Serve as a clinical subject matter expert supporting product and AI teams to evaluate new features for clinical safety and risk.
Conduct first-line clinical risk assessments across high-impact areas like documentation workflows and medication management.
Partner cross-functionally with product, engineering, regulatory, and clinical teams to guide safe innovation throughout the product lifecycle.
Our partner operates in healthcare technology, and we use an AI-powered matching process to connect candidates with roles. The environment is mission-driven and highly collaborative, focusing on improving outcomes across long-term and post-acute care settings.
Manage the member's clinical experience from request through desired outcome, including account activation and medical history drafting.
Coordinate video or phone consults with specialists and schedule monitors in advance, troubleshooting issues as needed.
Conduct ongoing follow-up post-consult and facilitate local recommendations, communicating with primary care physicians or specialists.
Transcarent is a health and care platform that combines medical, pharmacy, and point solutions with a generative AI-powered experience for health consumers. With over 1,700 employer and health plan clients serving 21 million Members, they foster a culture of People First, Care, Resilience, Results, and Humble and Human.
Supports clinical safety, accuracy, and oversight of integrated AI tools by reviewing AI-assisted outputs and surfacing risks.
Applies nursing judgment to review charts, calls, messages, and other member interactions to assess quality, safety, and member experience.
Assists with data collection and basic analysis for quality and safety work, and participates in cross-functional improvement efforts.
Included Health is a healthcare company delivering integrated virtual care and navigation. They are on a mission to raise the standard of healthcare for everyone, and offer members care guidance, advocacy, and access to personalized virtual and in-person care.
Support enterprise clinical information systems to enable safe, efficient patient care and assist clinicians with EHR issue resolution.
Assess clinical informatics needs and develop tools, decision support, templates, and training materials for healthcare professionals.
Facilitate working groups, stakeholder meetings, and field user engagement to improve clinical workflows and system use.
Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, we support more than a dozen agencies and have 300+ employees nationwide.
Supports and facilitates the design, development and implementation of Utilization Management data collection methodologies.
Displays and analyzes data to identify trends and works collaboratively to develop a plan of action.
Northside Hospital is an award-winning, state-of-the-art healthcare provider that is continually growing in Atlanta and beyond. As a large healthcare organization, they offer opportunities for healthcare professionals to join a team focused on expanding quality and reach of care.
Own the operator relationship end-to-end as the strategic partner to senior living operators, driving adoption, demonstrating ROI, and securing renewals across a complex, multi-stakeholder book of business.
Drive commercial outcomes by leading executive business reviews with data-driven storytelling, spotting expansion opportunities, and maintaining ownership of net dollar retention.
Build account plans, mentor CSMs and CSDs, and represent the voice of the customer internally across Sales, Product, and the CCOE.
Inspiren offers the most complete and connected ecosystem in senior living, combining compassionate care with technology to bring peace of mind to residents, families, and staff. Backed by nurse specialists and powerful analytics, the company provides integrated solutions that drive efficiency, profitability, and better care outcomes for senior living operators.
Perform concurrent inpatient utilization review using InterQual criteria to determine medical necessity.
Engage in clinical collaboration with physicians and care teams to support appropriate level-of-care decisions.
Maintain documentation, comply with regulations, and ensure quality customer service.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations serving over 700 clients across 10 industries. With over 66,000 employees across 13 countries and 65 delivery centers, the company combines scale and expertise to create meaningful impact.
Lead clinical quality strategy and client audit readiness for high-stakes client and consultant engagements.
Build longitudinal quality assurance systems to monitor member journeys and ensure service reliability.
Drive AI-enabled quality surveillance and pattern detection to scale quality operations.
Included Health is a healthcare company that delivers integrated virtual care and navigation, breaking down barriers to provide high-quality care for every person. The company is remote-first and offers a comprehensive benefits package, aiming to raise the standard of healthcare for everyone.
Coordinate patient care remotely using phone or video, focusing on assessments, care plans, and resource access.
Identify process improvements through data collection and auditing, while navigating multiple EHR platforms.
Utilize home health expertise to triage patient needs and maintain open communication with patients, caregivers, and providers.
ThedaCare is a community health system consisting of seven hospitals and numerous clinics, serving as the third largest health care employer in Wisconsin. With approximately 6,800 employees, the organization emphasizes innovation, compassion, and a commitment to improving community health.
Provide clinical and operational leadership to support timely, evidence-based coverage determinations in Utilization Management.
Coach reviewers on consistent application of medical-necessity criteria, medical policy, and benefit plan language.
Monitor daily workflow health, coordinate coverage plans, and communicate barriers and risks to the UM Manager.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. The company serves employers, health plans, and health systems with data-driven solutions and is on a mission to empower people to lead healthier lives.
