Qureos Mentor

Alignment Healthcare

<div>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.
The Accounts Payable Specialist is responsible for day-to-day accounts payable functions. This position reports to the Sr. Manager, Accounting and Accounts Payable and must be a self-starter and independent, detail-oriented team member. This team member is responsible for ensuring that all vendor invoices are paid in a timely manner and AP agings are monitored and maintained. 
 
This position will be working hybrid onsite 3 days a week in office.
Job Duties/Responsibilities: 
1. Matches invoices with purchase orders and receiving documents; 
2. Process and review accounts payable transactions for proper coding and approvals; 
3. Reconciles vendor statements and research and correct discrepancies; 
4. Interfaces with vendors and employees to troubleshoot and resolve accounts payable matters in a timely manner; 
5. Prepares daily batches of accounts payable invoices for review and ultimate posting by the Sr. Manager, Accounting and Accounts Payable; 
6. Process weekly check disbursements for claims and accounts payable for various entities; 
7. Responsible for following up with department heads on invoice approvals and vendors as necessary. 
8. Assists with other special projects as needed (audits document request, yearly 1099 reporting for independent contractor); 
9. Assists with the Company&rsquo;s expense reimbursement process, including but not limited to reviewing and approving expenses reports, ensure expense reports are in compliance with company policy, resolving/following up on questionable expenses, ensuring that expenses are current; answer questions on how to use the company&rsquo;s expense tracking tool; and 
10. Other responsibilities as assigned by Accounting Management.
Job Requirements:
Experience:<ul><li>Required: Minimum 2 years of accounts payable experience including full cycle accounts payable</li></ul>
Education:<ul><li>Required: High School Diploma or GED.</li><li>Preferred: Associates or Bachelors in Accounting</li></ul>
Specialized Skills:<ul><li>Required:</li></ul><ul><li>
Knowlege of Accounting or Bookeeping</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>
ESSENTIAL PHYSICAL FUNCTIONS: 
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.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee reg-ularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job in-clude close vision and the ability to adjust focus. 
Pay Range: $41,472.00 - $62,208.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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.<ul><li>DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.</li></ul></div>

