Senior Specialist, Member & Community Interventions; Remote in Pacific Time

Overview

Employer Industry: Healthcare

• Opportunity for career advancement and growth within the organization
• Competitive benefits and compensation package
• Supportive and collaborative work environment
• Chance to make a positive impact on community health and member experience
• Flexibility with potential travel requirements

• Provide project and program direction and guidance for other specialists within the department
• Implement evidence-based member intervention strategies, including managing interventions and quality activities
• Monitor and ensure timely and accurate completion of key member intervention activities
• Write narrative reports to interpret regulatory specifications and document findings of department interventions
• Evaluate project/program activities to identify opportunities for improvement

• Bachelor s Degree or equivalent combination of education and work experience
• Minimum of 3 years’ experience in healthcare, with at least 2 years in health plan member interventions or managed care
• Solid business writing experience
• Operational knowledge and experience with Excel and Visio
• Excellent problem-solving skills and flexibility in adapting to changes

• 1 year of experience in Medicare and Medicaid managed care
• Experience with data reporting, analysis, and interpretation
• Certified Professional in Health Quality (CPHQ)
• Nursing License (RN may be preferred for specific roles)
• Certified HEDIS Compliance Auditor (CHCA)

#Healthcare #Member Interventions #Career Opportunity #Competitive Benefits #Quality Improvement

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.

We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.