VIVA HEALTH jobs - 37 jobs

Work Schedule: Hybrid - after a 5-6 month training period that will be completed 100% onsite at our downtown Birmingham office, this position can transition to a hybrid work schedule with a mix of in-office and remote work. The successful candidate must reside within a reasonable travel distance of Birmingham. Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits Comprehensive Health, Vision, and Dental Coverage 401(k) Savings Plan with company match and immediate vesting Paid Time Off (PTO) 9 Paid Holidays annually plus a Floating Holiday to use as you choose Tuition Assistance Flexible Spending Accounts Healthcare Reimbursement Account Paid Parental Leave Community Service Time Off Life Insurance and Disability Coverage Employee Wellness Program Training and Development Programs to develop new skills and reach career goals Employee Assistance Program See more about the benefits of working at Viva Health - ******************************************* Job Description The Credentialing Coordinator is responsible for credentialing and re-credentialing practitioners, ancillary service providers and allied health professionals to ensure their qualification to participate in VIVA HEALTH'S provider network. The Credentialing Coordinator will serve a primary role in receiving and incorporating provider data appropriately into the provider set-up workflow process. This position will act as a resource for provider data integrity, provider file management and network development. Key Responsibilities Receive, interpret and incorporate Council for Affordable Quality Healthcare (CAQH) provider data into the credentialing, re-credentialing, and provider data auditing process. Use CAQH data and credentialing software findings to make credentialing decisions regarding providers. Analyze trends in monthly credentialing data to forecast workload for CAQH. Communicate with internal departments to ensure quality assurance findings related to providers are reviewed and acted upon accordingly. REQUIRED QUALIFICATIONS: Bachelor's Degree or equivalent experience in credentialing 3 years of experience in credentialing Ability to analyze and solve problems related to credentialing of providers and facilities Proficient in manipulation of data to report statistical information to several of departments Ability to work independently, research and resolve processing issues in a timely manner with little to no supervision Organized, detail oriented, and skilled at multi-tasking Demonstrate excellent customer service skills through written and verbal communication Proficient in the Microsoft Office suite of products Knowledge of credentialing software, CAQH, CMS, NCQA guidelines, and JCAHO regulations

--------------------------------------------------------------- The Claims Examiner II is an intermediate level position responsible for the timely review, investigation and adjudication of all types of Medicaid, Medicare, group and individual medical, dental, and mental health claims. Estimated Hiring Range: $22.82 - $27.89 Bonus Target: Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. --------------------------------------------------------------- Essential Responsibilities Adjudicate medical, dental and mental health claims in accordance and compliance with plan provisions, state and federal regulations, and CareOregon policies and procedures. Re-adjudicate, adjust or correct claims, including some complex and difficult claims as needed. Consistently meet or exceed the quality and production standards established by the department and CareOregon. Provide excellent customer service to internal and external customers. Collaborate and share information with Claims teams and other CareOregon departments to achieve excellent customer service and support organizational goals. Determine eligibility, benefit levels and coordination of benefits with other carriers; recognize and escalate complex issues to the Lead or Supervisor as needed. Investigate third party issues as directed. May review, process and post refunds and claim adjustments or re-adjudications as needed. Report any overpayments, underpayments or other possible irregularities to the Lead or Supervisor as appropriate. Generate letters and other documents as needed. Proactively identify ways to improve quality and productivity. Continuously learn and stay up to date with changing processes, procedures and policies. Experience and/or Education Required Minimum 2 years' experience as a Medical Claims Examiner or other role that requires knowledge of medical coding and terminology (e.g., medical billing, prior authorizations, appeals and grievances, health insurance customer service, etc.) Preferred Experience using QNXT, Facets, Epic systems Knowledge, Skills and Abilities Required Knowledge Knowledge of CPT, HCPCS, Revenue, CDT and ICD-10 coding Knowledge of medical, dental, mental health and health insurance terminology Skills and Abilities Understanding of or ability to learn state and federal laws and other regulatory agency requirements that relate to medical, dental, mental health and health insurance industry and Medicaid/Medicare industry Ability to perform fast and accurate data entry Strong spoken and written communication skills Basic computer skills (ability to use Microsoft Outlook, Word and Excel) and learn new systems as needed Good customer service skills Ability to participate fully and constructively in meetings Strong analytical and sound problem-solving skills Detail orientation Strong organizational skills and time management skills Ability to work in a fast-paced environment with multiple priorities Ability to work effectively with diverse individuals and groups Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read, hear, speak, and perform repetitive finger and wrist movement for at least 6 hours/day Ability to lift, carry, reach, and/or pinch small objects for at least 1-3 hours/day Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person Hazards: May include, but not limited to, physical and ergonomic hazards. Equipment: General office equipment Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used. Work Location: Work from home Schedule: Monday - Friday, 8:00 AM to 5:00 PM We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information. We are an equal opportunity employer CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

