VIVA HEALTH jobs

VIVA HEALTH, ranked one of the Best Places to Work by Modern Healthcare, is currently seeking a Manager, Care Coordinator in Auburn, AL! The Manager, Care Coordination will supervise the day-to-day operations of a Care Coordination team, including program policies and procedures, documentation and records, and will work collaboratively with ACHN leadership to support overall quality goals. This position will work both internally and externally to ensure timely and efficient care is accessible to patients and to support delivering care providers. This position will also provide clear direction for achieving team goals and objectives. This position will travel to locations within the relevant service area through a reliable means of transportation insured in accordance with Company policy. This position will have work from home opportunities. REQUIRED: * BSN * Three years of experience in care coordination or case management in a medical or behavioral health setting * One year of experience in a supervisory or management role * Current RN license in good standing with the appropriate 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 * Excellent interview and telephone skills, as well as the ability to deal with providers and team members in a caring and helpful (assertive and tactful) manner * Working knowledge of health-related service delivery systems * Excellent communication and relationship skills * Ability to analyze varied environmental factors in relation to members' wellbeing * Organization and time management skills * Ability to be flexible, adaptable and work effectively in a variety of settings * Basic computer skills PREFERRED: * CCM Certification * Ability to utilize Microsoft Word and Excel

Nurses and Social Workers! VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is currently seeking a Care Coordinator in Dothan, AL! VIVA HEALTH knows that nursing and 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 can 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! VIVA HEALTH employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team! Care Coordinators use psychosocial and/or clinical knowledge to provide non-clinical services for Medicaid recipients to improve the medical compliance and health outcomes of the populations served. This position identifies barriers to medical compliance such as lack of transportation, illiteracy, or other social determinants that impact a member's health, and ensures services are delivered and continuity of care is maintained. The position analyzes the home and community environment and makes autonomous decisions regarding appropriate care plans and goals using a thorough knowledge of available community resources. These services are provided primarily in community and home settings via phone and/or in person. Local daytime travel is required via a reliable means of transportation insured following Company policy. This position will have work-from-home opportunities. GENERAL CARE COORDINATION REQUIRED: Licensed BSN/ADN Licensed BSW PREFERRED: Licensed MSW and/or Certified Case Manager (CCM) designation Experience in case management, human services, public health, or experience with the underinsured population Also requires a valid driver's license in good standing, willingness to submit to vaccine testing and screening, and may require significant face-to-face member contact with duties performed away from the principal place of business. All positions require excellent interview and telephone skills as well as the ability to deal with recipients in a caring and helpful manner. The Care Coordinators should have a working knowledge of health-related service delivery systems and excellent communication and relationship skills. This position requires the ability to analyze varied environmental factors to members' well-being and work independently in an autonomous setting and the ability to locate, augment, and develop resources, including information on services offered by other agencies.

Social Workers! VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is currently seeking a SW, Care Coordinator 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 can 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! VIVA HEALTH employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team! The ideal candidate will be located in Jefferson or Shelby county. Care Coordinators use psychosocial and/or clinical knowledge to provide non-clinical services for Medicaid recipients to improve the medical compliance and health outcomes of the populations served. This position identifies barriers to medical compliance such as lack of transportation, illiteracy, or other social determinants that impact a member's health, and ensures services are delivered and continuity of care is maintained. The position analyzes the home and community environment and makes autonomous decisions regarding appropriate care plans and goals using a thorough knowledge of available community resources. These services are provided primarily in community and home settings via phone and/or in person. Local daytime travel is required via a reliable means of transportation insured following Company policy. This position will have work-from-home opportunities. GENERAL CARE COORDINATION Required: Licensed BSW Preferred: Licensed Master of Social Work (LMSW) designation and/or Certified Case Manager (CCM) designation Experience in case management, human services, public health, or experience with the underinsured population Also requires a valid driver's license in good standing, willingness to submit to vaccine testing and screening, and may require significant face-to-face member contact with duties performed away from the principal place of business. All positions require excellent interview and telephone skills as well as the ability to deal with recipients in a caring and helpful manner. The Care Coordinators should have a working knowledge of health-related service delivery systems and excellent communication and relationship skills. This position requires the ability to analyze varied environmental factors to members' well-being and work independently in an autonomous setting and the ability to locate, augment, and develop resources, including information on services offered by other agencies.

