Telligen

Manager

• As a Nurse Care Manager, you will be responsible for care management of patients with acute and chronic medical conditions and the assessment of care needs of vulnerable populations for various clients.
• Our team currently has openings on both our Case Management team, which focuses on coordinating overall patient care, and our Disease Management team, which specializes in supporting patients with specific chronic conditions.
• You will perform assessment and evaluation of potential care management patients per client contractual obligations and/or state requirements.
• You will collaborate with health care providers and ancillary service providers to validate appropriate treatment plans and identify educational opportunities.
• You will effectively guide members to appropriate member benefit information.
• You will provide ongoing education and communicate with all health care providers to ensure appropriateness of care.
• You may recommend and make adjustments in care if needed.
• You will evaluate treatment adherence and reevaluate the patient's commitment to make necessary changes.
• You will document per contractual requirements related to individual member status, and/or medical necessity review, negotiation.
• You will escalate issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff members.

Nurse Care Manager – Disease Management

Call Center Representative

• You will oversee and ensure performance measures are met by evaluating client and staff performance outcomes.
• You will select, develop, and manage employees to achieve individual, team, and organizational success.
• You will ensure employee accountability through routine observation, performance measurement, and performance feedback.
• You will work closely with management team members to ensure cost-effective methods are in place and make recommendations to leadership for changes to improve efficiencies and reduce costs through process changes and automation.
• You will stay abreast of call center industry trends and make recommendations to leadership for improvements in meeting company strategic goals and objectives.

Operations Supervisor – Call Center

Community Manager

• Conduct comprehensive quality evaluations of HCBS waiver, Habilitation, CNRS providers, and self-directed services
• Assess provider compliance with state and federal regulations, policies, and procedures
• Develop and implement corrective action plans with providers
• Provide technical assistance and guidance to providers on HCBS topics.
• Document findings and maintain detailed records of provider evaluations
• Analyze data and prepare reports on provider performance and compliance
• Facilitate training sessions and educational workshops for providers
• Collaborate with stakeholders to implement quality improvement initiatives
• Monitor provider progress in meeting quality standards
• Stay current with evolving HCBS regulations and best practices

Home and Community Based Services Specialist

Client Services Representative

• You will ensure the highest level of customer satisfaction by partnering with team members and program support to meet contract specific service level agreements and successfully perform responsibilities as defined by the assigned contract(s). Your customer support will include answering general inquiries, troubleshooting issues, scheduling/rescheduling assessments, and other administrative responsibilities as assigned. You may refer more complex calls to appropriate team members.
• You will demonstrate professionalism through written and verbal communication with both internal and external customers, using multiple communication methods.
• You will provide general office support and may perform data entry into database within specified timeframes.
• You will prepare and distribute applicable correspondence from multiple sources to external participants following standard operating procedures and quality standards, to meet contract requirements.
• You will listen to concerns, analyze information, recommend solutions, and confirm customer satisfaction.
• You will work as an engaged team member to provide feedback, suggest improvement and work with leadership to achieve company and employee-owner goals.

Client Service Specialist – Temp

• Responsible for receiving and responding to inbound customer inquiries
• Perform outreach to providers and members
• Provide program support for contract members
• Provide technical and administrative support for various contracts
• Support internal applications and tools

Client Service Specialist

• Responsible for care management of patients with acute and chronic medical conditions
• Assess care needs of vulnerable populations for various clients
• Openings on both Case Management and Disease Management teams
• Coordinate overall patient care and support patients with chronic conditions

Nurse Care Manager – Case Management, Disease Management

Program Manager

• Responsible for providing program leadership on complex healthcare quality measurement projects and technical implementations for a state Medicaid program
• Work collaboratively with all entities involved in the program and serve as a liaison between Telligen project leadership and the customer
• Drive quality measurement initiatives by blending technical expertise, healthcare knowledge, and leadership capabilities
• Ensure programs meet and exceed expectations by overseeing program activities, timeliness, and internal quality control standards

• Responsible for providing program leadership on healthcare quality measurement projects and technical implementations
• Work collaboratively with all entities involved in the program
• Serve as a liaison between Telligen project leadership and the customer
• Bring a strong blend of technical expertise, healthcare knowledge, and leadership capabilities

• You will ensure programs meet and exceed expectations by overseeing program activities, timeliness, and internal quality control standards. You will serve as a liaison between the customer and the company. You will coordinate between internal Telligen program and analytic and technical teams.
• You will oversee the development and implementation of a large portfolio of quality measures. You will ensure adherence to state and national standards. You will provide analytic insights and reporting as needed. You will be responsible for ensuring high-quality, accurate measure results are shared to client.
• You will manage technical support channels to support internal and external customers. You will provide guidance on measure interpretation and technical issues.
• You will perform miscellaneous duties as assigned.

• As a Program Manager, you will be responsible for providing program leadership on complex healthcare quality measurement projects and technical implementations for a state Medicaid program.
• You will work collaboratively with all entities involved in the program and will serve as a liaison between Telligen project leadership and the customer.
• You will bring a strong blend of technical expertise, healthcare knowledge, and leadership capabilities to drive our quality measurement initiatives.

• Responsible for care management of patients with acute and chronic medical conditions
• Assess care needs of vulnerable populations for various clients
• Openings on the Case Management team focusing on overall patient care
• Openings on the Disease Management team specializing in specific chronic conditions.
• Hybrid position requiring presence in office two days per week.