--------------------------------------------------------------- This position is responsible for leading large scale, complex projects utilizing project management and LEAN principles and techniques. Work comprises all stages of the project lifecycle, including scoping, planning, management, and implementation. Some projects include a technology focus. Under limited supervision, this position acts as a liaison between internal and external partners, contractors and stakeholders to facilitate collaboration, consensus building and help ensure accountability, as well as maintain technical project reports, records and documentation. This is a senior level project management position and typically leads projects in support of highly integrated, enterprise-wide initiatives. Projects frequently have varied and numerous participants, areas of high ambiguity, and competing priorities and/or interdependencies with other projects. Estimated Hiring Range: $100,350.00 - $122,650.00 Bonus Target: Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. --------------------------------------------------------------- Essential Responsibilities Planning and Development * Develop project plans that outline components, communications, milestones, priorities, needs and resources. * Organize, facilitate, and participate in meetings of stakeholder groups to identify needs and build consensus and collaboration. * Work collaboratively in analyzing business needs to identify potential technical solutions and process impacts to inform business case and project proposals and project plans Project Management * Apply senior level skills in leading stakeholders; act as a resource to project team members. * Monitor and regularly communicate project status to Sponsors, Business Owners and other stakeholders, helping to ensure progress toward completion. * Make formal and informal presentations and reports, providing updates and other relevant information on the status of projects. * Represent the organization regarding project status and alignment with strategic plans; facilitate and work effectively to develop consensus within divergent groups and/or groups with divergent viewpoints. Quality Assurance * Identify potential difficulties and/or barriers to project goals and take steps to mitigate or avoid them. * Ensure compliance with all applicable standards, policies, laws, rules and regulations outlined in the project plan. Implementation * Employ advanced change management techniques to facilitate the adoption of the project. * Track large scale project costs and identify variances from project plans. * Develop and recommend operational processes and/or process improvements including supporting information systems. Documentation and Evaluation * Maintain appropriate records, information, documentation and reports. * At the time of project completion, close files and review records to ensure documentation is appropriate and complete. * Facilitate the evaluation of progress and challenges following implementation, identifying potential system or process improvement opportunities * Provide subject matter expertise and guidance for implementation, configuration and on-going support of internal systems, technology, and analytics. Organizational Responsibilities * Perform work in alignment with the organization's mission, vision, and values. * Support the organization's commitment to equity, diversity, and inclusion by fostering a culture of open mindedness, cultural awareness, compassion, and respect for all individuals. * Strive to meet annual business goals in support the organization's strategic goals. * Adhere to the organization's policies, procedures, and other relevant compliance needs. * Perform other duties as needed. Role Requirements * Minimum 5 years' related experience * 4 years managing projects Experience should include: *Independent leadership of a variety of medium and large scale projects, as well as leadership on occasional enterprise-wide, complex projects *Minimum 2 years' experience leading complex information systems projects Preferred skills & experience *Scrum, Agile, and/or Project Management International (PMI) Project Management certification *3 or more years' experience in health plan operations *Change Management - Process Improvement *Smartsheets Experience Knowledge & Abilities: * Expert knowledge of principles, methods, and techniques of project management and effective organizational change management * Knowledge of multiple project management frameworks, specifically variations of both agile and waterfall development methods * Understanding of multiple health plan functions and system implications preferred * Ability to apply process improvement and redesign principals and techniques such as Lean, PDSA, or Six Sigma * Expert ability to develop a formal and detailed project plan aligned with established timeline and budgetary guidelines * Advanced ability to lead and motivate peers, cross-functional partners and management toward project goal attainment * Excellent ability to manage multiple activities, matrixed teams, organization communications, and frequently competing priorities to implement change as necessary within time and budget constraints * Excellent skills in Microsoft Office, collaboration and project planning systems * Skilled at resource planning and negotiating with resource managers for needed skills and time from team members throughout the project/program lifecycle * Expertise with information systems in the health insurance or related industry preferred * Excellent communication skills, including listening, verbal, written, documentation, meeting facilitation, and presentations * Ability to maintain a high degree of professionalism in working with internal and external business partners * Ability to work effectively with diverse individuals and groups We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information. We are an equal opportunity employer CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

Role Overview: The Corporate Provider Network Management Account Executive plays a critical role in developing high-performing provider networks that meet state and Centers for Medicare & Medicaid Services (CMS) requirements for new and expanding markets. In this dynamic and fast-paced role, you will identify and recruit key providers, negotiate contracts, and establish trusted partnerships with healthcare professionals and organizations at a rapid pace. You will also contribute to the strategic direction of network development by creating business plans, process flows, and customized solutions that support organizational objectives. Work Arrangement: * Remote - Associate can work remotely anywhere in the United States. * This position requires 50-60% travel. Responsibilities: * Identify, contact, and recruit qualified providers to participate in the Plan network across new and existing service areas. * Negotiate contracts with hospitals, physicians, and ancillary providers. * Engage with providers at all organizational levels and across diverse system types. * Maintain consistent communication and follow-up with prospective providers until the enrollment process is complete. * Submit complete and accurate provider applications to the credentialing department to support timely processing. * Document and report issues that may impact recruiting efforts. * Stay current on all Request for Proposal (RFP) and application requirements relevant to network development. * Maintain clear, accurate records of all provider interactions and activities. * Support team members by identifying challenges and contributing innovative solutions that enhance processes and expand the use of technology. * Foster collaborative working relationships and build trust across teams. * Recommend creative operational approaches to reduce backlogs and improve resource utilization. Education & Experience: * Bachelor's degree in Business, Healthcare Administration, Healthcare Management, or a related field is required * 2 to 3 years of experience in Medicaid or Medicare provider contracting preferred. * 5 to 7 years of progressive business experience in provider network management. * Strong knowledge of provider network management processes and programs, including Performance Improvement Plans (PIPs), hospital savings initiatives, Accountable Care Organizations (ACOs), and Patient-Centered Medical Homes (PCMH), is strongly preferred. Licensure: * Valid driver's license and car insurance required. Skills & Abilities: * Strong understanding of customer and market dynamics and key business drivers. * Commitment to working collaboratively and strengthening provider networks. * Strong negotiation, communication, and active listening skills. * Demonstrated leadership and proven ability to achieve results.