Vendor Contract Administrator 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 Vendor Contracts Administrator is responsible for administering the full lifecycle of vendor contracts from development and execution through renewal and performance tracking, while maintaining accuracy, compliance, and alignment with VIVA HEALTH'S policies, regulatory standards, and operational needs. Key Responsibilities * Administer and maintain all vendor contracts within the contract management system, ensuring version control, accuracy, and accessibility. * Coordinate contract drafting, review, approval, and execution processes across internal departments. * Track key contract milestones, renewal dates, and performance obligations to ensure timely and compliant vendor management. * Act as the primary point of contact for contract inquiries, updates, and reporting. * Support vendor on-boarding by ensuring required documentation and internal approvals are complete prior to activation. * Prepare and maintain reports and dashboards related to contract status, expirations, and performance metrics. * Serve as the subject matter expert for the contract management system. Support user training, enhancements, and process improvements. * Assist with internal and external audits, providing documentation and data as needed to demonstrate compliance with VIVA HEALTH and regulatory standards. * Assist with contract negotiations and modifications. * Identify opportunities to enhance contract processes, improve efficiency, strengthen vendor governance, and improve accountability. REQUIRED QUALIFICATIONS: * Bachelor's Degree in Business Administration, Healthcare Administration, Legal Studies, or related field * Minimum of 3-5 years of experience in contract administration, preferably within a health plan, healthcare organization, or regulated industry * Exceptional attention to detail and organizational skills * Strong written and verbal communication abilities * Proactive with the ability to manage multiple priorities and meet deadlines in a fast-paced environment * Strong analytical, critical thinking, and problem-solving skills * Proficiency with contract management software * Proficiency with Microsoft Office applications, including Excel and Word * Understanding of healthcare compliance requirements (HIPAA, CMS, OIG, etc.) PREFERRED QUALIFICATIONS: * 5-7 years of experience in contract administration, preferably within a health plan, healthcare organization, or regulated industry * Certification in Contract Management (IACCM/WorldCC or NCMA) * Experience working for a regional or mid-size health plan * Familiarity with vendor risk management and procurement processes

Manager of Information Security 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 Manager of Information Security oversees and mentors a team of security engineers while remaining hands-on in designing, implementing, and monitoring security measures that safeguard the organization's digital assets. This individual will need a broad and strategic knowledge of principles, practices, and procedures in information security to plan, design, develop, execute, and support critical systems and projects. This role will lead the planning, design, enforcement, and audit of enterprise-wide security policies and procedures which safeguard the integrity of and access to enterprise systems, files, and data elements while actively engaging in tactical execution. This position will continuously assess, refine, and implement data security strategies proactively advising leadership with actionable risk assessments and security briefings. This individual evaluates and deploys emerging technologies, collaborates across IT Operations and Development, and strengthens organizational resilience by championing employee education, security culture, security best practice, and continuous improvement. This role drives value by balancing leadership responsibilities with direct technical contributions, ensuring scalable protection aligned with future business growth. Key Responsibilities * Direct and actively contribute to day-to-day security operations. * Perform hands on technical work in daily security operations while guiding team performance. * Lead the development and enforcement of comprehensive, scalable security policies and frameworks. * Recommend, implement, and optimize security protections across enterprise systems. * Conduct and oversee vulnerability assessments, mitigation, and remediation strategies. * Monitor and interpret threat intelligence using organizational tools. * Research, identify, and deploy solutions that strengthen the organizations cyber defense posture. * Detect, investigate, and resolve potential security breaches. * Participate in the vetting and management of third-party vendors and business associates. * Drive enterprise-wide risk assessments with quantifiable, business-aligned outcomes. REQUIRED QUALIFICATIONS: * Bachelor's Degree in Information Systems or related field or equivalent work experience * 7 years of I.T. environment experience with progressive responsibilities * 3+ years management experience in I.T. * Expertise in risk assessment tools, methodologies, and data-driven decision-making * Proficiency of security platforms such as: endpoint detection and response (EDR), internet traffic for both onsite remote users, and intrusion prevention (IDS/IPS/DLP) * Knowledge of databases (MSSQL/MongoDB/MySQL) * Advanced skills in Azure cloud including Purview and Defender * Hands on experience in penetration testing and vulnerability management * Knowledge of firewall and intrusion detection/prevention protocols * Proven ability to lead system administration and security across diverse environments (Windows, UNIX, Linux) * Skilled in drafting, enforcing, and scaling security policies, standards, and procedures * Strong communicator who can translate complex security risks into actionable business terms for executives * Ability to read and use the results of mobile code, malicious code, and anti-virus software PREFERRED QUALIFICATIONS: * CISSP, CISM, or equivalent advanced certifications * Knowledge of disaster recovery, computer forensic tools, technologies, and methods * Strong understanding of software development frameworks and code review * Knowledge of virtualization technology

