Teams at Altais

Processes incoming medical authorizations through Tapestry Link and OnBase, verifies eligibility and benefits, reviews requests, prepares denial letters, and obtains missing clinical documentation from provider offices. Provides authorization support to internal and external customers, documents activities accurately, meets turnaround requirements, maintains confidentiality and HIPAA compliance, and cross-trains with other utilization management coordinators.

Leads development and delivery of complex healthcare, clinical, provider, and financial datasets. Provides enterprise reporting, dashboards, data visualization, business intelligence, and decision support. Analyzes cost, utilization, provider, member, and clinical data to identify inefficiencies and savings opportunities. Serves as an internal analytics consultant, improves data procedures, automates reporting processes, trains team members, and ensures validation and documentation standards.

Analyzes, validates, and maintains provider data for credentialing, enrollment, health plan rosters, and regulatory submissions. The role performs data reconciliation, quality checks, reporting, exception resolution, and audit support while collaborating with credentialing, operations, compliance, contracting, enrollment, and IT teams. It also supports process improvement, automation, data governance, system testing, and documentation to improve provider data accuracy and submission timeliness.