Coho Integrated Solutions Jobs

Copper River Strategies is seeking an experienced Program Director (PD) to oversee contract operations and provide strategic leadership for a healthcare insurance program. The Program Director will be responsible for managing staffing, deliverables, quality assurance, risk mitigation, reporting, and stakeholder communication while ensuring successful contract performance and operational execution. The ideal candidate will bring extensive healthcare insurance experience, strong knowledge of Medicare Advantage, and proven leadership managing programs involving significant volumes of Protected Health Information (PHI). This position is primarily remote; however, onsite presence at the Center for Medicare & Medicaid Services (CMS) in Baltimore, Maryland, may be required on an as-needed basis to support program requirements, stakeholder meetings, and other business needs. Responsibilities (include but are not limited to): Oversee all contract operations and ensure successful execution of program requirements. Lead staffing, workforce planning, and personnel management activities. Manage the development, review, and timely delivery of contract deliverables. Establish and maintain quality assurance processes and performance standards. Identify, assess, and mitigate operational, compliance, and program risks. Develop and provide regular program status reports to leadership and stakeholders. Serve as a primary point of contact for Government and organizational stakeholders. Ensure appropriate handling, protection, and management of programs involving large volumes of Protected Health Information (PHI). Monitor operational performance and implement corrective actions when necessary. Coordinate cross-functional teams to ensure alignment with program objectives. Ensure compliance with applicable healthcare insurance and Medicare program requirements. Provide strategic leadership and operational oversight to support continuous program improvement. Essential Job Qualifications and Requirements: Education: Bachelor's or master's degree in Public Policy, Health, Business, or a related field from an accredited institution. Minimum of five (5) years of management experience with a master's degree, OR seven (7) years of management experience with a bachelor's degree Required Experience: Minimum of eight (8) years of experience in healthcare insurance, including Medicare, Medicaid, or private health insurance Demonstrated experience managing operations involving significant amounts of Protected Health Information (PHI) Demonstrated Knowledge & Skills: Strong knowledge of Medicare Advantage (Part C) Strong leadership, organizational, analytical, and communication skills Contract operations and deliverable management Quality assurance and performance management Risk mitigation and issue resolution Staffing and workforce management Program reporting and stakeholder communications Strategic planning and operational process improvement Position Pay Range $135,000 — $200,000 USD About Copper River & The Native Village of Eyak: Owned by the Native Village of Eyak (NVE), a federally recognized Alaska Native Tribe, the Copper River Family of Companies are a collection of entities that deliver a complementary set of solutions and services to support the diverse missions and requirements of our clients. Proud participants of the Small Business Administration’s (SBA) 8(a) Business Development Program since 2006, our companies consist of both current and graduation SBA 8(a) entities. It is our collective purpose to support the Tribe and diversify the NVE’s ability to facilitate economic advancement. The income generated from our companies helps the Native Village of Eyak fund health and social services, economic development, natural resource/environmental education, jobs, job training, and other benefits to the NVE in a manner that is consistent with Alaskan Native cultural values and traditions. Copper River’s Culture The Copper River Family of Companies has a positive, supportive, and thriving culture. At the foundation of our culture is a focus on collaboration. No matter your role or which operating company you work for, we are ONE TEAM working toward the same goals for our customers and for our collective owner- The Native Village of Eyak. How we treat each other is just as important as the work we deliver. Benefits Comprehensive medical, dental, and vision coverage Flexible Spending Account - healthcare and dependent care Health Savings Account - high deductible medical plan Retirement 401(k) with employer match Open leave policy and paid holidays Additional benefits including tuition reimbursement, transportation expense account, employee assistance program, and more! Note : These benefits are only applicable to full time, regular associates at Copper River. Disclaimer: The Copper River Family of Companies provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Copper River Strategies is seeking a Physician Consultant to provide clinical expertise and medical oversight in support of healthcare insurance operations. The Physician Consultant will resolve complex medical record issues, interpret clinical documentation, support intake, coding, quality assurance, and appeals activities. This position requires an actively practicing, board-certified physician with experience in health insurance, utilization review, or claims and a strong understanding of Medicare program requirements and clinical guideline interpretation. This position is primarily remote; however, onsite presence at the Center for Medicare & Medicaid Services (CMS) in Baltimore, Maryland, may be required on an as-needed basis to support program requirements, stakeholder meetings, and other business needs. Responsibilities (include but are not limited to): Provide clinical expertise in the review and interpretation of complex medical records. Resolve complex clinical documentation and medical record issues. Interpret clinical documentation in accordance with applicable medical guidelines and program requirements. Support intake and clinical review processes. Provide clinical guidance supporting coding accuracy and consistency. Support quality assurance activities and clinical quality reviews. Assist with the review and resolution of medical appeals. Apply clinical judgment to complex cases requiring physician-level expertise. Interpret Medicare program requirements and applicable clinical guidelines. Collaborate with clinical, operational, coding, quality assurance, and appeals teams. Provide recommendations regarding complex medical and clinical issues. Support continuous improvement of clinical review and healthcare insurance processes. Essential Job Qualifications and Requirements: Education and License: Board certified for a minimum of three (3) years in an American Board of Medical Specialties (ABMS)-recognized specialty Medical degree from an accredited medical school required Active, valid, unrestricted U.S. medical license required Required Experience: Actively practicing physician with a minimum of three (3) years of clinical practice experience Experience in health insurance, utilization review, or claims Demonstrated Knowledge & Skills: Knowledge of the Medicare program Demonstrated ability to interpret and apply clinical guidelines Strong analytical, clinical judgment, and communication skills Clinical evaluation and medical record interpretation Clinical documentation interpretation Coding review and clinical coding support Quality assurance and clinical quality review Appeals and complex case resolution Medicare program requirements Interpretation and application of clinical guidelines Position Pay Range $160,000 — $220,000 USD About Copper River & The Native Village of Eyak: Owned by the Native Village of Eyak (NVE), a federally recognized Alaska Native Tribe, the Copper River Family of Companies are a collection of entities that deliver a complementary set of solutions and services to support the diverse missions and requirements of our clients. Proud participants of the Small Business Administration’s (SBA) 8(a) Business Development Program since 2006, our companies consist of both current and graduation SBA 8(a) entities. It is our collective purpose to support the Tribe and diversify the NVE’s ability to facilitate economic advancement. The income generated from our companies helps the Native Village of Eyak fund health and social services, economic development, natural resource/environmental education, jobs, job training, and other benefits to the NVE in a manner that is consistent with Alaskan Native cultural values and traditions. Copper River’s Culture The Copper River Family of Companies has a positive, supportive, and thriving culture. At the foundation of our culture is a focus on collaboration. No matter your role or which operating company you work for, we are ONE TEAM working toward the same goals for our customers and for our collective owner- The Native Village of Eyak. How we treat each other is just as important as the work we deliver. Benefits Comprehensive medical, dental, and vision coverage Flexible Spending Account - healthcare and dependent care Health Savings Account - high deductible medical plan Retirement 401(k) with employer match Open leave policy and paid holidays Additional benefits including tuition reimbursement, transportation expense account, employee assistance program, and more! Note : These benefits are only applicable to full time, regular associates at Copper River. Disclaimer: The Copper River Family of Companies provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.