; procedures.</p><p>
7. Maintains professional / technical knowledge by attending appropriate educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies. Stay current of industry coding, compliance, and HCC issues. Required to maintain relevant continuing education units (CEUs) in relation to individual coding certifications.<br>
8. Other duties as assigned to meet the organization&rsquo;s needs.</p><p><b>
Job Requirements:</b></p><p><b>
Experience:</b></p><ul><li>Required: Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting required</li><li>Preferred:</li></ul><p><b>
Education:</b></p><ul><li>Required: High School Diploma or GED. Completion of a Medical Coding training program.</li><li>Preferred: Bachelor&rsquo;s degree in Business Administration, health Care Management or in a related field</li></ul><p><b>
Training:</b></p><ul><li>Required: Technical School or courses that are required to become a certified coder.</li></ul><p><b>
Specialized Skills:</b></p><ul><li>Required:</li></ul><ul><li>
Knowledge of</li><li>
Proficient user in MS office suite &ndash; Excel, Word, Outlook</li><li>
Previous use of Epic, Allscripts, EZCap</li><li>
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.</li><li>
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>
Report Analysis Skills: Comprehend and analyze statistical reports.</li></ul><p><b>
Licensure:</b></p><ul><li>Required: Certified Coder required, CCS, CCS-P, CPC, or CRC</li></ul><p>
Work Environment:</p><p>
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p>
Essential Physical Functions:</p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p>
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</p><p>
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p>
Pay Range: $64,384.00 - $96,577.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

MRA Coding Auditor - Remote

Join Alignment Healthcare and explore 15   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.