Accounts Payable Specialist

<div>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.
The Sr. AI Scientist combines deep analytical expertise with advanced software engineering skills to architect and deliver high-impact AI/ML solutions on our proprietary clinical intelligence platform. This role owns complex, ambiguous problems from discovery to production deployment, drive technical excellence across the team, and mentor data scientists while partnering with engineering, product, and clinical leaders to deliver measurable outcomes for Medicare Advantage members.
Job Duties/Responsibilities<ul><li>
Architect end-to-end AI/ML solutions for complex healthcare challenges (35%): Design and deliver production-grade machine learning systems for high-stakes applications including risk stratification, clinical decision support, autonomous chart review, and fraud detection. Define technical approach, model selection, and system architecture for multi-model systems and real-time decision engines that process millions of healthcare transactions.</li><li>
Own the full ML lifecycle from experimentation to production (25%): Build reliable, scalable AI services including experimentation, validation, deployment, monitoring, drift detection, and continuous improvement. Establish instrumentation, observability, alerting, and feedback loops to ensure model performance and reliability in production environments.</li><li>
Drive technical excellence and innovation (15%): Research and apply state-of-the-art methods in deep learning, NLP/LLMs, computer vision, and causal inference to healthcare problems. Champion engineering best practices including code quality, testing, documentation, reusability, and maintainability across the data science organization.</li><li>
Partner strategically with cross-functional leaders (15%): Collaborate with Product, Clinical, Operations, and Compliance teams to identify high-value AI opportunities aligned with business strategy. Translate complex technical concepts into clear business narratives for executive audiences and influence product roadmap and technology decisions.</li><li>
Provide technical mentorship and raise the bar (10%): Guide data scientists through code reviews, architectural discussions, and pair programming. Share knowledge through internal presentations and documentation. Support hiring by conducting technical interviews and modeling best practices in analytical rigor and problem-solving.</li></ul><div></div>
Job Requirements
Experience
Required:<ul><li>
5-8 years delivering production-grade data science or ML solutions with demonstrated business impact</li><li>
Proven track record architecting complex ML systems from research to production deployment</li><li>
Deep expertise in multiple ML domains and strong software engineering fundamentals</li><li>
Experience leading technical projects and mentoring data scientists</li></ul>
Preferred:<ul><li>
Healthcare domain expertise, particularly Medicare Advantage, risk adjustment, or claims analytics</li><li>
Experience with production document understanding systems (OCR, NER, entity extraction, LLM pipelines)</li><li>
Published research, open-source contributions, or patents in ML/AI</li><li>
Track record of translating research innovations into production systems</li></ul><div></div>
Education
Required: PhD in Computer Science, Machine Learning, Statistics, or related field<div></div>
Training
Required: 
Continuous learning in ML/AI advancements, healthcare analytics, and software engineering practices
Preferred: 
Training or certification in MLOps, cloud platforms (Azure, AWS, GCP), or healthcare regulations (HIPAA, CMS)<div></div>
Specialized Skills
Required:<ul><li>
Expert-level proficiency in Data Science methods, workflows, and best practices</li><li>
Advanced Machine Learning including ensemble methods, deep learning, NLP, LLMs, and computer vision</li><li>
Strong Statistical Analysis and experimental design capabilities</li><li>
Expert programming: Python, Java, SQL, or PySpark with an emphasis on production-grade, maintainable code.</li><li>
Advanced SQL and experience with high-volume, high-dimensional healthcare data</li><li>
Proficiency with Databricks (Spark, Delta Lake), MLflow, Unity Catalog, and cloud platforms</li><li>
Experience with Git workflows, CI/CD pipelines, Docker, and modern MLOps practices</li><li>
Deep understanding of healthcare data (claims, clinical, member) and Medicare Advantage operations</li><li>
Exceptional communication skills: ability to translate technical complexity into business value for diverse stakeholders</li><li>
Strong data visualization and storytelling capabilities with proven ability to influence technical decisions</li></ul>
Preferred:<ul><li>
Experience with NoSQL databases, performance optimization, and distributed computing</li><li>
Real-time ML inference and streaming architectures</li><li>
Contributions to internal ML platforms, frameworks, or open-source projects</li><li>
Experience presenting at technical conferences or publishing research</li></ul><div></div>
Licensure
Required: None 
Preferred: Industry certifications in ML, cloud platforms, or healthcare analytics<div></div>
Essential Physical Functions
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.
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.
Pay Range: $172,364.00 - $258,547.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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.<ul><li>DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.</li></ul></div>

Sr. AI & Data Scientist

<div>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.
Alignment Health is seeking a compassionate, organized, and team-oriented float medical assistant to join the Access Primary Care Physicians team in Placentia, CA. The Medical Assistant provides clinical and administrative support and works closely with clinicians to administer medical services. Responsible for assisting clinicians in the examination and treatment of patients under the direction of the Physician, PA or Nurse Practitioner. 
 
Schedule: Available between 7:30 AM- 5:00 PM (depending on office) 
 
Main office: Placentia, CA or Whittier CA 
Float offices: Hacienda Heights and Downey (with mileage reimbursement) 
 
Pre-planned float: (1) week notice 
Same day float: (2) hour notice 
 
No more than (1) office per day. 
 
