Own and manage shared inboxes and ensure timely review, triage, escalation and routing of requests
Identify trends, risks, or recurring issues and ensure escalation and action planning
Conduct compliance audits, write corrective action plans and work with department managers to ensure timely completion and compliance with local, state and regulatory requirements
Centene is transforming the health of communities, one person at a time. As a diversified, national organization, they offer competitive benefits and a fresh perspective on workplace flexibility.
Monitor patient equipment usage data to verify compliance milestones.
Initiate timely outreach to troubleshoot issues and provide encouragement.
Maintain detailed compliance logs and prepare monthly reports.
Sleep Doctor is on a mission to help millions get a full night's rest. As the most trusted name in sleep health, they combine clinical expertise with consumer-first experiences to help people understand their sleep, tackle real challenges, and wake up to healthier, more energized lives. They embody rapid, sustainable growth.
This role supports the organization's compliance program.
Monitors adherence to healthcare regulations, identifies risks, and conducts audits.
Provides education to staff on compliance-related matters.
Curai believes access to high-quality healthcare is a fundamental human right, not a privilege. They aim to transform healthcare delivery using AI and clinical expertise, making care affordable and effective. The company focuses on improving health outcomes and is committed to a diverse and inclusive environment.
Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.
Oversee the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers. Be the primary liaison for enterprise contract activations.
Lead the internal Credentialing Committee, presenting provider files and ensuring all primary source verifications (NPDB, OIG, SAM) are flawless.
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Their platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. At Foodsmart, their mission is to make nutritious food accessible and affordable for everyone, regardless of economic status.
Regularly engage with patients and track their adherence to their care plans.
Closely monitor your patients' device readings and dig into any out-of-bound values.
Maintain meticulous records of patient interactions, and program details.
Medsien is a leading provider of scalable remote care management, enabling healthcare practices to enhance patient engagement, improve outcomes, and optimize operational efficiency. Hundreds of organizations trust Medsien’s unparalleled technology solutions to implement exceptional remote care management programs, personalize every interaction, and improve the lives of those who need it most.
Design, implement, and continuously improve a comprehensive compliance program.
Serve as the company's Compliance Officer, maintaining all relevant policies and training programs.
Negotiate and manage key commercial contracts with minimal outside counsel involvement.
Sleep Doctor is helping millions get a full night's rest. As the most trusted name in sleep health, they make better sleep possible with proven support, clear answers, and hands-on care that fits real life. The company has between 50-200 employees and a high-trust culture.
Manage compliance issues through identification and resolution.
Design and maintain compliance workflows and controls.
Analyze data to identify risks and improve processes.
HealthEquity's mission is to save and improve lives by empowering healthcare consumers. We are passionate about providing a solution that allows American families to connect health and wealth. They value their employees as individuals and encourage a welcoming and inclusive environment.
Provide day-to-day compliance support for Gravie’s Individual Coverage Health Reimbursement Account (ICHRA) line of business.
Manage and oversee regulatory filings, facilitate response to regulatory complaints, and execute regulatory change management process.
Provide general compliance support and expertise to operational areas, and perform risk-based oversight audits.
Gravie aims to create health benefits that actually benefit small and midsize businesses and their employees. Their innovative benefit solutions and services are developed and delivered by a diverse group of unique people, and they encourage employees to be their authentic selves.
Own and maintain a centralized payer rulebook across all health plans.
Interpret payer requirements and translate them into clear operational workflows.
Own performance outcomes at the health plan level (KPIs, compliance, documentation).
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the healthcare system. They partner with health plans, providers, and community organizations to deliver culturally competent care and are scaling rapidly across states and populations.
Responsible for submission of the patient’s medical record to CMS or their delegated representatives, other contracted agencies, patients, and privately subpoenaed charts.
Provide administrative support to the Director of Home Health in compliance with organization policies and procedures and applicable laws and regulations.
Develop and maintain tracking tools to assist management with monitoring progress on compliance and accreditation standards.
By The Bay Health, established in 1975, is a non-profit that set the standard for hospice in the U.S. by emphasizing the role of the patient in making important medical decisions. Their spectrum of home-based services includes Skilled Home Health Care, Palliative Care, Adult Hospice Care and Pediatric Care.
Responsible for supporting nursing communities within the geographic location assigned.
Audits clinical services, reviews outcomes, and strategizes to improve resident care.
