Lead enterprise compliance program execution, including strategy, risk assessments, and policy governance.
Oversee compliance investigations, monitoring, auditing, and regulatory change management.
Provide guidance on federal and state healthcare regulations and emerging risks, partnering with senior leaders.
Oscar is a health insurance company built on a full-stack technology platform, focused on serving members. We started in 2012 and foster a culture of authenticity and belonging, with a mission to change healthcare.
Manage third-party and FDR oversight, including due diligence, risk tiering, and ongoing monitoring.
Lead privacy and security incident response, including breach risk assessment and reporting.
Administer compliance program, including drafting policies, presenting training, and conducting internal audits.
Evermore is a technology company that administers Smart Benefits to connect people to products and services they need. It is a Series B stage company backed by leading investors, fostering a culture of innovation and health equity.
Lead the hospice compliance program, covering regulatory oversight, risk management, and audit governance.
Manage corrective action and policy lifecycles, ensuring compliance with Medicare CoPs and state regulations.
Coordinate external audit responses and internal investigations with leadership.
Ennoble Care is a mobile primary care, palliative care, and hospice service provider that brings clinicians into patients' homes, offering continuum of care for those with chronic conditions. The company embodies a culture of compassionate service with its motto 'To Care is an Honor,' and seeks driven individuals to join their growing team.
Conduct complex compliance, operational, privacy, and risk management investigations across multiple healthcare settings.
Perform root cause analyses to identify systemic vulnerabilities and recommend corrective actions.
Collaborate with operational leaders, HR, Legal, and Revenue Cycle to develop risk mitigation strategies.
PT Solutions is a rehabilitation provider dedicated to expanding access to quality care across multiple therapy disciplines. The company fosters a tight-knit community and provides industry-leading professional development opportunities, including an APTA-accredited residency program.
Review OASIS documentation and plan of care to ensure compliance with regulations and accuracy.
Evaluate patient visit frequency and utilization to align with clinical needs and provider orders.
Collaborate with coding partners and escalate documentation improvement opportunities to leadership.
Graham Healthcare Group designs business and technology solutions to drive better care and outcomes in home health and hospice. As a subsidiary of a publicly traded company, they've been improving care coordination for over 20 years, focusing on patient-centered home care.
Provide day-to-day leadership and technical guidance for a Product Compliance team supporting Supplemental and Group insurance products.
Coordinate regulatory filings, research evolving requirements, and oversee compliance reviews of policy forms, endorsements, and marketing materials.
Partner cross-functionally with Product Development, Legal, Compliance, Claims, Marketing, and Operations to ensure product compliance.
Horace Mann helps educators protect their finances and plan for the future through insurance and financial products. Founded in 1945 by two teachers, the company serves over 4,100 school districts nationwide, is publicly traded on the NYSE, and holds more than $12 billion in assets.
Serve as the primary resource for quality assurance initiatives for the Family Heritage Division.
Develop and maintain systems, dashboards, and reports to make quality data actionable.
Monitor key performance indicators and investigate agent misconduct to ensure regulatory compliance.
Globe Life is an insurance company committed to empowering employees and fostering a caring, innovative culture. The company values collaboration, respect, and growth, helping employees make tomorrow better.
Own quality performance across all clinical tiers, including call and documentation quality for RNs, providers, and PSS Engagers, plus organization-wide clinical outcomes.
Lead and develop a team of Quality Reviewers, setting standards, conducting calibrations, and coaching to ensure consistent, defensible scoring.
Build and analyze quality dashboards and datasets to identify trends, root causes, and improvement opportunities, presenting findings to executive leadership.
CareTalk Health is a fully remote, nationwide virtual medical practice partnering with Medicare Advantage plans to deliver Annual Wellness Visits and close care gaps. We are a growing, collaborative team focused on making virtual care simple, reliable, and human.
Lead enterprise regulatory strategy and readiness to navigate evolving regulatory expectations.
Design and execute mock examinations and readiness programs to prepare for regulatory scrutiny.
Partner with senior leadership to translate regulatory developments into actionable business strategies.
Empower is a financial services company focused on transforming financial lives. We have a flexible work environment, fluid career paths, and a welcoming inclusive culture.
Independently manage Medicare, Medicaid, and TriCare cost reports and coordinate audits.
Lead the annual cost report peer-review process and manage provider appeals.
Collaborate with internal stakeholders and external reimbursement organizations to ensure compliance.
They are a large health system providing patient-focused healthcare services. The organization is collaborative and mission-driven, with a focus on financial sustainability.
Review facility credentialing applications for accuracy and completeness based on applicable standards.