**Role Overview:** The Provider Network Management Contractor is responsible for developing, contracting, and maintaining provider relationships within an assigned market. This role ensures the network is competitive, compliant, and aligned with organizational strategy. **Work Arrangement:** + Remote - Associate can work remotely anywhere in the United States. **Responsibilities:** + Supports overall network development strategy. + Assists departmental leadership with provider satisfaction, education, and communication efforts. + Negotiates provider contracts to achieve network strategy and maintain an adequate, compliant, and marketable network. + Negotiates Single Case Agreement (SCA) rates and converts SCA providers to contracted status. + Recruits and contracts providers to address network adequacy gaps, including high‑complexity specialties. + Ensures all contracts comply with Federal and State regulations, policies, and departmental procedures. + Structures contracts that support quality initiatives such as: Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), National Committee for Quality Assurance (NCQA), and Utilization Review Accreditation Commission (URAC) + Negotiates contract terms that drive provider satisfaction. + Works with CPNM (Clinical Provider Network Management) to manage the annual contracting schedule and expand the network as needed. + Serves as a payment/fee schedule Subject Matter Expert (SME) for complex specialties such as Federally Qualified Health Centers (FQHCs), Behavioral Health (BH), anesthesia, and others; available to support Account Executives (AEs) with claims resolution. + Maintains operational knowledge of key functions affecting the provider experience, including claims, payment integrity, provider data, credentialing, appeals, disputes, and related processes. + Negotiates provider agreements consistent with claims payment methodologies. + Expands or modifies the provider network to support new products or client needs. + Reviews contract terms and collaborates with Legal to secure optimal language. + Supports contracting activities across multiple product lines, including Long-Term Services and Supports (LTSS), Exchange (ACA Marketplace plans), and Dual Special Needs Plans (DSNP) + Acts as the lead negotiator for VBC (Value-Based Contracting) in partnership with the AE. **Education & Experience:** + Bachelor's degree required. + 3 or more years of Account Executive experience. + Minimum of 1 year of contract negotiation experience. + Demonstrated financial acumen and ability to navigate difficult conversations. + Understanding of reimbursement methodologies, including risk‑based and value-based contracting. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

VIVA HEALTH, ranked one of the Best Places to Work by Modern Healthcare, has an amazing opportunity for a Supervisor, Care Coordination in Birmingham, AL! The Supervisor, Care Coordination will supervise the day-to-day operations of a team of employees and will support staff by providing operational oversight and clear objectives and goals for the department. This position is responsible for caseload reviews and supervisory visits for the team. This position is also responsible for visiting provider offices to develop partnerships with providers and office staff. This position will carry a partial caseload as needed. This position is responsible for ensuring employees have supplies and other resources needed for the team to perform essential job functions. This position will travel to locations within the relevant service area through a reliable means of transportation insured following Company policy. This position has occasional work-from-home opportunities. REQUIRED: Degree in nursing from an accredited program of professional nursing Three years of experience in medical or behavioral health case management Current RN license in good standing with the State of Alabama Board Valid driver's license in good standing May require significant face-to-face member contact with duties regularly performed away from the principal place of business Willing to submit to vaccine testing and screening Ability to manage and direct staff in a positive and effective manner Demonstrate excellent oral and written communication skills as well as a thorough knowledge of medical terminology Working knowledge of health-related service delivery systems Ability to analyze varied environmental factors concerning recipients' well-being Highly motivated, goal-oriented, and willing to work to satisfy department goals when required Ability to be flexible and accommodate shifting priorities Ability to perform day-to-day responsibilities with minimal supervision, exercise independent judgment, and maintain confidentiality Strong presentation skills Basic computer skills PREFERRED: BSN Five years of experience in medical case management Current RN license in good standing with the State of Alabama Board Certified Case Manager Proficient in the use of Microsoft Office Suite of products such as Word, Excel, and PowerPoint

VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is currently seeking a Care Manager, Social Worker, Behavioral Health in Birmingham, AL! VIVA HEALTH knows that social work is not just a job, it is a calling. If you would like to fulfill your calling in healthcare, check us out! We offer regular hours with no mandatory nights or weekends. This way you can do what you love at work and are able to take care of the people you love at home! We also offer a great benefits package including tuition reimbursement for employees and dependents, paid parental leave, and paid day for community service, just to name a few! Our employees are a part of the communities they serve and proudly partner with members on their health care journeys. Come join our team! The Care Manager, Social Worker, Behavioral Health will evaluate member needs and requirements to achieve and/or maintain optimal wellness state. This position will guide members and their families toward resources appropriate for their care and wellbeing. This position will collaborate with a multidisciplinary team, employing a variety of strategies, approaches and techniques to manage a member's psychosocial health, physical and environmental issues. This position will work with the behavioral health panels for utilization management as well as provide fieldwork outside of the office setting. This individual will collaborate with our mental health providers to promote members' compliance with treatment regimes. This position will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy. REQUIRED: * MSW * 3 years' experience in social work * Current LMSW License in good standing with the State of Alabama * Valid driver's license in good standing * May require significant face-to-face member contact, with duties regularly performed away from the principal place of business * Willingness to submit to vaccine testing and screening * Background in behavioral health * Knowledge and comprehensive clinical assessment skills for chronic psychiatric disease management in adult populations * Ability to be flexible, adaptable, and able to work effectively in a variety of settings * Demonstrate excellent customer service skills through written and verbal communication * Organization and Time Management skills * Basic computer skills PREFERRED: * Master's degree in social work * 1 year experience in behavioral health case management * 1 year experience in case/complex care field management * LICSW * Certified Case Manager (CCM) * Ability to utilize Microsoft Word and Excel