Works alongside the management teams at each building to develop and implement processes, identify and resolve issues, while also managing staff.
Tutera Senior Living & Health Care is guided by one single purpose: To live the YOUNITE philosophy in every decision, every day. Based on genuine respect, YOUNITE is how they get to know residents and team members on a personal level and offer stability as a family-owned company founded in 1985.
Design, build, and scale patient support services infrastructure
Own the end-to-end patient journey from referral through therapy initiation
Establish program goals, performance benchmarks, and continuous improvement frameworks
Definium Therapeutics is a clinical stage biopharmaceutical company developing novel product candidates to treat brain health disorders. They aim to be the global leader in the development and delivery of treatments that improve patient outcomes. Founded in 2019, they are continuously expanding their presence and global footprint and searching for high-impact individuals to strengthen their team.
Define and evolve security governance and risk management strategy, aligning function-level priorities with enterprise objectives and the security roadmap.
Lead security-related audits, assessments, and regulatory inquiries in partnership with Legal, Compliance, Privacy, and Internal Audit.
Manage and hold accountable a third-party GRC services vendor, ensuring delivery quality, prioritization, and alignment to Clover’s risk appetite.
Clover Health is reinventing health insurance by combining data with human empathy to keep members healthier. They've created custom software and analytics to empower their clinical staff to intervene and provide personalized care. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
Supports coding and documentation quality assurance.
Performs internal audits to assess compliance and quality.
Researches coding, billing, and charging compliance issues.
Presbyterian Healthcare Services is dedicated to improving the health of patients, members, and communities. They are a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group, employing nearly 14,000 individuals.
Provide high-quality supervision, mentorship, and training to residents and pre-licensed clinicians.
Promote clinical excellence, ensure compliance with state licensure and CARF standards.
Maintain a small caseload to model best practices and stay grounded in direct care.
Backpack Health is building the next generation of exceptional behavioral health clinicians. It is a mission-driven team of clinicians and operators in an innovative, forward-thinking environment with a strong clinical community and mentorship culture.
Conduct weekly multidisciplinary rounds with Midwest and West Coast care teams, reviewing patient goals and providing clinical oversight.
Serve as the designated reviewer for patient escalations, applying clinical judgment to prioritize and direct cases to appropriate next steps.
Alternate monthly care delivery education sessions with co-Medical Lead, developing and facilitating case-based learning for various roles.
Waymark is a mission-driven team transforming care for people with Medicaid benefits by partnering with communities, delivering technology-enabled, human-centered support. We're designing tools and systems that bring care directly to those who need it most – removing barriers and reimagining what’s possible in Medicaid healthcare delivery.
Oversee day-to-day operations of the facility to meet State and Federal regulations.
Supervise all department managers to ensure the facility is in compliance.
Ensure customer service while facilitating the resolution of resident care issues.
Tutera Senior Living & Health Care aims to live the YOUNITE philosophy in every decision, every day, emphasizing respect and personalized care for residents and team members. Founded in 1985, it is a family-owned company which offers stability, competitive wages, and benefits, while also growing and developing its employees.
Prepares, reviews, and submits hospice claims accurately and timely, including Medicare, Medicaid, Managed Care, and other third-party payors.
Identifies, investigates, and resolves billing edits, claim rejections, denials, and payment discrepancies, including coordination of benefit (COB) scenarios.
Maintains strict confidentiality of all patient and financial data in accordance with HIPAA and company policies.
VitalCaring is a leading provider of home health and hospice services. Founded in 2021, they support, inspire, and uplift both their patients and their team members and has grown to over 100 locations across the country.
Perform audits to assess the quality of documentation, accuracy of charge code assignment and review financial billing statements.
Answer any physician and/or clinic questions and concerns regarding current ICD-10 and CPT guidelines.
Provide coding training and updates for coding staff, physicians and clinics as assigned.
Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. They have an innovative, multifaceted culture that embraces collaboration, excellence, discovery, and compassion.
Provide strategic and day-to-day leadership to multiple PCS locations.
Drive operational efficiency and effectiveness through standardized workflows and KPIs.
Hire, train, mentor, and evaluate performance of local branch leadership and operational staff.
AbriCare was founded with the mission to put caregivers first, because the best care for clients starts with supporting the people who deliver it. They aim to become a next-generation leader in Personal Care Services (PCS) and solve a structural workforce crisis.