**Role Overview:** The Product Submission Lead leads the enterprise's Qualified Health Plan (QHP) submission effort. The Lead is accountable for understanding, socializing, and complying with multiple state-specific and federal guidelines and filing deadlines throughout the year. The Product Submission Lead coordinates the annual QHP filing and certification process for existing ACFC Exchange markets and designated expansion states. Facilitates the QHP and certification process with business function stakeholders, third-party vendors, and supporting subject matter experts to obtain all required information to complete the filing and other related deliverables and submit the file according to applicable state and federal guidelines on the appropriate platform(s) (e.g., HIOS, SERFF). **Work Arrangement:** + Remote - Associate can work remotely anywhere in the United States. **Responsibilities:** + Supports the Affordable Care Act (ACA) product portfolio lifecycle and prepares necessary data and analyses. + Responsible for receiving, logging, assigning, tracking, and reporting status objections from the states and federal government through completion and regularly reporting them to the stakeholders and department leadership. + Works on topics of moderately complex scope, requiring the exercise of independent judgment (within defined practices and procedures), the application of subject matter expertise, and proficiency with Microsoft Office, regulatory systems, and submission tools. + Integrates and coordinates the work efforts and deliverables of small to medium cross-functional teams and can manage several tasks simultaneously within tight time frames. + Manages first to mid-level stakeholder relationships. **Education & Experience:** + 1 to 3 years in a project management or similar role; previous experience or familiarity with the ACA QHP filing process preferred. + Bachelor's Degree or equivalent experience. + Advanced proficiency in Microsoft Office Word, Excel, Outlook, PowerPoint, SharePoint, and Visio. + Experience with government programs and tools related to filing, finding, and utilizing online resources. + Demonstrates working knowledge of health plan business functions, capabilities, operational policies, and processes. **Skills & Abilities:** + Detail-oriented, able to work in "gray areas" towards a solution. + Strong organizational and communication skills and the ability to communicate with all organizational levels. + Ability to function at a high level with minimum supervision. + Demonstrated ability to learn and apply the learning in a business environment. + Ability to communicate with leadership. + Proven ability to work across organizations and gain/build stakeholder trust. ; 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.

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 Coverage Determination Pharmacist will provide leadership at the health plan regarding clinical pharmacy decisions and programs. This position will serve as a clinical reviewer for the Plan's Commercial (employer groups) and Medicare Part D Coverage Determinations. Key Responsibilities * Perform Coverage Determination reviews (prior authorizations, formulary exceptions, etc.) for both Medicare and Commercial lines of business. Reviews will be completed in accordance with applicable policies and procedures, regulations, and guidelines. * Research individual cases and render decisions with Pharmacy department leaders or Medical Director input as needed. * Assist in maintaining criteria for pharmacy related coverage determinations, exception requests, complaints, and appeals, and ensure criteria and decisions are properly communicated and applied. * Assist department management in the development and maintenance of coverage determination decision trees. * Assist in ensuring processes are carried out in accordance with Centers for Medicare & Medicaid Services (CMS) and other regulatory requirements. REQUIRED QUALIFICATIONS: * Registered Pharmacist (Rph) or Doctor of Pharmacy (PharmD) * Licensed Pharmacist in good standing with the State of Alabama * Excellent oral and written communication skills * Good computer skills including Microsoft suite of products PREFERRED QUALIFICATIONS: * 5 years' experience in Medicare Advantage Coverage Determinations, health plan, or pharmacy benefits management

