Whether helping an employer improve the health and well-being of its employees, a state Medicaid director with cost containment or managing federal programs that are advancing innovation in healthcare delivery, the depth and breadth of our healthcare expertise is what sets us apart.
For more than 45 years, Telligen solutions have been delivering true results for health plan sponsors and federal and state programs.

Telligen

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manager

Telligen is a trusted partner for U.S. government health agencies, state Medicaid agencies, self-funded employer and Taft-Hartley health plans, and managed care organizations. The company aims to improve health outcomes for millions of people nationwide through proven health management solutions and healthcare expertise. Telligen provides quality improvement, data analytics, quality measures, program management, and health information technology solutions to federal and state health agencies and national programs. It also offers utilization management, care management, and wellness solutions for health plans and employers. Their work includes efforts as a Quality Innovation Network-Quality Improvement Organization and a Hospital Quality Improvement Contractor across multiple states. Telligen has received Population Health Program Accreditation for its expertise in population health management.

Whether helping an employer improve the health and well-being of its employees, a state Medicaid director with cost containment or managing federal programs that are advancing innovation in healthcare delivery, the depth and breadth of our healthcare expertise is what sets us apart. For more than 45 years, Telligen solutions have been delivering true results for health plan sponsors and federal and state programs.

• Manage the day-to-day operations of Utilization Management programs across multiple contracts and populations.
• Lead planning, implementation, evaluation, and ongoing management of UM workflows to ensure compliance with regulatory, accreditation, and contractual requirements.
• Monitor key UM performance indicators including timeliness, determination accuracy, appeal overturn rates, and documentation quality. When risks or gaps are identified, leads root cause analysis and corrective action planning.
• Ensure UM operations remain compliant with applicable federal and state regulations, client requirements, and accreditation standards (e.g., URAC).
• Partner with Quality and Compliance teams to support audits, corrective action plans (CAPs), policies, procedures, and readiness activities.
• Lead continuous improvement initiatives focused on clinical consistency, medical necessity application, letter accuracy, peer review processes, and regulatory adherence.
• Maintain financial accountability for assigned UM contracts, including staffing models, productivity expectations, and budget adherence.
• Monitor operational performance against contractual service level agreements (SLAs) and utilization benchmarks.
• Participate in proposal development, pricing inputs, and operational feasibility discussions as a UM subject matter expert.
• Coach, guide, and direct UM staff to achieve individual, team, and organizational objectives.
• Ensure appropriate training, competency validation, and ongoing education for UM nurses, physician reviewers, and support staff.
• Foster a culture of accountability, clinical integrity, and continuous improvement consistent with Telligen’s Management Philosophy that managers coach, engage, and support people to achieve results.
• Represent Telligen in meetings with clients, providers, regulators, and internal stakeholders related to UM operations.
• Collaborate with Medical Directors, Compliance, Quality, and Operations leadership to resolve issues and improve service delivery.
• May present UM outcomes, trends, and improvement initiatives to internal or external audiences.
• Stay current on utilization management trends, regulatory updates, accreditation changes, and evolving medical management best practices.

Manager – Utilization Management, RN

Manager of Utilization Management responsible for operational oversight and compliance of programs at Telligen. Leading staff and ensuring quality and performance of healthcare services provided.

• Manage the day-to-day operations of Utilization Management programs across multiple contracts and populations.
• Lead planning, implementation, evaluation, and ongoing management of UM workflows to ensure compliance with regulatory, accreditation, and contractual requirements.
• Monitor key UM performance indicators including timeliness, determination accuracy, appeal overturn rates, and documentation quality. When risks or gaps are identified, leads root cause analysis and corrective action planning.
• Ensure UM operations remain compliant with applicable federal and state regulations, client requirements, and accreditation standards (e.g., URAC).
• Partner with Quality and Compliance teams to support audits, corrective action plans (CAPs), policies, procedures, and readiness activities.
• Lead continuous improvement initiatives focused on clinical consistency, medical necessity application, letter accuracy, peer review processes, and regulatory adherence.
• Maintain financial accountability for assigned UM contracts, including staffing models, productivity expectations, and budget adherence.
• Monitor operational performance against contractual service level agreements (SLAs) and utilization benchmarks.
• Participate in proposal development, pricing inputs, and operational feasibility discussions as a UM subject matter expert.
• Coach, guide, and direct UM staff to achieve individual, team, and organizational objectives.
• Ensure appropriate training, competency validation, and ongoing education for UM nurses, physician reviewers, and support staff.
• Foster a culture of accountability, clinical integrity, and continuous improvement consistent with Telligen’s Management Philosophy that managers coach, engage, and support people to achieve results.
• Represent Telligen in meetings with clients, providers, regulators, and internal stakeholders related to UM operations.
• Collaborate with Medical Directors, Compliance, Quality, and Operations leadership to resolve issues and improve service delivery.
• Stay current on utilization management trends, regulatory updates, accreditation changes, and evolving medical management best practices.