Training provided.<div>
Location: Placentia, CA (Primary) 
Float Locations: Hacienda Heights, Whittier, and Downey (mileage reimbursement provided) 
Schedule: Between 7:30 AM &ndash; 5:00 PM (varies by office)</div><div></div><div>
Make an Impact Every Day</div><div>
Alignment Health is looking for a compassionate, organized, and team-oriented Float Medical Assistant to join our Access Primary Care Physicians team. In this dynamic role, you&rsquo;ll provide both clinical and administrative support while working side-by-side with Physicians, Physician Assistants, and Nurse Practitioners to deliver high-quality patient care.</div><div>
If you enjoy variety in your day, collaborating with a care team, and making a difference in patients&rsquo; lives&mdash;this role is for you.</div><div></div><div>
What You&rsquo;ll Do</div><div>
Front Office Responsibilities</div><ul><li>
Welcome and greet patients in a friendly, service-oriented manner in alignment with company policies and workflows</li><li>
Oversee patient check-in by ensuring charts are prepared, records are up to date, and required paperwork is complete</li><li>
Manage patient check-out, including scheduling follow-up appointments, collecting co-payments (if applicable), and ensuring documentation is finalized</li><li>
Schedule and confirm patient appointments</li><li>
Reconcile co-payments at the end of each day</li></ul><div>
Back Office Responsibilities</div><ul><li>
Room and interview patients, measure vital signs, and document reason for visit</li><li><div>
Explain procedures, perform treatments, and administer prescribed medications</div></li></ul><div></div><div>
Float Expectations</div><ul><li>
Primary office: Placentia, CA</li><li>
Additional locations: Hacienda Heights, Whittier, and Downey</li><li>
Pre-planned float assignments provided with 1-week notice</li><li>
Same-day float assignments may occur with 2-hour notice</li><li>
No more than one office assignment per day</li><li><div>
Training provided</div></li></ul><div></div><div>
What You Bring</div><div>
Experience</div><ul><li>
Required: 1 year of customer service experience</li><li>
Preferred: 2 years of experience as a medical assistant</li><li>
Preferred: Experience working with a Medicare population</li></ul><div>
Education &amp; Training</div><ul><li>
Required: High School Diploma or GED</li><li>
Required: Completion of a Medical Assistant program from an accredited school</li></ul><div>
Licensure Preferred: Medical Assistant (MA) Certification</div><div></div><div>
Additional Qualifications</div><ul><li>
Preferred: Bilingual in English and Spanish (not required)</li><li><div>
Must have reliable transportation and/or a valid, unrestricted driver&rsquo;s license</div></li></ul><div></div><div>
Work Environment &amp; Physical Requirements</div><ul><li>
Regularly required to talk, hear, stand, walk, and sit</li><li>
Frequent use of hands for handling tools, equipment, and controls</li><li>
Ability to reach with hands and arms</li><li>
Frequently lift and/or move up to 10 pounds</li><li>
Requires close vision and ability to adjust focus</li><li><div>
Reasonable accommodations may be made for individuals with disabilities</div></li></ul><div></div><div>
Key Skills for Success</div><ul><li>
Strong communication skills with the ability to interact professionally and positively with patients, team members, and vendors</li><li>
Ability to collaborate, teach, and support team members</li><li>
Effective written and verbal communication</li><li>
Solid mathematical skills, including basic calculations and simple statistics</li><li>
Strong reasoning and problem-solving abilities</li><li><div>
Excellent organizational and time management skills in a fast-paced environment</div></li></ul><div></div><div>
Join Alignment Health and be part of a team that&rsquo;s dedicated to delivering compassionate, coordinated care&mdash;where your contributions truly matter.</div>
Pay Range: $41,472.00 - $62,208.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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.<ul><li>DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.</li></ul></div>

Float Medical Assistant (Front & Back Office) – Hacienda Heights & Whittier, CA

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. The Hybrid Manager for our Pharmacy Technicians is responsible for the day-to-day supervision and performance management of the pharmacy technician team. This role ensures operational efficiency, supports the MAPD Pharmacy department&rsquo;s goals related to medication adherence and pharmacy quality, and collaborates cross-functionally to enhance member experience and outcomes. Job Responsibilities: Supervise Pharmacy Technician Leads and pharmacy technicians to ensure timely and accurate completion of work supporting pharmacy operations. Monitor team performance and provide coaching, feedback, and development opportunities. Conduct performance evaluations and support corrective action processes as needed. Translate strategic goals into actionable workflows for the technician team. Foster a culture of accountability and continuous learning through coaching, mentoring, and performance feedback. Collaborate with the Sr. Manager, Pharmacy Technicians to implement workflow improvements and operational policies. Ensure compliance with departmental procedures and regulatory requirements. Support audit readiness and ensure technician documentation meets internal standards. Assist in resolving issues related to claims processing, member/provider correspondence, and PBM interactions. Work cross-functionally to enhance workflows and improve pharmacy quality outcomes, Star performance, and member satisfaction. Support various pharmacy programs and campaign activities. Participate in departmental meetings and contribute to quality improvement initiatives. Participate in PBM oversight meetings and quality control monitoring. Other duties and projects not listed above Supervisory Responsibilities: Oversees assigned staff. Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and performance management. Job Requirements: This is a Hybrid remote role, working in office at least 2-3 days per week and will require more days in office to cover for other members of management for time off coverage. Experience: Required: 3&ndash;5 years of experience as a pharmacy technician, with at least 1&ndash;2 years in a supervisory or lead role. Preferred: Call Center Management experience highly preferred, Experience in managed care, Medicare Part D, or pharmacy quality programs Education: Required: High school diploma or equivalent required Preferred: Associate or Bachelor&rsquo;s degree in healthcare, business, or related field Specialized Skills: Required: Strong leadership and team management skills. Excellent communication and interpersonal abilities. Proficient in workflow coordination, performance monitoring, and coaching. Proficient in Microsoft Office Suite and pharmacy systems (e.g., claims platforms, CRM tools). Licensure: Required: Active Pharmacy Tech License or equivalent work experience Essential Physical Functions: 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. 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. 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. Pay Range: $58,531.00 - $87,797.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. 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. *DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.