Provider File Maintenance (PFM) Specialist Work Schedule: Mostly Remote - after an onsite training period at our downtown Birmingham office, this position can transition to work mostly remote, with occasional onsite days. The successful candidate must reside within a reasonable travel distance of Birmingham. Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits * Comprehensive Health, Vision, and Dental Coverage * 401(k) Savings Plan with company match and immediate vesting * Paid Time Off (PTO) * 9 Paid Holidays annually plus a Floating Holiday to use as you choose * Tuition Assistance * Flexible Spending Accounts * Healthcare Reimbursement Account * Paid Parental Leave * Community Service Time Off * Life Insurance and Disability Coverage * Employee Wellness Program * Training and Development Programs to develop new skills and reach career goals * Employee Assistance Program See more about the benefits of working at Viva Health - ******************************************* Job Description The Provider File Maintenance (PFM) Specialist is responsible for maintaining accurate provider demographic, payment, and contractual information in VIVA HEALTH'S claims processing system. Key Responsibilities * Enter and update providers in VIVA HEALTH'S claims processing system. * Verify integrity of data by comparing it to source documents. Review input data for errors or missing information and resolves any discrepancies. * Monitor and maintain Medicare opted-out providers and Medicare precluded providers. * Communicate terminated and reinstated providers to all areas of VIVA HEALTH. * Perform fee schedule maintenance in the claims processing system. Support the configuration team, as needed, in maintaining system reference files. REQUIRED QUALIFICATIONS: * High School Diploma or GED * Healthcare industry knowledge * Ability to work under pressure to meet deadlines with minimal supervision * Demonstrate excellent customer service skills through written and verbal communication * Ability to produce quality-focused work * Ability to work independently and as a member of a team * Basic computer skills PREFERRED QUALIFICATIONS: * Some College * Claims processing and/or provider credentialing/contracting knowledge * 2 - 3 years' experience with PowerSTEPP * Proficient knowledge of Microsoft Excel and Microsoft Outlook

--------------------------------------------------------------- This position is responsible for performing data management in Workday and other ancillary systems at a senior level. Core areas of responsibility include data configuration, administration, analysis, reporting, stewardship, and project management. Functional areas of focus may include employment functions such as talent acquisition, compensation, benefits, and learning or finance functions such as accounting, budgeting, and procurement. Estimated Hiring Range: $124,200.00 - $151,800.00 Bonus Target: Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. --------------------------------------------------------------- Essential Responsibilities Data Configuration and Administration Lead functional administrator tasks for multiple areas within Workday with understanding of cross-functional dependencies. Interpret needs and develop and guide functional teams on routine to complex business processes and workflows. Identify and create new calculated fields, rules, validations, alerts, mass operations management (MOM), passive events, custom objects, custom fields, and standard and custom organizations with expert understanding of the impacts across the organization. Lead functional assessment, setup, and testing of Workday system releases. Lead continuous improvement of system processes and procedures, identifying opportunities for automation and efficiency gains while driving alignment with organizational goals and objectives. Stay updated, interpret, and guide others on system releases, enhancements, and best practices to ensure optimal system performance and user experience. Lead and/or participate in user group meetings/conferences. Identify risks, configuration options to improve processes, and recommend best practices and mitigations based on Workday functionality. Data Analysis and Reporting Apply advanced skills in gathering and analyzing data and providing summaries, reports and dashboards to department staff and other audiences; effectively interpret user needs and serve as a key resource for other Workday staff. Review metrics and report on a regular basis; perform advanced analysis and apply seasoned knowledge for explaining trends, unexpected changes and outliers. Administer reporting intake process; meet with all levels of management to discuss, clarify, interpret, and guide in requests for data; effectively translate requests into deliverable projects and provide options to meet end goals where constraints exist. Maintain data integrity in systems by creating new custom reports or automated alerts to identify and mitigate recurring or critical errors; guides others in resolving errors. Identify and troubleshoot complex report sharing issues and security or object errors; develop report tagging framework to automate and simplify for users. Collaboration and Data Stewardship Provide expert level troubleshooting and resolution for complex issues and cross-functional errors and develop solutions to avoid repeat errors. Within scope of assigned security role, partner with IS to ensure data feeds with internal and external systems and vendors perform as expected; where having visibility and included on notifications, monitors and reports errors and plays a lead role with resolution. Serve as the primary representative and liaison between People and Culture, IS, Finance, external vendors, and other stakeholders for ERP system design and implementation projects and upgrades. Provide advanced technical support, troubleshooting, and guidance to system users; identify and develop effective aids for system users and provides user education. Collaborate with and effectively bridge communications between IS, People and Culture, and Finance to address system inquiries and issues. In collaboration with IS, communicate planned and unplanned ERP systems outages. Develop and leverage expert understanding of data, data infrastructure and processes used for reporting department metrics and for measuring operational and/or program performance. Develop and oversee technical documentation, such as data dictionaries, glossaries, and procedures for relevant data and reports; partners with IS as appropriate. Project Management Provide expert level support on help requests and projects. Maintain project request tracking. Lead project prioritization in collaboration with management and functional team; assess scope, effort, resource requirements, and impact along with feasibility and reasonable deadlines. Set up and test changes in appropriate tenant. Document changes and testing in accordance with change approval and prioritization processes; migrate changes between tenants, as authorized. Advise management and stakeholders on options realistically available to meet requests and project requirements within feasible timelines and resource constraints. Use expert knowledge of system capabilities to develop creative solutions and enhancements. Advise management where use of external consultants would be cost-effective or recommended due to impact, resource constraints or other considerations. Experience and/or Education Required Minimum 5 years' experience performing data administration, configuration, and analysis in the functional area where the position resides Minimum 4 years' experience in Workday, directly administering, troubleshooting, and configuring minimum of 3 HCM or Finance modules Preferred Experience leading Workday implementations or upgrades Experience developing EIB and API integrations, and experience supporting, troubleshooting, and testing Connector and Studio integrations Knowledge, Skills and Abilities Required Knowledge Excellent understanding of data management fundamentals and reporting, including data structures, integration, stewardship, and governance Ability to lead in applying and performing qualitative/quantitative measurement and data collection design principles Advanced understanding of functional policies and procedures Skills and Abilities Excellent ability to anticipate, understand, and interpret data requests and provide timely and accurate reports Advanced research, analytical and problem-solving skills Ability to review and recommend the best course of action or solution based on impacts Ability to identify and lead process improvements and streamline manual processes Advanced Excel and ETL (extract, translate, load) skills that comply with specified data requirements Strong verbal and written communication skills, as well as interpersonal skills Ability to collaborate effectively with ERP cross-department stakeholders and vendors Ability to convert systems terminology into understandable content for educating users Ability to effectively document information; ability to synthesize findings and present recommendations to stakeholders Excellent organizational skills and attention to detail Ability to handle confidential information and upmost discretion, sharing data in support of security access controls, and obtaining appropriate approvals for any relevant exceptions Ability to keep information confidential Ability to work effectively with diverse individuals and groups Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day Ability to hear and speak clearly for at least 3-6 hours/day Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person Hazards: May include, but not limited to, physical and ergonomic hazards. Equipment: General office equipment Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used. Work Location: Work from home We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information. We are an equal opportunity employer CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

