Altais

Medical Director

• Act as the primary medical leader responsible for interfacing with health plans regarding benefits, coverage issues, appeals, and administrative matters
• Attend HMO hearings on appeals and provide clinical expertise in resolving escalated medical and administrative issues
• Provide clinical leadership and guidance to Primary Care Physicians (PCPs), specialists, and other providers across the AHS network
• Chair the Credentialing Committee, ensuring all network providers meet the required qualifications
• Lead and provide oversight of the Utilization Management Committee (UMC)
• Oversee Quality and HEDIS programs, ensuring compliance with performance standards

Chief Medical Officer

Manager

• Responsible for developing and implementing strategies to integrate new practices into Altais's Networks of Care
• Own growing and maintaining a network of healthcare professionals ensuring availability of high-quality healthcare services
• Identify and research potential physicians and providers to generate new leads
• Deliver full cycle relationship from initiation to onboarding of new providers including executing agreements, credentialing
• Foster and maintain relationships with prospective physicians, understanding their needs and providing solutions
• Conduct service presentations and proposals to prospective physicians and providers
• Remain current on network trends, competitor offerings, and industry developments
• Maintain deep understanding of services and offerings and be able to effectively communicate them
• Work closely with cross-functional teams

Physician Network Development Manager

Advisor

• Serve as the primary internal contact for service lines provided by Altais to network physicians
• Support day-to-day administrative operations and provide exceptional service to physicians
• Monitor physician participation and advocate for current and future products and services
• Educate physician practices on policies, procedures, and claims payment policies
• Assist with onboarding new physicians and staff
• Facilitate internal and external meetings to discuss issues and promote relationships

Provider Services Advisor

Accounting Manager

• Oversees all aspects of the financial accounting process including general ledger maintenance; journal entry review monthly close; balance sheet reconciliation; financial reporting, and budget variance analysis for all AHS entities
• Responsible for hierarchy and scalability in chart of accounts and accuracy in the general ledger and financial statements and has ultimate authority over classification and booking of all transactions
• Participate in the ongoing development/establishment of accounting policies and procedures and operational strategies
• Assists Controller in coordinating the annual budget process
• Make recommendations for changes as needed and ensure that company policies and procedures are followed and establishes the proper techniques to discover and prevent fraud through highly structured internal controls

General

• Serve as primary contact for assigned practices
• Support Altais IT with the successful implementation, adoption, & long-term use of tools
• Lead Informatics/optimization/proficiency efforts
• Identify opportunities & lead internal projects
• Collect and analyze data on operational needs

Senior Practice Informatics Specialist

Vice President

• Responsible for leading the design, implementation, and continuous improvement of clinically oriented, data-driven initiatives
• Serve as the primary outward-facing interface with external partners for the design, implementation, and optimization of clinical, data-driven initiatives
• Translate partner needs, contractual priorities, clinical performance goals, and operational requirements into structured program plans, workflows, milestones, and success measures
• Partner with health plan, technology, quality, risk adjustment, and population health partners to support program implementation, performance monitoring, and issue resolution
• Represent the organization in partner discussions related to clinical program design, data exchange, and reporting expectations
• Develop scalable approaches for clinical initiatives that can be adapted across markets, partners, and lines of business as the function matures
• Partner closely with Medical Economics to define, monitor, and interpret clinical performance metrics that support risk adjustment, quality submissions, and population health outcomes
• Collaborate with quality, risk adjustment, medical management, provider performance, and analytics teams to identify performance opportunities and develop improvement strategies
• Partner with IT to improve clinical data intake, quality, governance, integration, usability, and reporting
• Work with dotted-line project resources to ensure milestones, deliverables, dependencies, and risks are actively managed

AVP, Clinical Programs, Analytics

Actuary

• Generate and distribute routine reports to support risk adjustment actuarial best estimate calculation and financial reporting.
• Extract and compile information from various systems to support executive decision-making.
• Research and develop reports and analysis for senior management; effectively communicate results.
• Assist in the preparation of forecasts/filings related to risk adjustment.
• Developing risk score reporting with Cozeva, internal claims and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings.
• Collaborate with operational staff to analyze, understand, modify, and communicate models and results.
• Make recommendations to management based on relevant findings.
• Utilizes Power BI to display relevant reporting within a refresh cycle.
• Analyzes key trends and performance related to clinical programs, provider network performance, other programs or practices, and providers of health care.
• Peer review and train junior level actuarial analyst including prioritization of work and projects.

Senior Actuarial Analyst

Sales

• Own and optimize sales pipeline, marketing, implementation, and customer relationship management strategy.
• Focus on sales to existing providers in CA & HI and leveraging existing people in the organization.
• Grow the sales pipeline, keep leads warm, progress, and close customers with signed contracts.
• Ensure proper implementation and launch post-contract.
• Track and report on sales pipeline progress.
• Collaborate with cross-functional teams for marketing campaigns and improve customer retention.