Lead the analysis and interpretation of complex hospital market, operations and financial data.
Build and manage advanced market analysis and financial models to assess hospital market research and growth opportunities.
Develop clear, executive-level presentations and materials that communicate insights and strategic recommendations to hospital leadership.
Wipfli provides solutions for clients pursuing operational excellence and/or technical solutions. They are a firm that believes in flexibility and focuses on relationships, encouraging each individual to follow their own path.
Interpret medical rules, regulations, fee schedules, and edits that payers post.
Understand and manipulate payer data to build federal, state, and commercial coding and financial tables.
Maximize the efficiency and use of product solutions by properly maintaining payer specific edits.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. They operate across a range of markets and have an amazing team of 25,200 people in 32 countries.
Lead the resolution of complex financial and benefits billing escalations to ensure accurate member financial tracking.
Perform root-cause analysis on multi-system issues, coordinate corrective actions, and reconcile claims data across platforms.
Act as the primary bridge between internal and external teams to clarify issues and expedite resolutions while communicating clearly with members.
Maven Clinic is the world's largest virtual clinic for women and families, providing clinical, emotional, and financial support through its digital platform across fertility, maternity, parenting, and menopause care. It is an award-winning, mission-driven company trusted by over 2,000 employers and health plans, with a culture recognized for innovation and as a great place to work.
Assist with financial planning and budgeting processes to create financial plans within targeted levels.
Analyze financial statements and data and present financial data using detailed reports and charts.
Research and prepare variance analysis and explanations.
UnityPoint Health is committed to its team members and has been 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 us together.
Independently manages day-to-day application operations for assigned departments, escalating highly complex issues as needed.
Optimizes the application through development of new functionality, testing, and implementing scheduled vendor releases and system upgrades.
Ensures application changes follows change management procedures and protocols and creates and maintains required documentation.
Bozeman Health is committed to caring for the communities of Southwest Montana by being their partner in health and wellness, compassionately delivering the best care for each person, every time. In every role, our employees are inspired by their ability to care for our community.
Oversee and implement pricing strategy for PBM opportunities.
Drive full pricing process for traditional and pass through PBM RFP opportunities.
Communicate range of pricing scenarios/options to internal stakeholders.
VytlOne is an independent, fully integrated total pharmacy solutions partner, offering mission-driven hospitals, health systems, health centers, and employer partners a way to unlock revenue, growth, and better outcomes. With over 1,600 professionals across the U.S., they operate as One Team, united by a bold mission and a spirit of innovation.
Monitor assigned accounts for irregularities, non-payments, and delayed payments.
Contact Sponsors/CROs to follow up on unpaid invoices and ensure timely payments.
Investigate and resolve sponsor, patient and customer disputes, maintaining strong business relationships.
Sarah Cannon Research Institute (SCRI), a subsidiary of McKesson, is one of the largest community-based cancer programs advancing oncology treatments and improving outcomes for cancer patients across the globe. SCRI's research network brings together more than 1,300 physicians who are enrolling patients into clinical trials at more than 200 locations in 20+ states across the U.S.
Provide account-specific pricing guidance for new clients and renewals.
Conduct analysis to identify the financial impact of pricing decisions.
Collaborate on improving pricing models using projected and actual healthcare costs.
Garner Health aims to transform the healthcare economy by delivering high-quality and affordable care. They partner with employers to redesign healthcare benefits using incentives and data-driven insights, guiding employees to better care.
Assist team on a smooth end-to-end billing process
Investigate, document, and follow up on denials and underpayments
Complete recurring work queues on a monthly basis
Omada Health is reverse engineering healthcare delivery, focusing on the space between doctor visits. They offer virtual-first models with human-led care teams, connected devices, and AI to support chronic conditions and have served over two million members across 2,000+ organizations.
Assist other teams as required throughout the quarter.
Twilio is shaping the future of communications from home, delivering solutions to businesses and empowering developers to craft personalized customer experiences. They are dedicated to remote-first work with a vibrant team and a strong culture of connection and global inclusion.
Oversees the monthly, quarterly, and annual financial reporting responsibilities.
Participates in month end close support and prepares budget/forecast variance analysis.
Analyzes financial data to explain variance drivers, identify trends, and call attention to opportunities to improve performance.
US Anesthesia Partners is the highest-quality single-specialty anesthesia practice in the United States. They have over 6,000 employees across 10 states and their clinical and non-clinical staff support each other as they work toward a common vision.
Provide strategic financial insights to executive leadership and operational teams to drive program profitability.
Wealthy Group of Companies LLC provides trauma-informed care exclusively to children and adolescents. The organization has centers across Pennsylvania, Ohio, and Delaware and operates with a strong emphasis on clinical excellence.
Analyze "trigger reports" to identify potential financial exposure early in the claims process.
Gather clinical information to evaluate liability and make recommendations to stakeholders.
Provide cost containment by managing Stop Loss claims and negotiating prices for medical services.
Ullico is the only labor-owned insurance and investment company and has been a partner of the labor movement for over 95 years. The company provides insurance products for members, leaders, and employers, as well as investments.
Supports Medical Policy Directors (MPD) through various aspects of the New Policy processes.
Performs multi-faceted data and report analytics to provide accurate client or policy information.
Researches and examines client questions and drafts accurate responses.
Cotiviti provides payment accuracy and analytics-driven healthcare solutions. They have a large team, and cultivate an inclusive and equitable environment for all employees.
Communicating with providers regarding claims, service issues and general network provider complaints.
Developing an adequate provider network in assigned geographical areas (currently Texas metroplex areas).
Building and maintaining relationships with contracted providers, including inquiries related to contract status, roster corrections and information accuracy.
Evry Health, a Globe Life company, aims to bring humanity to health insurance. They are a high-technology health plan expanding benefits and access, and feature a personalized, human approach. Globe Life has 16.8 million policies in force, with more than 3,000 corporate employees and 15,000 agents.
Collaborate with Sales Operations and Business Intelligence to build a pricing and contract dashboard.
Calyxo, Inc. is a medical device company that aims to address the profound need for improved kidney stone treatment. The team is led by executives and investors with a proven track record of commercializing paradigm-shifting devices to meet unmet needs within urology.
Independently research and configure systems to improve processes, add efficiencies, and promote patient safety.
Promote the effective use and benefits of healthcare systems, leveraging clinical/business knowledge to inform workflow and system design.
Embrace change positively, seek process improvements, and demonstrate innovative thinking, while taking responsibility for actions and adhering to service excellence standards.
SolutionHealth is an integrated health system uniquely focused on providing access to high-value, primary, and specialty care. Our IT department is diverse, strategic, and innovative focusing on patients, community, clinicians, outcome, safety, and quality.
Monitor compliance with assigned responsibilities and coordinate with patient financial services.
Conduct initial and continued clinical authorization reviews.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Conducting collection activity on appealed claims by contacting government agencies and third party payers.
Requesting additional information from Patients, Medical Records, and others as needed.
Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed.
Sutherland helps strengthen brands by improving customer experiences. They're a global company with nearly 40,000 employees across over 100 countries, focusing on customer care and delivering extraordinary service.