Quality Improvement Manager – Utilization Management

Manager of Utilization Management responsible for operational leadership and compliance oversight of programs at Telligen. Overseeing staff and workflows in a compliance-focused environment with performance management.

client-services-representative

• This position is responsible for receiving and responding to inbound customer inquiries
• Performing outreach to providers and members
• Providing program support for contract members
• Providing technical and administrative support for various contracts, including support of internal applications and tools

Part-Time Client Service Specialist

Part-Time Client Service Specialist responsible for customer support and outreach to providers. This role involves technical and administrative support for various contracts while working in a hybrid environment.

program-manager

• Manage customer-facing program(s) of various size and complexity.
• Direct cross-functional, multi-disciplined teams in the successful execution and timely completion of all assigned responsibilities.
• Collaborate internally and externally with other project and program management personnel, contractors, and stakeholders to configure, train, and deploy software solutions.
• Develop and administer comprehensive governance plans, detailed implementation plans, and sound training and execution strategies according to Company and customer standards.
• Collaborate with workstreams, contractors, and other stakeholders to integrate and align sub-projects and external projects to overall project plans.
• Build and maintain highly effective relationships at all levels and manage customer’s expectations for all program and related projects.
• Lead and perform implementation tasks to ensure performance targets, levels, and metrics (timeline, budget, quality, and cost) are effectively monitored and reached.
• Track and oversee the resolution of issues by the project team and escalates upstream as prescribed by policies, project charters, and governance plans.
• Manage the scope and drive delivery to ensure deliverables, work products, and expected benefits are produced in an accurate and timely manner.
• Prepare and deliver program and project-related performance data, information, and status reports to executives, management, technical and non-technical team members in various mediums.
• Develop and maintain workflow diagrams and other documentation used to optimize team performance, improve systems, and implement new clients.
• Participate in quality improvement initiatives with an emphasis on workflow optimization to ensure programs and related projects are meeting high-quality standards.
• Implement, maintain, and optimize the repositories ensuring all files, documents, and artifacts are updated timely and accurately, and stored in accordance with archiving and retention policies.
• Provide input regarding project management-related processes, qualifications, and competencies for new business development and capture.

Program Manager

Program Manager managing customer-facing programs at Telligen, a population health management organization. Directing teams and collaborating with stakeholders to deploy software solutions while ensuring quality standards.

learning-and-development

• Collaborate with client to identify training needs and create or procure training for direct support professionals, and/or case managers.
• Serve as liaison with internal and external customers to ensure projects, plans, and/or products are completed satisfactorily.
• Serve as a representative of the Company at external client meetings.
• Promote company expertise and solutions to prospective clients.
• Partner with team members and internal/external customers as necessary, to determine and evaluate methods to encourage participation in the quality improvement and/or special project initiatives.
• Maintain positive relationships with internal and external clients to ensure continued participation.
• Monitors project expenses to ensure alignment with budget.

Program Training Specialist – LTSS

Iowa Medicaid LTSS Training Specialist responsible for competency-based training for providers. Collaborating with clients and overseeing training initiatives for service compliance.

analyst

• Analyzing and designing software development processes
• Presenting recommendations for process improvements
• Organizing, developing, and delivering new processes, training, and status reports
• Facilitating the collection of software development process information
• Producing process maps of current development processes
• Reviewing, documenting, analyzing, and auditing software development processes
• Coordinating the establishment, maintenance, collection, and distribution of timeline reports
• Assisting in the development of procedures, changes, and tools to improve documentation

Process Analyst

Process Analyst responsible for analyzing software development processes at Telligen. Presenting recommendations for improvements and delivering training and status reports.

• Responsible for care management of patients with acute and chronic medical conditions.
• Assess care needs of vulnerable populations.
• Collaborate with health care providers to validate treatment plans.
• Guide members to appropriate benefit information.
• Provide ongoing education and communicate with health care providers for appropriate care.
• Document per contractual requirements.

Nurse Care Manager – Case Management, Disease Management

Nurse Care Manager responsible for care management of patients and assessing care needs in health programs. Participating in Case Management and Disease Management teams for various clients.

Telligen

About the company

Open jobs

7 jobs found

Manager – Utilization Management, RN

Telligen

Quality Improvement Manager – Utilization Management

Telligen

Part-Time Client Service Specialist

Telligen

Program Manager

Telligen

Program Training Specialist – LTSS

Telligen

Process Analyst

Telligen

Nurse Care Manager – Case Management, Disease Management

Telligen