Hybrid-Manager, Pharmacy Technicians

<div>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.
The Supervisor Workforce Management Real-Time and Analytics is responsible for 24/7/365 intraday workforce management to ensure optimal alignment between staffing and contact center demand across the Alignment Health enterprise. This role is both leadership as well as tactical supporting team of Real Time Analysts (RTA) that monitors real-time performance against forecast and staffing plans, identifies variances, and executes immediate corrective actions to achieve service level, ASA, occupancy, and efficiency targets. The Supervisor serves as the operational bridge between Workforce Management and enterprise Operation groups with tactical execution to proactively manage risk, maintain schedule adherence, and protect the customer experience. 
Balancing delivering clear root cause analysis and driving collaborative solutions and maintaining real-time operational awareness. In an environment where change is constant, closely monitoring variables and scenarios as they unfold&mdash;and being able to clearly explain outcomes, is essential to this role.
Job Duties/Responsibilities:
Team Leadership &amp; Culture<ul><li>
Lead and coach the RTA team by supporting real time operational oversight</li><li>
Foster a culture of caring connections, accountability, and service excellence aligned with Alignment&rsquo;s serving-heart culture</li><li>
Set clear performance expectations tied to quality, turnaround time, productivity, compliance, and member satisfaction</li><li>
Conduct regular coaching sessions, intraday performance to ensure high standards of service and KPI attainment</li><li>
Support onboarding, training, and continuous skill development to strengthen work force management knowledge and collaboration skills</li><li>
Hands on leader that steps in to support tactical execution as well as leading RTA</li><li>
Collaborative with emotional intelligence to engage and influence teams outside of supervisory responsibility</li><li>
Ensures team compliance with Alignment policies, CMS regulations, and applicable laws</li><li>
Creates a strong culture of engagement, accountability, and professional development</li></ul>
Intraday Performance Management<ul><li>
Monitor real-time performance against key metrics including Service Level, ASA, Abandon Rate, AHT, Occupancy, and Schedule Adherence</li><li>
Compare actual workload and staffing to forecast and capacity plans; identify intraday variances and implement corrective actions</li><li>
Manage real-time queue, skill, and routing adjustments (ring groups) to balance workload and optimize resource utilization</li><li>
Coordinate with Operations to execute intraday actions such as overtime, VTO, off-phone adjustments, meetings, training, or break/lunch changes</li><li>
Flexibility to work shift based on operational need</li></ul>
Adherence &amp; Capacity Control<ul><li>
Monitor and drive real-time adherence to minimize unplanned shrinkage and ensure delivery of planned capacity</li><li>
Identify and communicate adherence risks or behavioral trends impacting service performance</li><li>
Partner with Operations leadership to improve adherence, occupancy balance, and schedule efficiency</li></ul>
Intraday Analysis &amp; Communication<ul><li>
Perform intraday trend analysis of volume, handle time, and volume drivers</li><li>
Identify emerging risks related to contact spikes, AHT changes, absenteeism, system issues, or external drivers</li><li>
Provide timely and concise communication and actionable recommendations to Operations and the broader WFM team</li><li>
Maintain intraday reporting and status updates on performance, risks, and mitigation actions</li></ul>
Forecast vs. Actual Management<ul><li>
