Perform detailed reviews of wound care documentation, including patient records, treatment plans, and progress notes.
Assess compliance with clinical guidelines, regulatory requirements, and organizational policies
Collect and analyze data related to wound care outcomes, treatment effectiveness, and patient satisfaction
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. They connect clients with highly qualified professionals, offering tailored services to meet their clients' unique business needs.
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.
Conduct quality audits of inpatient clinical determinations to ensure alignment with clinical guidelines and quality standards
Analyze QA findings and translate insights into actionable recommendations for operational leaders and cross-functional partners
Provide coaching and feedback to improve clinical decision accuracy, guideline adherence, and overall team performance
Cohere Health delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. They work with over 660,000 providers and are backed by leading investors such as Deerfield Management. The coherenauts who succeed there are empathetic teammates who are candid, kind, caring, and embody their core values and principles. Cohere is deeply invested in ensuring that they have a supportive, growth-oriented environment that works for everyone.
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.
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.
Follow VitalCaring billing Standard Operating Procedures and regulatory billing guidelines
Collaborate with your supervisor and the billing team to address payor and billing concerns
Ensure documentation accuracy and submit claims in accordance with Medicare and other payor requirements
VitalCaring is a leading provider of home health and hospice services. Founded in 2021, VitalCaring has grown into a leading provider of home health and hospice services, with over 65 locations across the country. They foster a culture of support, growth, and excellence.
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.
Provides quality driven telephonic clinical assessments, health education, and utilization management services.
Provides assessments to individuals using telecommunications in accordance with computer-based algorithms, protocols, and guidelines.
Uses clinical knowledge to assess, disposition, make recommendations for care, provide education and health information.
Carenet Health values the expertise and dedication of their team members. They are committed to offering an appealing compensation package and creating an inclusive environment for all employees.
Oversee the RN Reviewer team including one RN Team Lead
Manage the daily timeliness report and ensure all cases meet expected turnaround times
Monitor the nurse productivity reports daily and provide feedback to the nurses, managing performance to ensure consistency
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. They work with over 660,000 providers and handle over 12 million prior authorization requests annually.
Kodiak Solutions transforms the healthcare industry through technology-driven solutions, specializing in healthcare finance, unclaimed property, risk management, and revenue cycle management. With an innovative platform, they offer cloud-based systems, automated workflows, and advanced data management tools.
Provide timely, high-quality clinical recommendations grounded in evidence-based practice.
Effectively communicate assessment findings and provide advice to the in-center team.
Provide input into resident care plans in collaboration with the in-center team.
Summerset is the second largest retirement village operator in New Zealand, passionately dedicated to providing quality service to its clients. They are growing quickly, with 39+ villages, and proud of their dynamic work environment and diverse workforce.
Administer assessments/screening tools to identify and prioritize member needs.
Develop individualized care plans and lead care coordination efforts.
Build strong, empathetic relationships with members, driving collaboration.
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. They deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers; through our leading-edge care model, Tuesday Health is shaping the future of community-based palliative care nationwide.
Directly responsible for the provision of direct patient care within the assigned setting, supervising 2-3 associate therapist.
Directly responsible for the supervision, staffing and coordination of clinical employees within the program’s service lines.
Conducts ongoing chart reviews to ensure compliance with established standards.
Ascend Healthcare provides fully integrated, quality psychiatric and behavioral health services in a compassionate, convenient, and affordable manner. They deliver integrated psychiatric and behavioral health solutions with a commitment to equity, compassion, and operational excellence, fostering collaboration, a patient-first mindset, and career growth.
Conducts telephonic visits with clients to complete assessments and provide disease management education.
Support program enrollment and monitor participation for clients post-discharge.
Document communication with clients, caregivers, and providers timely and accurately.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging our extensive global network, we connect clients with highly qualified professionals, offering tailored services to meet our clients' unique business needs.
Review all assigned OASIS assessments for accuracy, completeness, and consistency.
Validate diagnosis coding and sequencing per CMS guidelines.
Identify and correct errors impacting reimbursement, quality measures, or compliance.
They are responsible for coding, reviewing, validating, and correcting OASIS assessments to ensure clinical accuracy, regulatory compliance, and optimal reimbursement. This is an adaptive, remote-friendly role designed to scale with agency census and workflow needs.
Conduct virtual wellness visits to patients in their homes.
Perform health risk assessments and medication reviews.
Provide comprehensive care coordination and management.
Sprinter Health is an on-demand mobile health service that sends medical professionals to patients’ homes. They are building the clinical and technological infrastructure to realize a future of healthcare untethered with a rapidly growing team of visionary leaders.
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.
Serve as the vendor’s lead clinical subject matter expert on clinical denials management and prevention.
Partner with provider clients to design and implement best practices for denial prevention and appeal workflows.
Conduct complex clinical case reviews for DRG validation, identifying and defending clinically appropriate DRG assignments.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage over 24 years of expertise and their E360 RCM ™ platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers. EnableComp is a multi-year recipient of the Top Workplaces award recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.