AllyAlign Health

  • Glen Allen, VA, USA
AllyAlign Health Remote * (Glen Allen, VA, USA)
Oct 10, 2021
This position is a remote/work from home role with the ability of working anywhere in the US.Role Summary:AllyAlign Health () is a rapidly growing organization focused on revolutionizing the long-term healthcare ecosystem for the benefit of our members, provider and payer partners. Our unique approach to managing care delivery and proactively partnering with healthcare providers has enabled us to achieve industry leading health outcomes for our members. AllyAlign Health has partnered with several Nursing Home companies to form Institutional Special Needs Plans (I-SNPS), which are a form of Medicare Advantage Plans. In this model, AllyAlign is responsible for administering the health plans, providing shared services such as member enrollment, call center, claims processing, authorization processing, financial services, compliance services and grievance and appeals administration. AllyAlign has grown aggressively and is working to expand our operational capacity and capability....
AllyAlign Health Remote * (Glen Allen, VA, USA)
Oct 03, 2021
This role is fully remote and can work anywhere in the US The Healthcare Claims Analyst is responsible for the analytical review of all healthcare claims data. This position will be looking for inaccurate payments, performing trend analysis and determining the root causes behind variation in expense. The Analyst works both collaboratively and independently to complete complex analysis leading to meaningful business decisions.Essential Functions:Research, analyze data, present results, and recommend intelligent solutions to solve problems and address business challenges by applying a knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise.Structure analytical results in an organized, visual manner to tell a meaningful, actionable story.Write SQL queries and apply varying analytical techniques to solve specific business problems.Review and analyze the effectiveness and efficiency of existing and proposed processes and systems, and...
AllyAlign Health Remote * (Modesto, CA, USA)
Oct 03, 2021
This role is fully remote and can work anywhere in the USGeneral Purpose/Scope: The Senior Medicare Compliance & Audit Specialist serves as an integral part of the AllyAlign Health (AAH) Compliance team reporting to the Medicare Compliance Director. The Senior Medicare Compliance & Audit Specialist will (i) be responsible for ensuring Medicare requirements and standards are understood by AAH business partners, IT, and other matrix partners; (ii) perform compliance monitoring and auditing activities; and (iii) assist in the management of corrective action plans (CAPs). The Senior Medicare Compliance & Audit Specialist's primary areas of focus will be Part C pre-service organization determinations, utilization management functions, clinical decision making, quality and special needs plans model of care (SNP-MOC). Duties and Responsibilities:Serves as a subject matter expert on Medicare compliance matters including answering interdepartmental questions concerning various...
AllyAlign Health Remote * (Nashville, TN, USA)
Oct 01, 2021
AllyAlign Health () is a rapidly growing organization focused on revolutionizing the long-term healthcare ecosystem for the benefit of our members, provider and payer partners. Our unique approach to managing care delivery and proactively partnering with healthcare providers has enabled us to achieve industry leading health outcomes for our members. AllyAlign Health has partnered with several Nursing Home companies to form Institutional Special Needs Plans (I-SNPS), which are a form of Medicare Advantage Plans. In this model, AllyAlign is responsible for administering the health plans, providing shared services such as member enrollment, call center, claims processing, authorization processing, financial services, compliance services and grievance and appeals administration. AllyAlign has grown very aggressively and is working to expand our operational capacity and capability.Role Summary: AllyAlign Health is seeking a professional with a minimum of 4+ years of Microsoft and OnBase...