Perform quality audits on clinical documentation across clinical departments.
Collaborate with leadership to develop corrective action plans and provide 1:1 coaching.
Support organizational readiness for NCQA and other regulatory audits.
Oscar is the first health insurance company built around a full stack technology platform, focusing on serving members with a concierge-level experience. It started in 2012 and is an Equal Opportunity Employer cultivating an authentic, inclusive environment.
Lead external customer audits and utilization management oversight activities as a subject matter expert.
Analyze complex UM data, investigate findings, and prepare evidence-based responses for regulators and accreditation organizations.
Collaborate with operational, technical, and client-facing teams to drive compliance and process improvements.
This company is a healthcare organization specializing in utilization management and regulatory compliance. It operates with a remote team across the United States, fostering a collaborative and improvement-driven culture.
Conduct clinical audits and risk assessments to identify compliance gaps.
Manage multiple client engagements and deliver accurate project results.
Build strong client relationships and present findings to leadership.
Kodiak Solutions transforms healthcare through technology-driven solutions, specializing in finance, unclaimed property, and risk management. Their innovative platform streamlines operations, allowing providers to focus on patient care.
Provides administrative and project support for quality assurance and program activities.
Coordinates project logistics, documentation, procurement, and compliance processes.
Maintains records, tracks deliverables, and supports audit-ready documentation across workstreams.
This organization is dedicated to international development and quality assurance programs. It fosters a collaborative, mission-driven culture with a focus on inclusion and professional growth.
Oversee CMS and state audit readiness, live audit management, and corrective action plans.
Build internal monitoring, training, and reporting to foster a culture of compliance.
Collaborate with clinical and operations teams to integrate audit findings into improvements.
Habitat Health empowers older adults to experience more good days through the Program of All-Inclusive Care for the Elderly (PACE), delivering coordinated medical and social care in homes and communities. Supported by leading healthcare organizations and investors, the company is expanding its scalable model with a mission-driven culture focused on participant well-being.
Manage referral and clinical documentation workflows to ensure patient records are complete and available for coordinated care.
Obtain and review clinical documentation from network providers, resolve missing records, and maintain accurate recordkeeping.
Collaborate with clinicians, Military Treatment Facilities, and internal teams to support efficient referral and documentation processes.
International SOS Government Medical Services supports healthcare programs that improve patient care and operational readiness across the U.S. and internationally. Founded in 1984, the company operates in more than 90 countries and delivers healthcare, medical assistance, emergency response, and workforce support services worldwide.
Respond to service requests from internal and external customers accurately and on time.
Maintain case documentation with precision to keep records audit-ready.
Compile and distribute monthly reports and data summaries for leadership.
Personify Health offers a personalized health platform combining health plan administration, wellbeing solutions, and care navigation. The company serves employers and health plans with data-driven solutions, fostering a mission-driven culture focused on improving health outcomes.
Perform audits of enrollment, disenrollment, eligibility, and plan/PCP change transactions for health plan enrollment associates.
Review enrollment (834) file transactions and coordinate with state systems to confirm member effective dates and eligibility.
Collate, compile, and report QA performance to management and individuals, providing feedback for improvement.
HealthEdge provides AI-powered operational infrastructure for health insurance companies. UST HealthProof has a global workforce of over 4,000 people built on a foundation of simplicity, integrity, people-centricity, and leadership.
Act as a key liaison between Territory Managers, patients, and internal teams to ensure seamless order processing.
Manage administrative tasks including order submissions, paperwork coordination, and patient communications.
Provide consistent follow-up on outstanding paperwork, schedule appointments, and maintain accurate records.
Enovis Corporation is a medical technology company dedicated to developing clinically differentiated solutions that improve patient outcomes in orthopedics. It is powered by a culture of continuous improvement, global talent, and innovation, with a focus on transforming workflows.
Review prior authorization cases to ensure clinical and operational standards are met.
Audit AI outputs, third-party reviews, and internal decisions for accuracy and compliance.
Collaborate cross-functionally to refine workflows and improve patient access to treatment.