Provider Services Specialist Work Schedule: This is an onsite position, working in the VIVA HEALTH corporate headquarters in Birmingham, AL. 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, receiving at least a 4 out of 5 Star rating for 10 years in a row, 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 Appeals Specialist is responsible for the intake of all appeals received from contracted and non-contracted providers in a timely and accurate manner. This role will assist in processing the intake of appeals from mail, email, fax and other electronic means and is responsible for ensuring appeals are entered correctly and timely into the department's database system. This individual will assist in the coordination of a timely resolution according to federal and state guidelines and VIVA HEALTH policies and procedures. This position will also assist with intake of Medicare appeals and grievances received from members and non-contracted providers. Key Responsibilities * Record appeals in the department's system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case. * Classify contracted and non-contracted provider appeals according to federal and state regulations, as well as internal and organizational policies and procedures. * Route appeals to other departments as needed for investigation to resolve the cases. * Route other incoming mail, email and faxes to the appropriate departments in a timely manner. * Assist with recording Medicare appeals and grievances requests in the department's system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case. * Be available to work 8 a.m. to 5 p.m. Monday through Friday at the Company's corporate headquarters, plus overtime and weekends as required. REQUIRED: * High School Diploma or GED * 1+ years' experience in managed care, health care customer service, or appeals and grievances * Excellent written and verbal communication skills, interpersonal skills, organization skills, and the ability to handle multiple tasks * Ability to carefully follow processes in sequential order * Ability to meet established productivity, schedule adherence, and quality standards * Attention to detail and ability to meet strict deadlines * Ability to learn and use various computer platforms and ability to use applications of Microsoft Office * Ability to use critical thinking skills to develop solutions to non-clinical issues using fact-based decision making * Ability to work occasional planned and unplanned overtime to meet deadlines with minimal supervision PREFERRED: * Associate's Degree * 1+ years' experience processing Medicare appeals and grievances * Knowledge of Medicare regulations * Experience with administrative and/or coordinator positions with exposure to protected health information (PHI)

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

Work Schedule: Hybrid schedule with regular onsite presence at the VIVA HEALTH corporate office and some work-from-home opportunities. 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, receiving a 5 out of 5 Star rating - the highest rating a Medicare Advantage Plan can achieve 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 Medicare Appeals & Grievances Specialist is responsible for intake of all Medicare appeals and grievances received from members, non-contracted providers, and government entities in a timely and accurate manner. This position will assist in processing the intake of appeals and grievances from mail, email, fax, and other electronic means and is responsible for ensuring appeals and grievances are entered correctly and timely into the department's database system. Will assist in the coordination of a timely resolution according to federal and state guidelines and VIVA HEALTH policies and procedures. Key Responsibilities Record appeals and grievances in the department's system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case. Classify member and non-contracted provider Medicare grievances and appeals according to federal and state regulations, also internal and organizational policies and procedures. Route appeals and grievances to other departments as needed for investigation to resolve the cases. Maintain production and quality goals in accordance with department metrics. Alert department leaders when an increase in volume might cause a backlog. REQUIRED: High School Diploma or GED 1+ years' experience working in managed care, healthcare customer service, or appeals and grievances Excellent written and verbal communication skills, interpersonal skills, organization skills, and the ability to handle multiple tasks Ability to carefully follow processes in sequential order Ability to meet established productivity, schedule adherence, and quality standards Attention to detail and ability to meet strict deadlines Ability to learn and use various computer platforms and ability to use applications of Microsoft Office Ability to use critical thinking skills to develop solutions to non-clinical issues using fact-based decision making Ability to work occasional planned and unplanned overtime to meet deadlines with minimal supervision PREFERRED: Associate's Degree 1+ years' experience processing Medicare appeals & grievances Knowledge of Medicare regulations Experience with administrative and/or coordinator positions with exposure to protected health information (PHI)

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: * Graduate of a professional program of nursing or a Master's level degree in a health-related field * 5 years of management experience in Acute, Post-acute, or managed care setting * Current RN License or LBSW license in good standing in 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 * 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 LMSW license in good standing in the State of Alabama * Chronic Care Management (CCM) * Knowledge of community resources and Medicaid regulations

VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is currently seeking a Manager, RN Care Management in Birmingham, AL! VIVA HEALTH knows that nursing is not just a job, it is a calling. If you want to fulfill your healthcare calling, 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 an excellent benefits package including tuition reimbursement for employees and dependents, paid parental leave, and a paid day for community service, to name a few! VIVA HEALTH has been the first and only Alabama-based plan to be named an overall 5-out-of-5 Star Medicare Advantage Plan. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Join our team! The Manager, RN Care Management is responsible for the coordination, development, administration. and implementation of Care Management programs. This position provides supervision to assigned Care Management staff in providing one-on-one care management and is the primary liaison between the health plan and the providers. This individual will work with the Chief Medical Officer, Behavioral Health Medical Director, and designees to provide clinical oversight and clear directives of objectives and goals for the assigned team. This role assesses the information and tools needed to better manage Care Management members, measures outcomes through analysis of reports, and monitors the documentation and effectiveness of the interventions provided by the Care Managers. This position travels to locations within the relevant service area through a reliable means of transportation insured in accordance with Company policy and will have work-from-home opportunities. REQUIRED: * Graduate of an accredited program of professional nursing, ADN/BSN * Three years of supervisory experience * 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 * Excellent written and verbal communication skills * Strong organizational and time management skills * Ability to manage and direct personnel in a positive and effective manner * Good computer and data entry skills * Ability to be flexible, adaptable, and able to work effectively in a variety of settings * Strong professional level of knowledge in the adult population and chronic disease management PREFERRED: * Experience in Acute/or post-acute settings * Certified Case Manager (CCM) * Knowledge of Microsoft Word and Excel * Knowledge of community resources, Medicare and Medicaid regulations

VIVA HEALTH, ranked one of the Best Places to Work by Modern Healthcare, is currently seeking a Manager, Care Coordinator in Auburn, AL! The Manager, Care Coordination will supervise the day-to-day operations of a Care Coordination team, including program policies and procedures, documentation and records, and will work collaboratively with ACHN leadership to support overall quality goals. This position will work both internally and externally to ensure timely and efficient care is accessible to patients and to support delivering care providers. This position will also provide clear direction for achieving team goals and objectives. This position will travel to locations within the relevant service area through a reliable means of transportation insured in accordance with Company policy. This position will have work from home opportunities. REQUIRED: BSN Three years of experience in care coordination or case management in a medical or behavioral health setting One year of experience in a supervisory or management role Current RN license in good standing with the appropriate 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 Excellent interview and telephone skills, as well as the ability to deal with providers and team members in a caring and helpful (assertive and tactful) manner Working knowledge of health-related service delivery systems Excellent communication and relationship skills Ability to analyze varied environmental factors in relation to members' wellbeing Organization and time management skills Ability to be flexible, adaptable and work effectively in a variety of settings Basic computer skills PREFERRED: CCM Certification Ability to utilize Microsoft Word and Excel

Manager of Information Security 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 Manager of Information Security oversees and mentors a team of security engineers while remaining hands-on in designing, implementing, and monitoring security measures that safeguard the organization's digital assets. This individual will need a broad and strategic knowledge of principles, practices, and procedures in information security to plan, design, develop, execute, and support critical systems and projects. This role will lead the planning, design, enforcement, and audit of enterprise-wide security policies and procedures which safeguard the integrity of and access to enterprise systems, files, and data elements while actively engaging in tactical execution. This position will continuously assess, refine, and implement data security strategies proactively advising leadership with actionable risk assessments and security briefings. This individual evaluates and deploys emerging technologies, collaborates across IT Operations and Development, and strengthens organizational resilience by championing employee education, security culture, security best practice, and continuous improvement. This role drives value by balancing leadership responsibilities with direct technical contributions, ensuring scalable protection aligned with future business growth. Key Responsibilities Direct and actively contribute to day-to-day security operations. Perform hands on technical work in daily security operations while guiding team performance. Lead the development and enforcement of comprehensive, scalable security policies and frameworks. Recommend, implement, and optimize security protections across enterprise systems. Conduct and oversee vulnerability assessments, mitigation, and remediation strategies. Monitor and interpret threat intelligence using organizational tools. Research, identify, and deploy solutions that strengthen the organizations cyber defense posture. Detect, investigate, and resolve potential security breaches. Participate in the vetting and management of third-party vendors and business associates. Drive enterprise-wide risk assessments with quantifiable, business-aligned outcomes. REQUIRED QUALIFICATIONS: Bachelor's Degree in Information Systems or related field or equivalent work experience 7 years of I.T. environment experience with progressive responsibilities 3+ years management experience in I.T. Expertise in risk assessment tools, methodologies, and data-driven decision-making Proficiency of security platforms such as: endpoint detection and response (EDR), internet traffic for both onsite remote users, and intrusion prevention (IDS/IPS/DLP) Knowledge of databases (MSSQL/MongoDB/MySQL) Advanced skills in Azure cloud including Purview and Defender Hands on experience in penetration testing and vulnerability management Knowledge of firewall and intrusion detection/prevention protocols Proven ability to lead system administration and security across diverse environments (Windows, UNIX, Linux) Skilled in drafting, enforcing, and scaling security policies, standards, and procedures Strong communicator who can translate complex security risks into actionable business terms for executives Ability to read and use the results of mobile code, malicious code, and anti-virus software PREFERRED QUALIFICATIONS: CISSP, CISM, or equivalent advanced certifications Knowledge of disaster recovery, computer forensic tools, technologies, and methods Strong understanding of software development frameworks and code review Knowledge of virtualization technology