Track forecast accuracy at the interval level and document key drivers of variance</li><li>
Monitor external or business events that may impact contact demand</li><li>
Provide intraday insights to support short-term forecasting adjustments and continuous improvement</li></ul>
WFM Systems &amp; Scheduling<ul><li>
Create, maintain, and publish workforce schedules within WFM and ACD telephony platforms</li><li>
Validate schedule integrity, staffing levels, and ring/skill group assignments</li><li>
Monitor real-time system performance and escalate telephony, routing, or application issues impacting service delivery</li><li>
Ensure data accuracy across WFM and telephony platforms</li></ul>
Analytics, Reporting &amp; Insights<ul><li>
Produce and analyze reports on key metrics such as service level, speed to answer, abandonment rate, AHT, adherence, and occupancy</li><li>
Identify trends impacting member access, operational performance, and staff productivity</li><li>
Develop actionable insights and recommendations to improve efficiency and member experience</li><li>
Maintain data integrity and ensure reporting aligns with organizational and regulatory standards</li><li>
Root Cause Analysis (RCA) Subject Matter Expert<ul><li>
Expert on identifying the underlying reason(s) behind a problem and providing an action plan with owners</li></ul></li></ul>
Cross-Functional Collaboration &amp; Continuous Improvement<ul><li>
Partner with Operations, Technology, Compliance and other internal teams to improve operational service processes</li><li>
Participate in cross-functional discussions to enhance workflows, reduce friction points, and improve the overall employee and member experience</li><li>
Escalate recurring operational issues with data-backed insights following problem statement 5 Whys, root cause analysis and proposed solutions</li><li>
Support continuous improvement initiatives that enhance Real Time operational delivery processing efficiency</li><li>
Tactical problem solving and execution focus</li></ul>
Job Requirements:
Experience:<ul><li>Required:</li></ul><ul><li>
Minimum 8+ years in a contact center environment</li><li>
Minimum 5+ years in Workforce Management, Real-Time</li><li>Preferred:</li><li>
RTA support of enterprise wide multiple queue complex operation</li></ul>
Education:<ul><li>Required: High School Diploma or GED</li><li>Preferred: Bachelor&rsquo;s degree or equivalent experience highly desired</li></ul>
Training:<ul><li>Required: None</li><li>Preferred: WFM or Contact Center related certification</li></ul>
Specialized Skills:<ul><li>Required:</li></ul><ul><li>
Intraday management and service recovery strategies</li><li>
Understanding of Erlang-based staffing principles and interval planning</li><li>
Knowledge of key WFM drivers: shrinkage, occupancy, service level, ASA, AHT, forecast accuracy</li><li>
Advanced Excel skills (data analysis, pivot tables, trend analysis)</li><li>
Ability to interpret interval-level performance data and translate insights into operational actions</li><li>
Strong problem-solving and decision-making in a high-volume, real-time environment</li><li>
Effective communication and collaboration with Operations and WFM partners</li><li>
Experience with WFM and telephony platforms (Talkdesk or equivalent)</li></ul>
Licensure/Certification:<ul><li>Required: None</li></ul>
Other:<ul><li>Required: Shift, Weekend and Holiday coverage support as required</li></ul>
Essential Physical Functions:
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.
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.
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.
Pay Range: $64,384.00 - $96,577.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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.<ul><li>DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.</li></ul></div>

