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.
Review clinical documentation for accuracy and compliance.
Identify errors and coordinate corrections with clinical staff.
Support education for nurses and caregivers on documentation standards.
Abby Care tackles the challenge of family caregiving by training and employing family caregivers to get paid for the care they already provide at home. They are building a tech-powered, family-first care platform to efficiently deliver care, improve health outcomes, and provide the best-in-class experience nationwide.
Develop, maintain, and execute complex inpatient coding audit processes.
Design and deliver clinical coding education and training programs.
Partner with staff to resolve audit findings and improve coding accuracy.
CRD Careers is a boutique recruitment agency specializing in Sales and HR placements. We connect growth-minded companies with high-impact professionals who drive real results. This company's approach is precise, people-first, and built for long-term success.
Review final 485/POCs for compliance and accuracy.
Cross-check orders, goals, frequencies, and documentation.
Approve or flag charts for correction.
Urrly uses AI to review every application against the same clear requirements for the role. Their goal is to create a more objective, consistent, and equal opportunity hiring process for all applicants.
Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordination activities.
Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.
Interview, hires, mentors, evaluates, coaches and manage performance for a diverse care coordination team.
Humana Inc. is committed to putting health first for its teammates, customers, and company. Through Humana insurance services and CenterWell healthcare services, they aim to make it easier for the millions of people they serve to achieve their best health.
Provide case management to members, addressing medical, social, psychological, physical, and spiritual needs.
Develop, implement, and monitor care plans in conjunction with PCPs, caregivers, and team members.
Help meet member's needs through coordinated care and support.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans expanding services to meet patient needs. At MJHS, they foster collaboration, celebrate achievements, and promote fairness, offering comprehensive compensation, career development, and work-life balance.
Own the development and maintenance of standardized role-specific resources
Deliver engaging and inspiring training, both virtually and in person
Act as a key resource for new hires throughout the onboarding process
WelbeHealth serves vulnerable seniors with quality and compassion using the Program of All-Inclusive Care for the Elderly (PACE). The company seems to value its employees and offers work/life balance.
Provide direct support for assigned state-based BSN | MPEN VN PN |ADN campus nursing students, supporting retention, progression, and NCLEX-RN exam preparation.
Guide, implement, and execute all developed licensure initiatives across assigned campuses and sites.
Monitor and analyze key performance indicators that align with the Content Mastery Series and NCLEX success, ensuring data-driven interventions and student support strategies align with outcomes.
Unitek Learning helps thousands of students launch and accelerate their careers every year. It is a rapidly growing and highly successful company, and offers a competitive salary, generous benefits, unlimited growth potential, and a collegiate work environment.
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.
Regularly monitor and conduct evaluations of interactions.
Provide in-the-moment coaching to Advocates to improve their performance.
Ivy Rehab provides world-class care in physical therapy, occupational therapy, speech therapy, and applied behavior analysis (ABA) services. Their culture promotes authenticity, inclusion, growth, community, and a passion for exceptional care for every patient.
Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
Assess payment determinations using clinical information and established guidelines.
Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), they empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth.
Support the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network–Quality Improvement Organization (QIN-QIO) Program by providing hands-on technical assistance and quality improvement (QI) support to nursing homes.
Collaborate with nursing homes to assess performance, conduct root cause analyses, and co-develop Quality Action Plans (QAPs) aligned with CMS priorities.
Play a vital role in driving the adoption of evidence-based interventions, guiding providers through regulatory requirements, and helping them improve safety, care quality, and outcomes for Medicare beneficiaries.
Health Services Advisory Group (HSAG) is dedicated to transforming healthcare delivery in the United States. They achieve this through quality improvement initiatives and technical assistance. They are a growing team focused on making healthcare better for everyone and also giving back to the community.
Provide high-quality, evidence-based primary care via telehealth.
Help establish and maintain a QA program.
Serve as a Pod Lead for a group of clinicians.
Vitable is a health benefits platform that makes healthcare better for employers of everyday workers, bringing accessible, high-quality care to millions. They are growing rapidly and looking for eager team members who are hungry for change and passionate about delivering better care.
Provide medical record review and medical waiver adjudication.
Conduct military medical assessments.
Maintain familiarity with USCG and DoD medical policies and HIPAA compliance standards.
Spectrum Healthcare Resources provides healthcare professionals to government and civilian healthcare facilities. We focus on delivering comprehensive solutions. We are dedicated to providing the best service possible.
Working with a team of Intake Coordinators and Utilization Review Nurses to ensure quality and timely determinations.
Striving for continuous improvement and an excellent work-life balance to produce top-notch results.
Coordinating and providing care management that is timely, effective, efficient, equitable, safe, and member centered.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Own end-to-end provider credentialing and enrollment across Medicaid, Medicare, Medicare Advantage.
Ensure credentialing policies and documentation meet payer and regulatory requirements.
Build and continuously improve credentialing infrastructure, including SOPs and policies/procedures.
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; they are scaling rapidly across states and populations.
Conduct training needs analyses to determine specific training needs for department staff.
Identify, select, and develop appropriate training programs, including the selection or design of appropriate training aids.
Assist in auditing work performed by staff and present findings and recommendations for areas of improvement to management
Centene is committed to helping people live healthier lives. As a diversified, national organization, Centene provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well; Centene is an equal opportunity employer that is committed to diversity.
Design engaging training, lead coders through evolving standards, perform high level audits, and shape best practices across multiple specialties.
Conduct detailed audits to identify under coding, over coding, documentation gaps, and compliance risks.
Spot trends in documentation and coding performance and collaborate on workflow improvements.
Oregon Health & Science University values a diverse and culturally competent workforce. They are an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status.
Engage with members to support their chronic and/or complex health care needs.
Create and manage individualized care plans to meet healthcare goals.
Partner with members, families, providers, and resources to coordinate care.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. They prioritize members' well-being and are committed to service, sustainability, and innovation.
Conduct coverage reviews based on member plan benefits and policies.
Document clinical review findings, actions, and outcomes.
Communicate and collaborate with providers for benefit determinations.
Capital Blue Cross promises to go the extra mile for their team and community. They foster a flexible environment where health and wellbeing are prioritized and employees consistently vote it as one of the "Best Places to Work in PA."
Stand up and run the daily clinical operations for PIN/CHI delivery.
Define the care team structure, supervision ratios, and operating cadence.
Ensure billing-ready documentation is completed correctly every time. Partner with Compliance + RCM support to prevent leakage/denials caused by ops errors.
Carewell is focused on providing the most trusted and reputable retail source for caregiving products. They have been recognized as one of the fastest-growing companies in the US.