Nurses! VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is currently seeking a RN, Care Coordinator in Mobile, AL! 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 or weekends. This way you can do what you love at work and can 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! VIVA HEALTH employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. Come join our team! Care Coordinators use psychosocial and/or clinical knowledge to provide non-clinical services for Medicaid recipients to improve the medical compliance and health outcomes of the populations served. This position identifies barriers to medical compliance such as lack of transportation, illiteracy, or other social determinants that impact a member's health, and ensures services are delivered and continuity of care is maintained. The position analyzes the home and community environment and makes autonomous decisions regarding appropriate care plans and goals using a thorough knowledge of available community resources. These services are provided primarily in community and home settings via phone and/or in person. Local daytime travel is required via a reliable means of transportation insured following Company policy. This position will have work-from-home opportunities. GENERAL CARE COORDINATION REQUIRED: * Licensed BSN/ADN PREFERRED: * Certified Case Manager (CCM) designation * Experience in case management, human services, public health, or experience with the underinsured population Also requires a valid driver's license in good standing, willingness to submit to vaccine testing and screening, and may require significant face-to-face member contact with duties performed away from the principal place of business. All positions require excellent interview and telephone skills as well as the ability to deal with recipients in a caring and helpful manner. The Care Coordinators should have a working knowledge of health-related service delivery systems and excellent communication and relationship skills. This position requires the ability to analyze varied environmental factors to members' well-being and work independently in an autonomous setting and the ability to locate, augment, and develop resources, including information on services offered by other agencies.

Provider Services Specialist Work Schedule: This is an onsite position, working in the VIVA HEALTH corporate headquarters in Birmingham, AL. 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, receiving at least a 4 out of 5 Star rating for 10 years in a row, 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 Appeals Specialist is responsible for the intake of all appeals received from contracted and non-contracted providers in a timely and accurate manner. This role will assist in processing the intake of appeals from mail, email, fax and other electronic means and is responsible for ensuring appeals are entered correctly and timely into the department's database system. This individual will assist in the coordination of a timely resolution according to federal and state guidelines and VIVA HEALTH policies and procedures. This position will also assist with intake of Medicare appeals and grievances received from members and non-contracted providers. Key Responsibilities Record appeals in the department's system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case. Classify contracted and non-contracted provider appeals according to federal and state regulations, as well as internal and organizational policies and procedures. Route appeals to other departments as needed for investigation to resolve the cases. Route other incoming mail, email and faxes to the appropriate departments in a timely manner. Assist with recording Medicare appeals and grievances requests in the department's system(s) timely and accurately, ensuring all necessary documentation is uploaded with the case. Be available to work 8 a.m. to 5 p.m. Monday through Friday at the Company's corporate headquarters, plus overtime and weekends as required. REQUIRED: High School Diploma or GED 1+ years' experience in managed care, health care customer service, or appeals and grievances Excellent written and verbal communication skills, interpersonal skills, organization skills, and the ability to handle multiple tasks Ability to carefully follow processes in sequential order Ability to meet established productivity, schedule adherence, and quality standards Attention to detail and ability to meet strict deadlines Ability to learn and use various computer platforms and ability to use applications of Microsoft Office Ability to use critical thinking skills to develop solutions to non-clinical issues using fact-based decision making Ability to work occasional planned and unplanned overtime to meet deadlines with minimal supervision PREFERRED: Associate's Degree 1+ years' experience processing Medicare appeals and grievances Knowledge of Medicare regulations Experience with administrative and/or coordinator positions with exposure to protected health information (PHI)