• Receive and respond to inbound customer inquiries from members and providers
• Perform outreach to providers and members
• Provide program support for contract members
• Provide technical and administrative support for various contracts, including support of internal applications and tools
• Ensure customer satisfaction and meet contract-specific service level agreements
• Answer general inquiries, troubleshoot issues, schedule/reschedule assessments, and perform other administrative responsibilities
• Demonstrate professionalism through written and verbal communication using multiple methods
• Perform data entry and prepare and distribute correspondence following standard operating procedures
• Listen to concerns, analyze information, recommend solutions, and confirm customer satisfaction
• Work as an engaged team member to provide feedback and suggest improvements
• Perform miscellaneous duties as assigned

Bilingual

• Conduct face-to-face and/or virtual assessments of members who may need skilled nurse assessment services using a skilled care acuity tool.
• Provide recommendations for services based on members' health care needs for members in the community or ready for facility discharge.
• Document assessment results and negotiate service plans as needed.
• Serve as mentor or preceptor for new staff and assist in formal training of assessors.
• Complete quality assurance audits and inter-rater-reliability reviews.
• Participate in process improvement initiatives and provide ongoing education to health care providers.
• Perform miscellaneous duties as assigned.

Assessor Reviewer, RN – Bilingual Spanish/English

• Manage the day to day operations of health management lines of service and/or contracts/programs, with emphasis on case management programs and care coordination initiatives
• Lead a team in creation, implementation, evaluation and ongoing management of strategic plans to ensure contract deliverables, program requirements and evaluation measures/metrics are met within assigned funding/budget
• Facilitate analyses and initiate action plans when deliverables/requirements are at risk
• Develop and maintain relationships with team stakeholders and provide technical assistance, including issue research and resolution
• Develop and implement process improvement methods and ensure timely, satisfactory, compliant operations within assigned funding/budget
• Participate in sales, business development and proposal activities; develop concept papers, contribute content or review proposals as subject matter expert
• Monitor budgets and financials for assigned contracts and hold financial accountability
• Coach, guide and direct team members to achieve individual, team and organizational objectives and provide resources/support as needed
• Represent the company and present at meetings and/or conferences; work externally with providers or clients and recommend improvements/efficiencies
• Stay abreast of industry trends and changes and perform miscellaneous duties as assigned

Quality Improvement Manager – Case Management

Medical Director

• Oversee Telligen's Mississippi Quality Assurance team to ensure the proper provision of program services.
• Serve as a clinical liaison for quality management and improvement activities for the FFS and MississippiCAN programs.
• Oversee and have accountability for the medical review activities of the organization or assigned contracts.
• Conduct critical peer reviews to ensure the health provided is appropriate and necessary.
• Instruct and train physician reviewers and assist Telligen staff with reviewer training.
• Serve as a technical expert on the peer review process and participate in advisory panels and committee meetings.
• Represent Telligen policies and procedures to medical and non-medical persons.
• Work during normal business hours of DOM and be located at the DOM Central office (minimum 3 days/week in office).

Medical Director, Quality

Artificial Intelligence

• Responsible for face-to-face assessments of vulnerable populations for various clients; persons being assessed reside in the community or in facilities.
• Performs face-to-face and/or virtual assessments of persons with disabilities.
• Some contracts may require collaborating with healthcare providers and ancillary service providers to create or validate the appropriate treatment plan.
• Documents assessment results for the individual member status or negotiates service plan as needed.
• Provides ongoing education.
• May communicate with all health care providers to ensure appropriateness of care.
• May complete review decisions regarding services needed to be successful in the community.
• Must be able to work from home and travel within a specific geographic area to conduct assessments.

Assessor Reviewer I

• Manage the day to day operations of health management lines of service and/or contracts/programs, with particular emphasis on case management programs and care coordination initiatives
• Lead a team in the creation of a strategic plan, implementation of plan, evaluation and ongoing management to ensure contract deliverables/program requirements and evaluation measures/metrics are met and/or exceeded
• Facilitate analyses and initiate action plans when deliverables/requirements are at risk
• Develop and maintain relationships with team stakeholders and provide technical assistance, including issue research and resolution
• Develop and implement process improvement methods and ensure operations are completed in a timely, satisfactory, compliant manner within assigned budget
• Participate in sales, business development and proposal activities, contribute as a subject matter expert, and monitor budgets and financials for assigned contracts
• Coach, guide and direct team members to achieve individual, team and organizational objectives and provide resources and support to meet departmental and Company goals
• Represent the company at meetings and/or conferences, work externally with providers or clients, and make recommendations for improvements and/or efficiencies
• Stay abreast of industry trends and changes and perform miscellaneous duties as assigned

Software Engineer

• Collaborate with AI tools (such as Claude Code, GitHub Copilot) to develop and maintain AI agents and solutions.
• Analyze business processes and identify opportunities for AI automation.
• Design and document AI workflows and integration points.
• Support the implementation of AI solutions across different departments.
• Help optimize existing AI workflows and systems.
• Work with cross-functional teams to gather requirements and translate business needs into technical solutions.
• Create documentation and test cases using AI-assisted tools.
• Monitor AI system performance and help troubleshoot issues.
• Participate in AI solution training and deployment activities.

AI Developer/Designer

• The Assessor Reviewer I is responsible for face-to-face assessments of vulnerable populations for various clients.
• Persons being assessed reside in the community or in facilities.
• Assessor Reviewers may complete review decisions regarding services needed to be successful in the community.
• Performs face-to-face and/or virtual assessments of persons with disabilities.
• Collaborates with healthcare providers and ancillary service providers to create or validate treatment plans as required by some contracts.
• Documents assessment results and negotiates service plans as needed.
• Provides ongoing education and may communicate with all health care providers to ensure appropriateness of care.
• If hired, a two day in-person training in West Des Moines is required for this role.

• This position is responsible for receiving and responding to inbound customer inquiries, performing outreach to providers and members, providing program support for contract members, and providing technical and administrative support for various contracts, including support of internal applications and tools.
• This is a temporary 3 month position.