Generator Health operates a platform that streamlines prior authorization processes for patients and providers. They handle tens of thousands of patients weekly and emphasize collaboration and accuracy in a high-autonomy remote environment.
Interpret federal and state regulations to ensure compliance and drive process improvements.
Analyze data in Excel to identify trends, savings, and process improvements.
SIHO Insurance Services provides health insurance administration and related services, focusing on payment integrity and regulatory compliance. The company operates in a managed care environment and emphasizes collaboration, professionalism, and adaptability among its employees.
Maintain, organize, and monitor electronic and paper medical records for completeness and regulatory compliance.
Process release of information requests while verifying identities, authorizations, and legal requirements.
Monitor compliance with HIPAA and regulatory standards, support audits, and drive quality improvements.
US Security & IT supports healthcare organizations with information management and compliance solutions. The company offers a supportive, collaborative remote environment with a focus on wellbeing and professional growth.
Maintain accurate operational databases, account records, and documentation in accordance with procedures.
Manage assigned work queues, set up agreements, and draft professional consumer correspondence.
Collaborate with stakeholders and vendors, ensuring compliance, confidentiality, and escalation of issues.
CCMR3 specializes in debt recovery solutions with a focus on empathy, integrity, and ethical conduct. The company is a leading firm in the industry, fostering a dynamic, collaborative culture that values teamwork and results-driven performance.
Manage end-to-end IRB meeting workflows, including submissions, reviewer assignments, and meeting preparation.
Facilitate communication among client services, IRB Chairs, Board members, and clients to ensure timely review processes.
Prepare and review informed consent forms for regulatory compliance and quality.
The company coordinates Institutional Review Board (IRB) meetings within a highly regulated clinical research environment. They offer a collaborative and inclusive culture focused on ethical, patient-centered outcomes, though company size is not specified.
Manage tutoring session reports, user rostering, and scheduling to ensure operational accuracy.
Coordinate tutor substitutions, onboarding, and cross-functional issue resolution.
Identify opportunities to improve workflows and maintain strong communication with leadership.
They operate an online tutoring marketplace connecting students with tutors. They are a growing, education-focused organization with a collaborative, team-oriented culture.
Assess clinical documentation for compliance with AMA and CMS coding guidelines.
Provide education and guidance to providers, clinical staff, and coders on documentation standards.
Analyze audit data, report findings, and collaborate with leadership to improve coding practices.
UnityPoint Health is a healthcare system providing medical services across Iowa, Illinois, and Wisconsin. It is recognized as a top workplace, committed to team member support, development, and a culture of belonging.
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.
Coordinate and arrange certification and 2nd party audits, overseeing end-to-end processes in compliance with program and ISO 17065 requirements.
Serve as the main contact for clients and external stakeholders, delivering excellent customer service and maintaining up-to-date operational knowledge.
Manage audit scheduling, maintain client records, and support continuous improvement of systems and procedures.
Eurofins Scientific is an international life sciences company providing analytical testing services to make life safer, healthier, and more sustainable. Over 30 years, it has grown to 58,000 staff across 900 laboratories in 54 countries, fostering a decentralized and entrepreneurial network.
Ensure the Enrollment Team delivers high-quality, compassionate interactions with prospective members through call audits and evaluation reviews.
Lead calibration sessions and identify trends, opportunities, and improvements for QA rubrics and processes.
Use data and AI technology to surface insights, optimize quality platforms, and advance strategic quality initiatives.
Thyme Care is a market-leading value-based oncology care enabler that partners with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for people with cancer. They are a tech-native organization with a culture centered on human connection, innovation, and continuous improvement, serving thousands of patients across the country.
Accurately transcribe client data from Electronic Medical Records (EMRs) into required electronic formats.
Monitor shared inboxes and internal dashboards, documenting incoming communications and following up with clients or teams.
Export and upload documents within CorroHealth's proprietary system and support cross-functional departmental tasks.
CorroHealth provides healthcare revenue cycle solutions and clinical expertise to help providers meet their financial health goals. They invest in team member development and leverage technology to deliver scalable, accountable services.