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 Executive Director, Lead Medical Director is responsible for providing direction and support on medical, pharmaceutical, and quality issues related to the members of VIVA HEALTH. This position will oversee the Medical Directors and be involved in coordinating coverage for the utilization review team, the case management daily review for acute, transitions of care staff, post-acute care, and pharmacy redeterminations. This role in collaboration with the Vice President, Clinical Services will co-chair the Utilization Management/Quality Improvement (UM/QI) committee, Credentialing Committee, and serve on other committees as needed. This position will prepare utilization data, high-cost trending, and collaborate with the facility partners at the quarterly Joint Operating Committee meetings and monthly clinical calls. Key Responsibilities Provide direction and support while offering a quality medical perspective to the Medical Management department. Assist in developing and implementing operational processes, including but not limited to workflow changes, departmental documentation, and staff education to maximize departmental efficiency. Assist with the relationships between VIVA HEALTH and participating network physicians. This includes initiating discussions with physicians to make appropriate medical review decisions and responding to requests for discussion of cases, approval/denial decisions, etc. Provide assistance to the Provider Services department for physician education initiatives as needed. Provide support to internal staff in the Quality, Pharmacy, and Credentialing departments to create sound policies, procedures, and departmental goals. Act as Chair for corresponding committees when asked by the Vice President, Clinical Services. Aid in oversight and audits as needed. Administer best practices guidelines and provide guidance to Case Management for concurrent review. Assist in the development of medical necessity criteria on both new and/or uncommonly used drugs for use in coverage and denial decisions. Serve as a subject matter expert in the grievance process and provide official signoff for all denial decisions. Formulate and recommend cost containment ideas for patients in either an ambulatory or hospital setting. Provide internal decision support regarding medical necessity and over/under utilization of medical services in the VIVA HEALTH member population. Provide on-call coverage and assistance to nurses outside normal business hours to ensure required turnaround times are met. Maintain working knowledge of VIVA HEALTH Certificates of Coverage for its unique member populations and assist in ongoing document development. REQUIRED QUALIFICATIONS: Medical degree from an accredited University 10 or more years clinical experience in direct patient care Management or Supervisory experience Current Physician license in good standing in the State of Alabama Board Certified Physician Ability to identify problems, collect data, establish facts, and draw valid conclusions Strong analytical, time management, and organizational skills; Ability to integrate diverse objectives with a high level of attention to detail Ability to read, analyze, and interpret various materials and effectively present information to individuals and groups; Effective oral and written communication skills Proficient in basic mathematical skills; Ability to read and explain graphs and charts Ability to read, analyze, and interpret procedures as well as government regulations; Ability to effectively present information and be persuasive in both one-on-one and group settings Ability to maintain favorable public relations while remaining sensitive to a variety of cultural, social, and educational backgrounds; Culturally sensitive with prior experience working with diverse groups on personal and financial issues; Skilled in discussion facilitation and problem solving Basic PC skills, including but not limited to Microsoft Word and Excel proficiency; Ability to use Electronic Health Record Knowledge of information and techniques needed to diagnose and treat human injuries, diseases, and deformities; This includes symptoms, treatment alternatives, drug properties and interactions, and preventative health care measures Knowledge of general medical principles and practices; Ability to assess and problem solve while working with a healthcare team; Ability to remain calm under stress Administrative and supervisory skills PREFERRED QUALIFICATIONS: Experience in both inpatient and outpatient clinical settings Experience in managed care and/or population health

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 in Montgomery, AL! 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: Graduate of a professional program of nursing or a Master's level degree in a health-related field 5 years of management experience in Acute, Post-acute, or managed care setting Current RN License or LBSW license in good standing in 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 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 LMSW license in good standing in the State of Alabama Chronic Care Management (CCM) Knowledge of community resources and Medicaid regulations