Qlarant

Attorney

• Supports the Chief Legal Counsel and Program Integrity leadership by providing legal and regulatory assistance for investigations, appeals, hearings, and requests from external stakeholders.
• Assists in preparing responses to congressional inquiries, Freedom of Information Act (FOIA) requests, and Requests for Information/Action (RFIs/RFAs).
• Contributes to joint operating agreements and liaises with federal and state partners, ensuring compliance with Medicare and Medicaid laws, regulations, and program integrity requirements.
• Develops knowledge of administrative processes while gaining experience in legal analysis, case preparation, and government regulatory frameworks.

Legal Analyst II

Quality Specialist

• Facilitates routine evaluations to assess the extent to which individuals with intellectual developmental disabilities (IDD) are receiving customized support and services
• Performs scheduled reviews to assess effectiveness of IDD service providers
• Assists management in identifying areas for improvement in service delivery
• Analyzes data related to program outcomes and client satisfaction

Quality Review Specialist III

Operations

• Develop and execute comprehensive operational strategies that align with the company’s long-term goals and market demands.
• Lead and mentor cross-functional teams to ensure high performance, engagement, and professional development.
• Oversee daily operations, including supply chain management, production, quality assurance, and customer service to maintain operational excellence.
• Collaborate with executive leadership to identify opportunities for process improvements, cost reductions, and technology integration.
• Establish and monitor key performance indicators (KPIs) to track operational effectiveness and implement corrective actions as needed.
• Manage budgets, forecasts, and resource allocation to optimize operational efficiency and financial performance.
• Drive compliance with regulatory requirements and industry standards to mitigate risks and uphold corporate governance.
• Foster a culture of innovation, continuous improvement, and operational agility to respond effectively to changing business environments.

SVP – Operations

• Controls organizational activities overseeing and leading the company's operational structure and flow
• Develops senior managers responsible for creating and advancing strategic initiatives
• Establishes strategy for cross-functional teams to create ongoing operational solutions
• Executes strategies engaging resource management to drive optimal utilization of resources
• Acts as a key liaison between executive leadership and operational teams
• Develops teams responsible for contracts to reduce fraud and waste
• Establishes vision for deliverables to clients and key stakeholders
• Formulates plans for the development of new business opportunities
• Establishes strategies for the implementation of new contracts
• Manages budgets for Operations and oversees financial reporting system
• Develops teams responsible for customer relationships

VP – Operations

Analyst

• Works with a team of internal and external professionals as a subject matter expert
• Participates in planning and execution of team projects, assisting with setting strategic goals
• Implements processes and uses necessary tools to enhance project execution and drive consistent performance improvements
• Conducts research of program areas/topics defined by management; participates in internal and external focus groups
• Utilizes experience to identify appropriate reports, rules, and regulations for drafting vulnerability reports
• Meets regularly with teams to discuss current and future projects; advises teams and management
• Contributes to final written product presented to stakeholders; proofreads written products of team members
• Serves as a productive member of external and internal teams to ensure all deadlines for deliverables are met
• Briefs management on projects, including completion timelines and potential difficulties
• Provides clinical input as a Subject Matter Expert for program integrity and program vulnerability
• Identifies and mitigates risks proactively, implementing strategies to ensure continuity of project execution
• Participates in project reporting and performance analysis, ensuring accuracy of project data

Program Integrity Analyst III

Data Analyst

• Leads advanced analytics initiatives that transform complex data into strategic insights and measurable business impact.
• Oversees the design and execution of predictive modeling, machine learning, and statistical studies.
• Applies deep technical expertise in tools such as SAS, SQL, R, Python, and Tableau.
• Partners with senior leadership and research teams to uphold scientific rigor in study design.
• Mentors junior data analysts and scientists in advanced methodologies.
• Designs and implements high-performance algorithms and machine learning models.
• Drives the development of innovative data science solutions.

Data Analyst/Scientist IV

Auditor

• Ensures the integrity and accuracy of claims processes and protocols.
• Collects data for audits/investigations into claims, utilizing analytical skills and attention to detail.
• Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions.
• Adheres to industry regulations and policies for managerial follow-up.
• Analyzes data to assess the validity of claims.
• Provides accurate recommendations to management for claim resolution and closure.
• Documents and inputs all findings while preparing comprehensive reports that may be used for legal or audit/investigative purposes.

Auditor/Investigator II

Data Scientist

• Develops actionable insights to help identify, understand, and resolve moderately complex business problems
• Leverages big data and innovative problem-solving techniques to forecast future trends and outcomes based on past data patterns
• Works individually, as well as with higher-level data scientists, designing experiments to solve problems with code and building predictive models and machine learning algorithms tailored to solve intricate business challenges
• Develops an in-depth understanding of the business's needs and objectives, enabling the identification and formulation of pertinent questions that can be effectively addressed through data analysis
• Applies deep learning algorithms and models for tasks such as image recognition, natural language processing, and other complex patterns
• Applies highly developed knowledge when applying advanced statistical methods to analyze complex datasets, uncovering nuanced insights and relationships
• Acts as a top-level specialist, optimizing machine learning models for efficiency, scalability, and improved performance in real-world applications
• Develops strategy for expertly selecting and engineering features to enhance model interpretability, accuracy, and generalization
• Designs and conducts A/B tests and experimentation to evaluate the impact of changes and interventions
• Leads cross-functional collaboration efforts, working closely with diverse teams to integrate data science solutions into business operations
• Develops algorithms that can scale to handle large datasets and complex computations, ensuring efficiency in processing
• Implements systems to deploy machine learning models into production environments, enabling their integration into operational systems
• Develops automated data pipelines for efficient data collection, processing, and integration, streamlining the end-to-end data science workflow