Supervisor, WFM Real-Time & Analytics

<div>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.
As a leader in the care of older adults, we are seeking an Advanced Practice Provider (Nurse Practitioner or Physician Assistant) who enjoys managing complex patients in a collaborative, highly coordinated home-based setting. The provider will work closely with physicians, advanced practice providers, social workers, case managers, nutritionists, and other members of our health care team, as well as participate in multidisciplinary conferences that focus on the most high-risk members. He/she will have access to advanced technology, including an innovative, patient-friendly home monitoring system, Epic EMR, and a proprietary decision support tool that synthesizes data from a variety of sources into actionable alerts that drive care.
General Duties/Responsibilities (May include but are not limited to):<ul><li>
M-F Traditional Work Hours, No Call, and No Weekends.</li><li>
Schedule: 3.5 days a week Conduct in-home assessments (with some outpatient clinical work) on health plan members (Max 5 per day) and the other 1.5 days a week work from home</li><li>
In-Home Assessments will include obtaining comprehensive history, physical exam, medication review, and appropriate cognitive/depression/safety screenings.</li><li>
Comfort with End-of-life care discussions imperative.</li><li>
Laboratory specimen collection in the home setting when appropriate.</li><li>
Identify diagnoses to be used in active medical management and care management of patients with focus on chronic disease management.</li><li>
Communicate findings of the patient assessment to inform the PCP of potential gaps in care.</li><li>
Provide patient/family/caretaker education, with an emphasis on close monitoring and follow up of patient needs.</li><li>
Emphasis on knowledge of appropriate community resources for referral.</li><li>
Comply with all HIPAA regulations and maintain security of protected health information (PHI).</li></ul>
Supervisory responsibilities:
N/A
Minimum Requirements:
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.
Minimum Experience:
Computer literacy/EMR proficiency
At least one (1) year prior clinical experience
Education/Licensure:
Active California state license as a Nurse Practitioner/Physician Assistant
Active Nurse Practitioner/Physician Assistant Board Certification
Medicare Part D Prescriber
Valid California driver license and current automobile insurance
NP (Nurse Practitioner):
Active RN License (Must, upon hire)
Active NP License (Must, upon hire)
Furnishing number (Must, upon hire)
NPI Number (Must, upon start)
DEA Number (Must, within 6 months of start)
Board Certification: AANP, ANCC (Must, within 6 months of start)
Valid BLS (Basic Life Support) (Must, upon start)
Valid ACLS (Advanced Cardiovascular Life Support (Preferred)
PA (Physician Assistant):
Active PA License (Must, upon hire)
NPI Number (Must, upon start)
DEA Number (Must, within 6 months of start)
Board Certification: NCCPA (Must, within 6 months of start)
Valid BLS (Basic Life Support) (Must, upon start)
Valid ACLS (Advanced Cardiovascular Life Support (Preferred)
Other:
Knowledge of current clinical standards of care
Ability to work independently
Experience in care of older adult (geriatric) patients preferred
Home care experience preferred
Excellent administrative, organizational, and verbal skills preferred
Effective communication skills especially with older adults preferred
Previous EPIC experience preferred but not required preferred
Work Environment
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.
Essential Physical Functions:
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.
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.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.<div></div>
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.
Pay Range: $98,550.00 - $147,825.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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.<ul><li>DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.</li></ul></div>

