Lead execution and optimization of integrated clinical service operations across behavioral health, pharmacy, and nursing service lines.
Oversee workforce planning, capacity management, and performance tracking against key clinical and operational metrics.
Manage unit economics and translate growth strategies into operational roadmaps for new markets and payer partnerships.
Our partner is a mission-driven, high-growth healthcare organization focused on improving outcomes for complex patient populations through coordinated, value-based care. They operate in a fast-paced, remote-first environment with a strong focus on professional growth and cross-functional collaboration.
Lead HR consulting engagements focused on workforce optimization and cost containment within healthcare organizations.
Analyze HR spend, vendor contracts, and workforce processes to identify savings and efficiency opportunities.
Provide subject matter expertise across HR domains such as compensation, talent management, and workforce planning.
Jobgether uses AI-powered matching to connect candidates with hiring companies. They operate as a platform with a collaborative consulting environment and strong growth opportunities.
Establishes and implements the domestic managed care strategy for medical case management services.
Develops resource models, drives continuous improvement, and manages operational metrics to meet financial objectives.
Manages a network of providers to ensure quality and cost-effective medical management services.
Liberty Mutual is a global insurance company providing property and casualty insurance. The company has a large workforce and emphasizes an inclusive culture with comprehensive benefits and professional development opportunities.
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.
Conducts training for staff members related to Utilization Review process, clinical guidelines, and workflows.
Creates educational material by collaborating with key resources to incorporate clinical scenarios.
Reviews monthly quality audit findings and provides one-on-one coaching to staff for performance improvement.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, the company combines scale, expertise and execution to create meaningful, measurable impact.
Lead daily CDI operations, including staffing, workload balancing, and training for clinical documentation improvement.
Conduct real-time clinical reviews for complex cases and analyze data to ensure quality and accuracy.
Collaborate with physicians and staff to enhance documentation quality and compliance with coding guidelines.
Adventist HealthCare is a faith-based, not-for-profit healthcare organization providing comprehensive services including acute-care hospitals, rehabilitation, outpatient centers, and home care. With over 6,000 employees, they are the largest healthcare provider in Montgomery County, Maryland, focused on extending God's care through physical, mental, and spiritual healing.
Lead and oversee the Group Health Operations Management team, ensuring effective execution of utilization management services and operational workflows.
Drive achievement of key client performance metrics, including turnaround time, quality indicators, peer-to-peer success rates, and overturn rates.
Manage overall division profitability, including ownership of P&L performance and financial objectives.
Jobgether is a platform that uses AI-powered matching to connect candidates with job opportunities. They operate remotely and emphasize efficient, data-driven hiring processes.
Provides clinical oversight and medical necessity reviews for home health, DME, and related services using evidence-based guidelines.
Conducts peer to peer consultations and adverse determinations when clinical criteria are not met to support quality outcomes.
Collaborates with health plan leadership, participates in committees, and achieves SLA metrics for client performance guarantees.
CareCentrix provides clinical oversight and utilization management for home health, DME, home infusion therapy, and sleep medicine services. The company has an award-winning culture that values care, integrity, excellence, and innovation, operating with a drug-free workplace and equal opportunity commitment.
Supervise a team of 10-15 direct reports under the ECM team to ensure high-quality care management services.
Oversee client outreach, enrollments, and creation of Individual Care Plans, serving as an escalation point.
Drive the team to meet key performance indicators (KPIs) and collaborate with Directors on process improvements.
Vynca provides comprehensive care for individuals with complex needs, focusing on more quality days at home. They are a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.
Drive the strategy, performance, and growth of a healthcare transparency and cost navigation platform.
Own full P&L responsibility, including growth, profitability, and long-term strategic performance.
Lead cross-functional teams across product, technology, revenue, marketing, and client success to accelerate market adoption.
This partner company drives healthcare transparency and cost navigation through a flagship platform. They are a mission-driven, fast-paced organization focused on transforming healthcare affordability and equity.
Build meaningful relationships with patients and families to understand their goals and barriers.
Create personalized care plans addressing medical, behavioral, and social needs.
Coordinate care across providers and settings, ensuring safety, quality, and continuity.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to making great healthcare affordable and improving patient health. As a physician-led organization with a high degree of agility, it employs a remote team and fosters a collaborative, mission-driven culture focused on continuous learning.
Develop and execute growth, renewal, and retention strategies for government clients.
Manage multi-level client relationships, ensuring satisfaction and issue resolution.
Lead and mentor a team, driving best practices and high levels of customer service.
Cotiviti is a healthcare analytics and information company that helps clients improve financial performance and quality outcomes. It is a mid-to-large sized company with a focus on innovation and team culture, emphasizing growth and retention.
Define and lead the end-to-end client and family engagement strategy to drive retention and continuity of care.
Oversee the full client journey from intake through discharge, ensuring a seamless experience.
Act as senior escalation point for complex, high-need cases requiring advanced empathy and problem-solving.
The company is a high-impact digital health environment focused on meaningful healthcare impact. It is a remote-first organization with a mission-driven, collaborative culture emphasizing innovation in care delivery.
Serve as the primary relationship and strategy owner for large, multi-national employer partners.
Advise and lead employer partners to define and execute their mental health and wellbeing strategy using data-driven storytelling.
Craft clear, succinct business reviews that demonstrate value and return on investment.
Lyra Health is a leading provider of evidence-based mental health care, serving over 20 million people globally in partnership with employers and over 100 million through health plan relationships. The company has delivered more than 15 million sessions of care and published over 35 peer-reviewed studies, driving unmatched clinical effectiveness and cost efficiency.
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.
Drive revenue growth by selling outsourced services to hospitals and health systems, managing full-cycle sales from discovery to contract signature.
Collaborate with clients and internal teams to solve challenges and create winning strategies, leading cross-functional deal teams.
Balance prospecting and conversion of opportunities with a franchise owner mentality, ensuring regional success.
Sodexo partners with clients to provide food service, catering, facilities management, and other integrated solutions worldwide. We are a large global company committed to diversity and inclusion, fostering an environment where all employees are valued and respected.
Act as the primary point of contact for brokers and their clients, managing customer retention and expansion.
Facilitate smooth transitions, lead quarterly business reviews, and own the annual renewal process end-to-end.
Collaborate cross-functionally with sales, product, and support teams to improve the customer and broker experience.
Sana is a health plan solution built for small and midsize businesses, designed around integrated primary care service to make healthcare easy. Founded in 2017, we are a remote-first company with a fully distributed team across the U.S., valuing curiosity, ownership, and speed.
Lead client engagements to inform business and evidence strategy for life sciences products, focusing on patient-centric value and data-driven insights.
Execute quantitative and qualitative research, including claims analysis, protocol development, and programming in SAS/R to generate real-world evidence.
Drive business development, cultivating new and follow-on work while managing project delivery and building integrated RWE generation plans.
Avalere Health is a healthcare consultancy dedicated to reaching every patient possible through advisory, medical, and marketing services. With major hubs in London, Washington DC, and New York, and a global team, they foster an inclusive culture with employee network groups and flexible work arrangements.
Serve as the main point of contact for patients and families transitioning from or seeking post-acute services.
Make clinical level-of-care determinations using discussions, medical records, and other clinical data.
Provide patient education on home health, hospice, palliative care, Medicare coverage, and billing.
Gentiva is a national leader in hospice, palliative, and home health care, providing compassionate care to patients in their homes. With nearly 600 locations and thousands of clinicians across 38 states, they offer a collaborative environment where inspiring achievements are recognized.