Lead on-site implementation training and process improvement initiatives for patient access operations across new and existing health system sites.
Execute structured operational reviews, analyze site-level metrics, and develop targeted action plans with site leadership.
Ensure deployment of standardized registration, financial, and compliance workflows while providing performance updates to the Director.
Intuitive Health pioneered the combined emergency room and urgent care model, partnering with leading health systems nationwide. Serving more than 1 million patients annually, the company is ranked among the top 1% of global retailers in customer satisfaction.
Identify, analyze, and resolve clinical data quality issues across a multi-vendor EHR ecosystem to ensure accuracy and standardization.
Map clinical data elements to standardized code systems and validate mapping accuracy across clinical domains.
Support quality measure programs by ensuring data completeness and accuracy, and serve as clinical subject matter expert for AI-assisted data extraction and interoperability initiatives.
Aledade is a public benefit corporation that empowers independent primary care practices to thrive in value-based care, forming the largest network of its kind in the US since 2014. The company fosters a collaborative, inclusive, and remote-first culture focused on strengthening continuity of care and aligning incentives for patient health.
Perform clinical validation and medical record abstraction to ensure accuracy and compliance with CMS quality measures.
Identify and resolve data discrepancies in collaboration with internal teams and external vendors like Oracle Health.
Support timely regulatory submissions and cross-train across validation and abstraction functions for workload flexibility.
Banner Health is a large, nonprofit health care system in the US, providing hospital services, primary care, and research across multiple communities. With a network of hospitals and clinics, they employ skilled professionals using advanced technology to improve patient care.
Support implementation of new ER and urgent care facilities, working closely with clinical staff to adopt the Intuitive operating model through coaching and troubleshooting.
Provide detailed observations, recommend solutions, and drive performance improvement while collaborating with facility staff and leadership.
Design and deliver engaging educational materials and lead pre-opening training sessions to ensure operational readiness.
Intuitive Health pioneered the combined emergency room and urgent care model, setting a new standard for innovation in ambulatory care. Partnering with leading health systems nationwide, the company serves over 1 million patients annually and ranks among the top 1% of global retailers in customer satisfaction.
Oversee Patient Access Advocate functions across all facilities, emphasizing registration accuracy and point-of-service collections.
Document workflows, create standardized training plans, and improve dashboards to monitor registration, customer service, and throughput.
Support new facility implementations through detailed observations, coaching, and post-implementation analysis.
Intuitive Health pioneered the combined emergency room and urgent care model, partnering with leading health systems nationwide. Ranked among the top 1% of global retailers in customer satisfaction, the company serves more than 1 million patients annually.
Manage patient physiological markers and provide clinical triage.
Conduct wellness calls and collaborate with care teams to set health goals.
Drive patient engagement and ensure adherence to RPM program standards.
Vivo Care is building a platform to make healthcare continuous, personal, and truly connected. It is a fast-growing startup with a culture of inclusion, collaboration, and innovation.
Assess each client's current-state preference card workflows and define a future-state model aligned with Card Optimizer's capabilities.
Develop and deliver role-specific training for surgeons, OR nurses, and supply chain staff to drive adoption.
Build trusted, peer-level relationships with surgeons, OR directors, and clinical leaders to facilitate engagement and change.
We fix the healthcare supply chain with our AI-powered platform, Astra OS, giving hospitals end-to-end visibility into their operations. Founded in 2020, we have raised $43M and are trusted by leading health systems like Yale New Haven Health and Stanford.
Perform concurrent and retrospective reviews on all facility and appropriate home health services.
Monitor level and quality of care and proactively manage acutely and chronically ill patients.
Act as liaison to Plan Medical Director and coordinate interdisciplinary approach.
Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities. Founded in 2021, they serve 200,000+ seniors in 1,500+ communities across 32 states with a team of over 1,000 clinicians.
Analyze denied insurance claims and apply clinical reasoning to determine appeal merit.
Draft persuasive, medically sound appeal letters to recover denied revenue.
Collaborate with legal team to ensure appeals are compelling and complete.
Ternium specializes in resolving complex healthcare insurance claim denials and delays for hospitals. They have a dedicated, mission-driven team and value diversity and inclusion.
Oversee clinical enrollment for members, guiding them through protocols and eligibility for the most appropriate program.
Collaborate with a cross-functional team of nurses, health coaches, and providers to ensure a seamless member experience.
Utilize nursing judgment, motivational interviewing, and data tools to drive behavior change and improve health outcomes.
Twin Health is the only company applying AI Digital Twin technology to prevent and improve chronic metabolic diseases like type 2 diabetes and obesity. With more than $100 million raised and over 100 employees, Twin has been recognized as an Innovator of the Year and a Most Loved Workplace, backed by leading venture firms.