--------------------------------------------------------------- The IS Database Developer II is responsible for developing and maintaining database and ETL processes, as well as recommending and partnering in the design and development of effective solutions in support of business strategies. This role is essential toward maturing CareOregon's database and ETL development model. This position spends substantial time evaluating, architecting, and implementing IS priorities (plan, design, install, and maintain). Estimated Hiring Range: $111,690.00 - $136,510.00 Bonus Target: Bonus - SIP Target, 5% Annual Current CareOregon Employees: Please use the internal Workday site to submit an application for this job. --------------------------------------------------------------- Essential Responsibilities Database Development Actively participate in the design of custom databases and processes. Provide advanced database design support to the organization; lead small projects with assistance from Supervisor or Lead and participate and consult on other projects. Collaborate with other IS teams on best practices of database design and development. ETL Development Develop ETL processes for moderate to advanced activities. Develop moderate to advanced databases to meet application and web needs. Analyze business requirements; research and recommend solutions which include potential risks and mitigation. Develop and maintain appropriate technology documentation, including current design and operation. Standards and Policy Administration Propose requirements, standards and best practices for database and ETL development. Participate in the ongoing review of existing systems to ensure they are designed to comply with established standards and to empower business operations. Vendor Coordination and Relations Conduct product and vendor research, and present recommendations to more advanced database developers and/or management. Establish and maintain effective working relationships with vendors and related equipment suppliers, including installation and repair of services. Experience and/or Education Required Minimum 3 years of database and ETL development required. Experience should include some or all of the following: Database development and maintenance ETL development and maintenance Systems analysis and design Agile/Scrum methodology Note: For data warehouse focused roles, minimum 3 years' experience developing ETL for loading a dimensional model using a combination of T-SQL and SSIS 2012, 2014, or 2016 Preferred Bachelor's degree in Computer Science, Information Systems, or a related field Additional experience in related technology support and/or operational positions QNXT experience Knowledge, Skills and Abilities Required Knowledge Working knowledge/skills with the following: Microsoft SQL Server ETL tools, such as SSIS or Informatica Visual Studio Unit and integration testing Note: For data warehouse focused roles, advanced knowledge/skills of the dimensional model required in lieu of knowledge/skill requirements above General knowledge of BizTalk (preferred) Skills and Abilities Advanced abilities in troubleshooting system performance issues and root cause Effective communication skills, including listening, verbal, written, and customer service Ability to clearly articulate policies and instructions Demonstrated progress in conveying appropriate level of detail effectively to all levels of the organization including non-technical staff Ability to recommend policies, document risks, and propose solutions to information technology management and senior leadership Possess a high degree of initiative and motivation Ability to effectively collaborate with coworkers, staff, and leaders across all departments Ability to work effectively with diverse individuals and groups Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day Ability to hear and speak clearly for at least 3-6 hours/day Working Conditions Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person Hazards: May include, but not limited to, physical and ergonomic hazards. Equipment: General office equipment Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used. Work Location: Work from home We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information. We are an equal opportunity employer CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

