Responsible for quality assurance, accuracy and overall integrity of the UAS-NY assessment data and visit documentation completed by core team nurses as well as, business partners’ nurses.
Performing assessment audits, identifying trends that require staff retraining, and implementing corrective action plans in collaboration with Clinical management staff.
Responsible for ongoing orientation, training and education of Assessment Nurses conducting UAS-NY assessments, and participate in establishing educational modules for staff orientation and re-training.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that are expanding services in response to patients' and members' needs. MJHS is a supportive community committed to excellence, respect, and providing high-quality, personalized health care services.
Demonstrates knowledge of basic audit skills and adheres to Internal Audit Standards and UPH Internal Audit policies and methodologies.
UnityPoint Health is committed to their team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row. They champion a culture of belonging where everyone feels valued and respected, and believe in equipping you with support and development opportunities to deliver an exceptional employment experience.
Participate in provider case reviews to identify trends and deficits.
Coach providers and participate in client meetings to support expectations.
Contribute to workflow design, QA improvements, and risk management.
Amwell transforms healthcare with technology and people. They aim to provide convenient, affordable, and effective care, serving large healthcare organizations in the U.S. and worldwide.
Enhance healthcare quality by overseeing performance improvement initiatives.
Ensure compliance with regulations and support data analysis.
Monitor quality metrics and drive projects to improve healthcare outcomes.
Jobgether is a platform that connects job seekers with potential employers, using AI to match candidates with roles. They focus on ensuring applications are reviewed fairly and efficiently.
Work in a partially remote environment, collaborating with team members virtually each day.
Serve as a Subject Matter Expert (SME) on quality improvement measures, customer needs, and payer‑specific quality initiatives across commercial and government programs.
Conduct proactive patient outreach to identify and close quality gaps—educating patients, scheduling screenings, supporting treatment plan adherence, and improving outcomes.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Review clinical documentation for accuracy and compliance.
Evaluate CDI program effectiveness and identify gaps.
Provide feedback to improve documentation quality.
UASI has over 40 years of experience and enduring partnerships with its valued clients. They are proud of the stability they've built and the long-term success of their dedicated team.
Responsible for assisting in managing Epic in baskets including but not limited to results, orders, and patient messages.
Complete tasks within scope of certification, licensure and competency as delegated by provider to support patient care.
Provider appropriate and timely documentation in the patient’s electronic medical record using standardized workflows and processes
UnityPoint Health is committed to its team members and is recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare. They champion a culture of belonging where everyone feels valued and respected, honoring the ways people are unique and embracing what brings them together.
Responsible for coding procedures and entering charges to comply with regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to assure necessary documentation is present.
Participates in audits to evaluate code accuracy and develops methodologies to improve coding issues.
Northside Hospital is an award-winning and state-of-the-art healthcare provider that is continually growing. By constantly expanding the quality and reach of our care we hope to create even more opportunity for the best healthcare professionals in Atlanta and beyond.
Responsible for conducting medical records and coding related reviews to validate the integrity of coded procedures.
Works closely with clinical departments and Revenue Cycle Services to ensure compliance with coding guidelines, government, payer and internal charge capture policies.
Provides education and training to clinical providers and staff within the practices on proper documentation and coding guidelines, practices and procedures.
They are committed to diversity and inclusion, welcoming all as valued members. They focus on providing the highest level of care by taking care of their incredible teams.
Stand up and run the daily clinical operations for PIN/CHI delivery.
Define the care team structure, supervision ratios, and operating cadence.
Ensure billing-ready documentation is completed correctly every time. Partner with Compliance + RCM support to prevent leakage/denials caused by ops errors.
Carewell is focused on providing the most trusted and reputable retail source for caregiving products. They have been recognized as one of the fastest-growing companies in the US.
Support the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network–Quality Improvement Organization (QIN-QIO) Program.
Provide hands-on technical assistance and quality improvement (QI) support to healthcare providers.
Collaborate with providers to assess performance, conduct root cause analyses, and co-develop Quality Action Plans (QAPs).
Health Services Advisory Group (HSAG) is dedicated to transforming healthcare delivery in the United States. They are a growing team focused on improving healthcare quality, safety, and outcomes.
Oversee full operational execution of the Thera Nurse Navigator Program, ensuring alignment with program goals, compliance standards, and client expectations.
Deliver high‑quality patient education on therapy, disease state, expectations, and adherence support.
Provide coaching, guidance, and ongoing mentorship to Nurse Navigators to ensure adherence to program protocols, SOPs, and quality standards.
EVERSANA is committed to creating and delivering next-generation commercialization services to the life sciences industry, serving more than 650 clients. Their global team of more than 7,000 employees are grounded in their cultural beliefs and dedicated to improving patient lives around the world.
Provide high-quality, evidence-based primary care via telehealth.
Help establish and maintain a QA program.
Serve as a Pod Lead for a group of clinicians.
Vitable is a health benefits platform that makes healthcare better for employers of everyday workers, bringing accessible, high-quality care to millions. They are growing rapidly and looking for eager team members who are hungry for change and passionate about delivering better care.
Responsible for the review and update of existing concepts based upon required periodic review cycle or as needed based upon client or regulatory changes.
Collaborates with and leverages Segment Specialist expertise to ensure on-point results and ensure training material updates as necessary.
Conduct research, identify impact on existing concepts, and document accordingly and support activities required to package concepts.
Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plans. They are deployed by over 75 health plans, representing more than 170 million lives, and use an AI operating system, combined with expertise, to untangle healthcare data.
Perform comprehensive review and oversight of medical records for Risk Adjustment compliance keeping with CMS and departmental guidelines with a 95%+ accuracy rate
Collaborates with a variety of internal and external clients, including health care executives, physicians, provider office personnel, and payer representatives from various health plans to streamline and optimize accurate diagnosis code capture.
Reviews medical records and billing history to determine if specific disease conditions were correctly billed and documented.
Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote them one of the “Best Places to Work in PA” and they recognize that work is a part of life, not separate from it, and foster a flexible environment.
Interpret and apply CMS, Medicare, Medicaid, and AMA policies to define claims editing logic.
Analyze claims and edit performance data to confirm accuracy and prioritize enhancements.
Monitor regulatory updates and coding changes to keep edits current and compliant.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. They use an AI-powered platform with expertise across the payment continuum, serving over 85 health plans and 270 million lives.
Review daily inpatient and observation admissions to determine appropriate status.
Collaborate with physicians, case management, and insurance partners.
Utilize electronic medical records to support documentation, review, and reporting.
Logan Health aims to deliver quality, compassionate care for all, reimagining health care through connection, service and innovation. They value kindness, collaboration, trust, and strive for excellence in a supportive, mission-driven nursing culture.
Acting as first point of contact for all inbound compliance queries, routing matters as necessary to appropriate team members and tracking completion
Supporting and coordinating recurring compliance tasks that help mitigate regulatory risk to the company
Assisting with preparation and submission of routing regulatory filings such as state registrations and annual reports
Virta Health is dedicated to reversing metabolic disease in one billion people through personalized nutrition and virtual care. They have raised over $350 million and partner with health plans, employers, and government organizations.
Performs final reconciliation on clinic/provider visits, resolving documentation issues.
Reviews, abstracts, and codes multiple services and complex cases, assigning classifications.
Researches/resolves high volume accounts/claims and educates staff on guidelines.
University of Utah Health is a patient-focused organization with a mission to enhance the health and well-being of people through patient care, research, and education. They have five hospitals and eleven clinics and are known as a Level 1 Trauma Center, nationally ranked for academic research and patient experience.