Nurse Practitioner/Physician Assistant-Field Remote

<div>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.
The Director, Part D Stars is a key leader with direct accountability for Part D Star Ratings performance. This position owns the end to end execution, measurement, and continuous improvement of Part D Stars programs operated within the organization. 
This is a hands on leadership role suited for an experienced Part D Stars leader who has personally driven results through operational execution and deep measure expertise &mdash; not solely through vendor oversight or enterprise level governance. Success is defined by the ability to translate Part D Stars requirements into operational programs, reporting, and measurable results delivered by internal teams, while championing cross functional collaboration and organizational alignment.
**This position is remote. Must be available to take meetings during PST hours.** 
Job Duties/Responsibilities:<ul><li>
Lead the execution of initiatives to improve Part D Stars measures, including medication adherence (PDC), medication safety (SUPD, Poly-ACH, COB), Medication Therapy Management (MTM/CMRs), and related member experience measures.</li><li>
Develop and lead a multi‑year Part D Stars and quality roadmap aligned with CMS methodology, annual technical specifications, and enterprise Stars goals.</li><li>
Monitor CMS methodology updates, assess operational and reporting impact, and integrate changes into Stars strategies and workflows.</li><li>
Serve as a subject matter expert for Part D Stars measures and translate CMS methodology and specs into executable data logic and business rules, performance metrics, and operational requirements used to manage performance and forecast outcomes.</li><li>
Review and validate external performance reporting and resolve discrepancies between reported results and internal performance tracking.</li><li>
Develop and deliver dashboards, forecasts, and executive reporting that translate complex Stars data into actionable insights and recommendations.</li><li>
Monitor measure‑level performance, identify areas of risk or opportunity, and adjust interventions based on data‑driven insights.</li><li>
Provide leadership oversight for call center programs supporting Part D Stars performance, ensuring outcomes, effectiveness and quality.</li><li>
Partner with internal stakeholders, external vendors, and provider groups, as applicable, to support alignment, execution, and accountability for Part D Stars performance.</li><li>
Represent the organization in cross‑functional forums supporting Stars performance, quality improvement, and operational alignment.</li><li>
Lead, mentor, and develop a high performing team, fostering a culture of accountability, innovation, and continuous improvement.</li></ul>
Supervisory Responsibilities
This role includes direct supervisory accountability for pharmacy quality professionals and/or program managers. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Job Requirements:
Experience: 
Required:<ul><li>
7+ years of experience in Medicare Part D, Stars, or pharmacy quality management</li><li>
Minimum 5 years in a leadership role within a health plan, PBM, or IPA</li><li>
Demonstrated success improving CMS Star Ratings through pharmacy-driven initiatives, cross-functional collaboration, and PBM/vendor engagement</li><li>
Demonstrated expertise interpreting Part D Stars technical specifications and translating them into business logic and metrics</li><li>
Proven experience using data analytics to drive performance forecasting, Stars strategy, and operational decision-making</li></ul>
Preferred:<ul><li>
Prior experience managing PBM contracts or overseeing vendor performance governance</li><li>
Experience working within a high-growth or matrixed Medicare Advantage health plan environment</li><li>
Experience managing call center operations</li><li>
Background in MTM program design or formulary management</li></ul>
Education:
Required: Bachelor's degree required; fields such as Pharmacy, Health Sciences, Nursing, Public Health, or Business Administration are relevant
Preferred: Advanced degree strongly preferred: PharmD, RN, MPH, MBA, or a related clinical or health administration field. A demonstrated track record of clinical expertise and increasing leadership responsibility may substitute for advanced degree requirements on a case-by-case basis. 
Training: 
Specialized Skills:<ul><li>Required:</li></ul><ul><li>
CMS Part D Stars &amp; Regulatory Knowledge (Advanced): Deep, current knowledge of CMS Part D Star Ratings methodology, pharmacy quality measures, technical specifications, and regulatory change cycles that affect plan performance.</li><li>
Data Analytics &amp; Performance Reporting (Advanced): Proficiency in leveraging healthcare data to build forecasting models, performance dashboards, and executive reports. Ability to interpret complex statistical outputs and translate them into clear strategic recommendations.</li><li>
PBM &amp; Vendor Management (Advanced): Demonstrated ability to manage PBM relationships, navigate vendor contracts, and hold partners accountable to performance standards through governance structures and performance metrics.</li><li>
Clinical Pharmacy Program Design (Intermediate&ndash;Advanced): Working knowledge of clinical pharmacy programs including MTM, medication adherence interventions, SUPD, and formulary-related quality measures. Experience evaluating program ROI and clinical effectiveness.</li><li>
Cross-Functional Leadership &amp; Stakeholder Influence (Advanced): Proven ability to align diverse teams and senior stakeholders around shared quality goals. Strong executive communication skills and comfort operating in matrixed, fast-paced healthcare organizations.</li><li>
Strategic Planning &amp; Change Management (Advanced): Ability to design multi-year roadmaps, anticipate regulatory disruption, and translate strategy into executable, measurable operational plans.</li><li>
Analytical Reasoning &amp; Problem-Solving (Advanced): Ability to use advanced reasoning to define complex problems, collect and interpret data, draw valid conclusions, and design and implement effective resolution strategies.</li></ul>
Licensure:
Preferred:<ul><li>
Active and unrestricted Pharmacist license (RPh or PharmD) is strongly preferred for candidates with a pharmacy background</li><li>
California licensure preferred for candidates in California-based markets</li></ul>
Other:<ul><li>
Preferred:</li></ul>
Essential Physical Functions:
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 accommodation may be made to enable individuals with disabilities to perform the essential functions.
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.
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.
Pay Range: $149,882.00 - $224,823.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
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.<ul><li>DISCLAIMER: Please 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 information. Please 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 https://reportfraud.ftc.gov/#/. 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 careers@ahcusa.com.</li></ul></div>

Director, Pharmacy Part D Stars

Join Alignment Healthcare and explore 20   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.