Communicate with facilities to resolve discrepancies and obtain missing information.
Manage data entry, monitor compliance, and prepare reports for the Credentialing Committee.
Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities. Founded in 2021, the company serves 200,000+ seniors across 1,500+ communities in 32 states with a team of over 1,000 clinicians and professionals, and was ranked #147 on the Inc. 5000 list.
Lead credentialing and payer enrollment functions, setting strategic objectives and performance standards.
Manage vendor relationships and resolve enrollment-related revenue cycle issues.
Develop scalable processes, dashboards, and compliance initiatives to reduce backlogs and improve efficiency.
Jobgether is a platform that uses AI to match job seekers with opportunities. They partner with companies to manage applications and next steps, aiming to streamline the hiring process.
Maintain and update provider information in Provider Data Management systems, ensuring data accuracy and completeness.
Verify provider data from external sources, coordinate with partners to obtain missing information, and resolve discrepancies.
Collaborate with internal teams and support audits to maintain compliance with industry standards and regulations.
Curana Health is a national leader in value-based care, offering solutions to senior living communities and skilled nursing facilities. Founded in 2021, the company has grown to serve over 200,000 seniors in 1,500+ communities across 32 states, with a team of more than 1,000 clinicians and support staff.
Own the end-to-end credentialing and multi-state licensing process, including policies and procedures.
Oversee provider onboarding and offboarding, driving license and credentialing applications to completion.
Manage delegated credentialing programs and health plan audits, ensuring compliance with state and federal regulations.
Galileo is a team-based medical practice working to improve the quality and affordability of health care for all. Founded by healthcare pioneer Dr. Tom X. Lee, they are a team of leading innovators from healthcare, technology, and human-centered design.
Survey ambulatory care organizations across the United States within the scope of Joint Commission's Ambulatory Programs.
Engage health care staff in interactive dialogues to assess compliance and identify opportunities for improving care quality.
Prepare management reports that link standards deficiencies with systems vulnerabilities and communicate findings to leadership.
The Joint Commission accredits and certifies health care organizations to improve patient safety and quality of care. It employs a nationwide team of surveyors who work remotely and travel extensively.
Support the Chief Compliance Officer in developing and monitoring the Compliance Work Plan, including auditing and monitoring activities.
Manage intake, tracking, review, and response to governmental revenue cycle investigations and serve as the compliance resource for revenue cycle and operational leaders.
Develop and deliver role-based compliance training, translate regulatory changes into actionable policies, and monitor audit results to create corrective action plans.
UnityPoint Health is a healthcare organization providing comprehensive services across multiple states. Recognized as a Top 150 Place to Work in Healthcare, they are committed to team members and foster a culture of belonging.
Translate regulatory and financial reporting requirements into report logic and data definitions.
Develop, maintain, and update compliance reports for state filings, audits, and other obligations.
Investigate reporting discrepancies, isolate root causes, and drive remediation with engineering and finance.
Kin makes homeowners insurance and related products simpler and more affordable using data, technology, and human support. Founded in 2016, Kin is a remote-first employer with over 35 states and has been recognized as a Best Place to Work and a Great Place to Work.
Own daily execution of the chase queue, monitoring retrieval rates and AID ownership across roughly one million annual chases.
Oversee AI-enabled voice agent performance and adjust workflows to improve retrieval yield while reducing provider abrasion.
Manage staffing models, capacity forecasts, and serve as the operational point of contact for the customer retrieval relationship.
Reveleer provides a unified platform for risk adjustment, quality improvement, clinical intelligence, and member management, helping health plans and provider organizations navigate value-based care. The company is trusted by over 80 customer organizations nationwide and combines regulatory expertise with human-in-the-loop AI to support documentation integrity and operational readiness.
Supports and strengthens the Compliance program by providing advisory support to business stakeholders.
Conducts compliance investigations and assists with auditing and monitoring activities.
Advances policy governance and development, translating regulations into practical guidance.
Rula is a mental health company dedicated to providing evidence-based, compassionate care to treat the whole person. They are a remote-first organization with a culture that values diversity, equity, and inclusion, hiring in most U.S. states.
Evaluate the effectiveness and integrity of insurance operations across a portfolio of specialty insurance partners.
Lead and participate in reviews covering underwriting, documentation, compliance, reporting, and financial activities.
Analyze findings, identify risks, and communicate actionable recommendations to mitigate issues.
Jobgether is a platform that uses AI-powered matching to connect candidates with job opportunities. The company fosters a collaborative, remote-friendly culture and partners with various employers to streamline the hiring process.