Role Overview: The National Provider Contracting Director is responsible for leading the evaluation, negotiation, and management of contracts with national providers across existing and emerging markets. This leader will apply a disciplined, data-driven approach to assess the financial value of national provider contracts, considering volume, cost, quality, access, and member experience across markets and service lines. The role may focus on one or more national provider segments, including ancillary providers and hospital systems. Work Arrangement: * Remote - Associate can work remotely anywhere in the United States and must be able to travel as needed across multiple states. Responsibilities: * Evaluate opportunities to contract with national providers and determine economic value by leveraging multi-state scale and relationships. * Lead performance oversight for national providers, managing Service Level Agreements (SLAs) and identifying opportunities to mitigate cost and risk, including transitions to value-based payment models. * Advise and influence reimbursement strategy and medical policy related to national provider services. * Build and sustain strong relationships with current and prospective national providers. * Foster collaboration between Health Plan Network Management teams and corporate stakeholders to ensure an enterprise-wide approach to national provider contracting. * Ensure compliance with company provider contracting policies. * Negotiate and re-negotiate national provider contracts across both new and established markets, including the development and integration of value-based components. * Collaborate with Strategy and Finance to design contract structures that align with organizational objectives and comply with applicable state regulatory requirements. * Partner with New Business Provider Network Management (PNM) teams and Health Plan leadership to identify, pursue, and optimize national provider contract opportunities, whether for market entry, expansion, or contract redesign. Education & Experience: * Bachelor's degree or equivalent professional experience required. * 8 or more years of network development or provider relations experience, including a strong track record of negotiating with national providers. Licensure: * Valid driver's license and car insurance required Skills & Abilities: * Medicaid Managed Care and Medicare experience preferred. * Proven success in securing and finalizing provider contracts. * Strong understanding of contractual and regulatory requirements for network development and provider standards. * Excellent written, verbal, and presentation skills. * Strong leadership, analytical, and problem-solving capabilities. * Ability to build effective relationships with internal stakeholders and external partners.

Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits * Hourly pay starting at $17.00 and up * Strong incentive plan with an average of $7000/year (start earning as quickly as your 3rd month!) * Comprehensive Health, Vision, and Dental Coverage * 401(k) Savings Plan with company match and immediate vesting * Paid Time Off (PTO) * 9 Paid Holidays annually plus a Floating Holiday to use as you choose * Tuition Assistance * Flexible Spending Accounts * Healthcare Reimbursement Account * Paid Parental Leave * Community Service Time Off * Life Insurance and Disability Coverage * Employee Wellness Program * Training and Development Programs to develop new skills and reach career goals * Employee Assistance Program See more about the benefits of working at Viva Health - ******************************************* Job Description The Medicare Member Advocate I will assist members with questions and issues related to their coverage with VIVA MEDICARE - primarily via telephone in a call center environment. This position will work with a team of other Medicare Member Advocates to meet the overall department objectives to enhance the customer experience. This position has work-from-home opportunities but requires occasional on-site work. Key Responsibilities * Answer the minimum number of calls for a full eight-hour day as outlined in the Minimum Production and Quality Standards. * Receive and respond professionally and courteously to all member inquiries regarding eligibility, claims, general coverage questions, Primary Care Physician (PCP), address changes, provider network, and any questions or concerns about their health and prescription drug benefits with VIVA Medicare. * Document and forward grievances and Part D exception requests to the Appeals & Grievances department according to established policies and procedures. * Create accurate and timely member documentation concerning all phone calls taken according to departmental operating guidelines. * Ability to work evening and weekend shifts as needed. REQUIRED: * High school diploma or GED * One year of experience in a call center * Excellent oral and written communication skills * Effective listening and reading comprehension skills * Above-average data entry skills * Knowledge of standard office practices and procedures, including the operation of office equipment, including personal computers and word processing, spreadsheets, and presentation programs * Proper written and spoken English skills including spelling, punctuation, and grammar; basic business arithmetic * Ability to work with minimal supervision * Ability to work under pressure from deadlines and goals * Ability to complete all company-required, job-specific, and departmental training PREFERRED: * Some college * Experience in health or insurance-related call center * Experience working with the elderly population * Working knowledge of Medicare, medical terminology, and HIPAA guidelines

Electronic Data Interchange (EDI) Eligibility Specialist Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits * Comprehensive Health, Vision, and Dental Coverage * 401(k) Savings Plan with company match and immediate vesting * Paid Time Off (PTO) * 9 Paid Holidays annually plus a Floating Holiday to use as you choose * Tuition Assistance * Flexible Spending Accounts * Healthcare Reimbursement Account * Paid Parental Leave * Community Service Time Off * Life Insurance and Disability Coverage * Employee Wellness Program * Training and Development Programs to develop new skills and reach career goals * Employee Assistance Program See more about the benefits of working at Viva Health - ******************************************* Job Description The EDI (Electronic Data Interchange) Eligibility Specialist will develop and maintain existing eligibility EDI programs and other PC-based programs for VIVA HEALTH. This position will assist with the maintenance and execution of recurring processes surrounding eligibility business requirements. Key Responsibilities * Carry out the end-to-end steps to receive and transform data to be loaded into VIVA HEALTH'S systems. * Work closely with the Finance, Operations, and Medicare departments to support their respective business functions surrounding enrollment. * Work with third party vendors to analyze and setup appropriate processes for eligibility and claims data feeds from VIVA HEALTH'S systems. * Work with the Compliance/Legal departments to ensure proper documentation is in place before data feeds are setup. REQUIRED QUALIFICATIONS: * Bachelor's Degree or equivalent work experience * 1- 3 years' experience with database technology/process management * Demonstrated experience with successful ownership of processes * Excellent interpersonal skills for frequent interaction with users, managers, and vendors * Excellent verbal and written communications skills * Excellent attention to detail and accuracy * Knowledge of MS Access PREFERRED QUALIFICATIONS: * 3 - 5 years' experience with database technology/process management * Experience with MS SQL * Health Plan experience * Microsoft and/or PMI certifications * Understanding of the relationship between health plan eligibility and premium accounting * Knowledge of ANSI 5010 834 file formats * Knowledge of HIPAA and ACA

VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, has an opportunity for an RN, Care Manager in the Anniston/East Alabama area! VIVA HEALTH knows that nursing is not just a job; it is a calling. If you would like to fulfill your calling in healthcare, check us out! We offer regular hours with no mandatory nights and weekends. This way, you can do what you love at work and are able to take care of the people you love at home! We also offer a great benefits package, including tuition reimbursement for employees and dependents, 401(K), paid parental leave, and paid day for community service, just to name a few! Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team! The RN, Care Manager will evaluate members' needs and requirements to achieve and/or maintain an optimal wellness state. This position will guide members and their families toward interaction with resources appropriate for the care and well-being of members. The RN, Care Manager will collaborate with a multi-disciplinary team employing a variety of strategies, approaches, and techniques to manage members' physical, environmental, and psychosocial health issues. The RN, Care Manager will primarily perform fieldwork outside of the office setting. The incumbent will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy. This position has work-from-home opportunities but requires occasional on-site work. REQUIRED: * Graduate of an accredited program of professional nursing, ADN/BSN * Three years of experience in clinical nursing * Current RN license in good standing with the State of Alabama Board of Nursing * Valid driver's license in good standing * May require significant face-to-face member contact with duties regularly performed away from the principal place of business * Willing to submit to vaccine testing and screening * Knowledge and comprehensive clinical assessment skills for chronic disease management in adult populations * Ability to be flexible, adaptable, and able to work effectively in a variety of settings * Demonstrate excellent customer service skills through written and verbal communication * Organization and Time Management skills * Basic computer skills PREFERRED: * One year of experience in independent field-based clinical care * One year of experience in case/complex care field management * Ability to utilize Microsoft Word and Excel

**TITLE:** Developer Programmer Lead (Job ID 433318) Analyze, design, develop, test, and implement cost-effective software solutions and applications using MS SQL Server, .Net technologies. Use knowledge of application development methods including Agile and Waterfall to produce deliverables. Contribute to Detail Design Sessions and Code Reviews. Troubleshoot and solve design and coding problems by providing first/second level troubleshooting and technical and operational support with limited guidance. Translate business, technical and FACETS requirements into well-engineered, tested and deployed business applications systems, including new code construction, modifications to existing modules and/or package configuration and implementation. Analyze large volumes of unstructured data from internal and external sources using SSIS and DataStage to optimize data extraction, transformation, and load. Design, develop, and test technical solutions and ensure solutions are aligned with Enterprise Data Strategy throughout Software Development Life Cycle (SDLC). Remote work option 100% of the time. **EDUCATION/REQUIREMENTS:** Bachelor's degree (or foreign equivalent) in Computer Science, Information Technology, or a closely related field. 6 years of SDLC experience with implementing methodologies, monitoring performance and meeting critical objectives in efficient design and coding practices. 5 years of programming experience in MS Sql Server and .Net technologies including C#, ASP, ADO.net, REST, and Web Api. 4 years of experience using Core FACETS (Version 5.0 and above) with Claims Processing, Providers, Member Enrollment and Finance modules. 3 years of experience using ETL tools including SSIS to optimize data extraction, transformation, and loading of data from diverse sources to ensure accurate, timely data integration and analysis in order to support claim processing, patient care and regulatory compliance;using application development methods including Agile and Waterfall to produce deliverables and fundamentals of requirements specification, design, development and testing of business application systems;working with healthcare provider-related processes and formulating design upgrades to cater to healthcare plan needs, including understanding of industry specific terminology and regulations, effective communication with stakeholders, and development of tailored IT solutions for healthcare operations. Remote work option 100% of the time. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare is looking for nurses and social workers to join our team! Please visit our website at vivahealthcareers.com to apply! We are hiring Nurses and Social Workers for corporate and field opportunities in several areas: • Transitional Care • Behavioral Health • Care Coordination and Case Management • Quality Outreach • Leadership Opportunities These positions will provide non-clinical and case management services to promote the self-management of chronic diseases to members with special health care needs. Applicants with behavioral/mental health/psychiatric, pediatric, and case/care management experience are especially encouraged to apply. We offer regular business hours, paid holidays, competitive pay, and outstanding benefits. REQUIRED: •Please clearly indicate on your application which Licenses/Certifications you possess, along with your education and experience. •May require local travel via a reliable means of transportation insured in accordance with Company policy •Basic computer skills SOME PREFERENCES MAY INCLUDE: •Experience working with un- or under-insured population •Experience serving low-income population •Experience in case management, human services, or public health •Experience in provisioning of referral and follow-up services •Experience with completing psychosocial assessments •Experience with completing care plans

