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RN, Field Care Manager – Adults and Pediatrics

Full-stack Engineer

• Standardizes the quality assurance procedure for software
• Oversees testing and debugging and develops fixes
• Researches complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
• Follows established guidelines/procedures
• Provides on-call support as scheduled

Senior Software Engineer

Solutions Engineer

• Own the end-to-end Anaplan solution architecture across Workforce Planning and Workforce Management domains
• Operates at a strategic level, responsible for setting the overall architectural vision and standards for Anaplan across the organization.
• Serves as the subject matter expert and key advisor for complex, enterprise-wide Anaplan implementations and integrations.
• Subject matter expert in modeling frameworks, governance, and best practices, mentoring Lead Architects and other team members.
• Engages in strategic planning, platform optimization, and alignment with broader enterprise architecture initiatives.
• Lead the design and implementation of Anaplan modules for: Finance : Headcount cost modeling, compensation planning, forecasting, scenario analysis. HR : Position management, hiring plans, attrition modeling, workforce analytics.
• Oversee Architects and maintain integration strategies with enterprise systems (e.g., Workday, SAP, Oracle, Snowflake) and ensure seamless data flow across platforms.
• Subject matter expert on Anaplan security models, user roles, and access controls across domains.
• Lead and mentor offshore and cross-functional teams in model development, testing, and deployment.
• Establish, develop and maintain reporting and dashboard solutions using Anaplan and complementary tools (e.g., Power BI, Tableau).
• Serve as a strategic SME to Finance and HR leadership, helping shape the enterprise planning roadmap.
• Act as a cross-functional bridge between IT, Finance, and HR, ensuring alignment of planning tools with business strategy.
• Contribute to the enterprise technology roadmap by evaluating emerging trends in workforce planning, predictive analytics, and EPM platforms.
• Promote continuous improvement by identifying inefficiencies, proposing enhancements, and driving innovation across planning processes.
• Ensure compliance with data privacy, security, and governance standards (e.g., GDPR, HIPAA, SOX).
• Lead management efforts to drive adoption of new planning capabilities and tools.

Principal Anaplan Solution Architect

Medical Billing and Coding

• Identify opportunities to improve provider documentation and create education plans tailored to each assigned provider
• Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements
• Pull MRA reports, identify educational needs based on reports, and present information
• Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards
• Participate in teams to improve documentation, data integrity, and workflow processes
• Build ongoing relationships with staff and providers teams
• Conduct virtual education and/or provider onsite education, based on business needs
• Collaborate with other market provider facing roles

Medical Coding Educator

Program Manager

• Provide strategic leadership and oversight for the prioritization, planning, and execution of high-impact, enterprise-wide growth initiatives.
• Serve as the principal architect for large-scale Medicare Advantage strategy initiatives, guiding the end-to-end lifecycle from strategy development through implementation and value realization.
• Engage with executive leadership to frame and address complex challenges, leveraging advanced analytics, market intelligence, and financial modeling to inform strategic decision-making.
• Lead strategic integration efforts, ensuring cohesive alignment of growth initiatives across multiple business units and corporate functions.
• Develop and deliver executive-level presentations, reports, and recommendations that articulate strategic priorities, operating context, and actionable insights for senior stakeholders.
• Establish and own infrastructure and processes to monitor progress against enterprise strategic objectives, proactively identifying risks and implementing mitigation plans.
• Champion talent development and mentorship, cultivating a high-performing, diverse team and supporting professional growth for junior staff.
• Foster a culture of innovation, collaboration, and continuous improvement throughout the Growth organization.

Growth Strategy Director – Strategic Program Management

• Conducts telephonic and in-person assessments to evaluate members’ needs, guiding members and their families toward appropriate resources to support optimal wellness.
• Continuously monitors member progress through ongoing assessments and evaluations to ensure achievement of desired health outcomes.
• Develops individualized care plans based on comprehensive assessments, aligning with departmental and organizational strategies.
• Collaborates with healthcare providers and community resources to facilitate quality, cost-effective care and support.
• Ensures members receive necessary services and supports across Behavioral Health, Physical Health, Social Determinants of Health, and value-added benefits.
• Coordinates with the transdisciplinary care team, including at minimum the Primary Care Provider (PCP), to manage transitions of care.
• Documents and submits incident reports as required.

Field Care Manager, Behavioral Health

Vice President

• manage the development, operations, and results of a health plan
• establish long-range goals, objectives, and plans
• monitor financial and operational performance
• coordinate activities of senior managers and their respective functions
• represent the health plan externally and to governmental/external agencies
• develop and implement strategic plans for the scope of management that are aligned with the Segment or Business strategy

Regional VP – Provider Contracting

• Lead teams of nurses, care coordinators and behavioral health professionals responsible for care management.
• Supervise, direct and evaluate a diverse group of health care professionals.
• Maintain ongoing communication with departmental managers to ensure alignment and operational efficiency.
• Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics.
• Interview, hire, mentor, evaluate, coach and manage performance for a diverse care coordination team.