Associate Director of Care Management Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits * Comprehensive Health, Vision, and Dental Coverage * 401(k) Savings Plan with company match and immediate vesting * Paid Time Off (PTO) * 9 Paid Holidays annually plus a Floating Holiday to use as you choose * Tuition Assistance * Flexible Spending Accounts * Healthcare Reimbursement Account * Paid Parental Leave * Community Service Time Off * Life Insurance and Disability Coverage * Employee Wellness Program * Training and Development Programs to develop new skills and reach career goals * Employee Assistance Program See more about the benefits of working at Viva Health - ******************************************* Job Description The Associate Director, Care Management will be responsible for the oversight of the day-to-day operations of the Care Management department to include applicable contracted programs. This position is responsible for the coordination, development, administration, and implementation of care coordination and utilization management for the Care Management program and other designated populations. Along with other leaders, this position will develop and implement strategies to improve member outcomes, quality of care, increase member satisfaction, and meet productivity standards. This position will travel to locations within the relevant service area through a reliable means of transportation insured in accordance with Company policy. Key Responsibilities * Make all day-to-day program decisions including overseeing all personnel within the department to ensure staff is providing quality customer service and meeting productivity and quality benchmarks. * Ensure department is appropriately staffed with qualified and trained employees. Coach and motivate employees by modeling behavior consistent with VIVA HEALTH'S Core Values. Assess and manage performance of management staff; create a positive environment that encourages productivity, innovation, and compliance. * Work in collaboration with other Health Services leaders and other departments, attaining and improving HEDIS and STARs metrics for VCare and Special Needs Plans (SNP). Meet with external stakeholders as required determining priority areas to be addressed. Implement plans as indicated. * Work in collaboration with other Health Services leaders to evaluate opportunities to impact and improve internal processes and best practice for the team. * Execute strategies, monitor their success on an on-going basis, report on outcomes, and adjust strategies as needed. * Support the design and oversight of initiatives aimed at improving member health outcomes including transitions of care, complex case management, and social determinant of health interventions. * Oversee the review and validation of program reports and data files to ensure accuracy, completeness, and alignment with Centers for Medicare and Medicaid Services (CMS) and internal benchmarks. Collaborate with analytics and quality teams to identify discrepancies and ensure timely resolution. * Review and analyze data reports to identify trends in admissions, readmissions, and utilization patterns. Assess the impact of social determinants of health and other risk factors to develop targeted strategies that close care gaps and reduce avoidable utilization. REQUIRED QUALIFICATIONS: * Licensed BSW, RN, or master's level in a health-related field * 5 years of progressive leadership and management experience in complex, mission-driven healthcare or human services organizations, including responsibility for operational oversight, strategic planning, and performance outcomes. * Valid driver's license in good standing * May require significant face-to-face member contact with duties regularly performed away from the principal place of business * Willing to submit to vaccine testing and screening * Possess excellent assessment and organizational skills * Exhibit critical thinking and decision-making abilities, as well as conflict resolution skills * Excellent verbal, presentation, and written communication skills * Comfortable speaking to large groups * Ability to travel overnight as needed * Ability to perform tasks with little or no supervision * Basic computer skills including Microsoft Word and Excel PREFERRED QUALIFICATIONS: * BSN or a master's in social work * Experience in population health and/or chronic care disease management * Experience working for a Medicare Advantage Plan or Medicaid Plan * Current RN or LMSW license in good standing in the State of Alabama * Certified Case Management (CCM) * Knowledge of community resources and Medicaid regulations

**TITLE:** Application Architect (Job ID 434013) Develop, configure, code and test programs from specifications using SQL/SQL Server, .Net, and SSIS technologies. Interface with business analysts, project managers and clients to translate and clarify business, technical requirements. Contribute to technical design, the testing of her own work, and to the development of test plans throughout the Software Development Life Cycle ("SDLC") using modular code development, tuning and optimization. Maintain awareness of information security requirements and scalability issues during design and development. Prepare documentation that describes installation and operating procedures. Provide troubleshooting and technical and operational support. Create estimates of resource requirements. Provide production support for installed applications, and participate in technical design and application development methods including Agile and Waterfall from specifications under limited guidance. Troubleshoot applications problems with limited support and effectively identify and escalate issues as appropriate. Remote work option 100% of the time. **EDUCATION/REQUIREMENTS:** Bachelor's degree (or foreign equivalent) in Computer Science, Electronics Engineering, or a closely related field. 5 years of application development experience using C#.net, .Net core framework, and jQuery to develop web pages, Windows-based applications and create web extensions; using MS SQL server to write complex queries to pull data, analyze and generate reports, write stored procedures, functions, and triggers for new application development, and debug, review and apply performance tuning to existing code; working with GIT source code version control; and using DevOps and Agile development methodologies to architect applications utilizing Scrum ceremony framework. 2 years of experience in Azure or AWS to design and develop cloud-based applications. 1 year of experience working under HIPAA standards and interpreting data in the HL7 format to build cloud-based applications. Remote work option 100% of the time. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

VIVA HEALTH is seeking a Connect for Quality Nurse to join our team in Birmingham, AL! This is a remote position and requires occasional on-site work. We know that nursing is not just a job, it is a calling. If you would like to fulfill your calling in healthcare, check us out! We offer regular hours with no mandatory nights and weekends. This way you can do what you love at work and are able to take care of the people you love at home! Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team! The Connect for Quality Nurse will improve the quality of care, increase member and provider satisfaction, raise accuracy levels of risk-adjusted payment at the point of care, and have other duties as assigned. This position will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy. REQUIRED: Graduate of an accredited program of professional nursing, ADN/BSN Current RN license in good standing with the state of Alabama Board of Nursing Valid driver's license in good standing May require significant face-to-face member contact with duties regularly performed away from the principal place of business Willing to submit to vaccine testing and screening Ability to work under pressure to meet deadlines with little to no supervision Demonstrate excellent customer service skills through written and verbal communication Organized, detail-oriented, and skilled at multi-tasking Proficient in Microsoft Office suite of products PREFERRED: 2 years of experience in a quality improvement program