Plan, develop, and direct all aspects of onshore and offshore BPaaS activities to ensure operational efficiency and customer success.
Establish operational objectives, policies, and procedures in compliance with contracts and regulations, and develop strategies to achieve key performance measures.
Provide executive-level briefings to senior leadership and build collaborative relationships with client leadership to drive continuous improvement.
Lead and manage daily performance of assigned frontline teams, ensuring adherence to quality, productivity, and service standards.
Analyze key operational metrics and trends to identify risks and improvement opportunities.
Foster employee growth through structured coaching, mentoring, and ongoing performance feedback.
Carenet Health is a healthcare services company that provides patient engagement and care coordination solutions. The company operates with a focus on delivering a seamless member experience through its BPO operations, though specific size and culture details are not provided.
Architect and execute the strategic roadmap for provider data management, credentialing, and network adequacy, acting as the enterprise authority on data integrity.
Lead a high-performing remote team, establishing rigorous metrics for third-party vendors and integrating AI/LLMs to automate and optimize provider data processes.
Oversee the accuracy and compliance of the Provider Directory, partner with the Chief Medical Officer on credentialing, and drive cross-functional collaboration across Clinical, Claims, and Product teams.
Clover Health is redefining health insurance by leveraging data and technology to deliver personalized, high-quality care for Medicare Advantage members, aiming to make healthcare easier and more accessible. As a mission-driven company with a remote-first culture, they prioritize diversity and inclusion, fostering a team of passionate individuals focused on improving lives through innovation.
Manage all operations for a few processes or clients to meet SLAs and drive operational efficiency.
Work closely with the team and managers to achieve quantitative and qualitative SLAs and KPIs.
Ensure measures are in place to improve quality, turnaround time, and overall process efficiency.
UST HealthProof reshapes the future of health insurance by reducing administrative costs and building better healthcare experiences through a modern, cloud-based core administration ecosystem. It is a fast-paced, growing company run by leaders with strong health plan and technology backgrounds, fostering a supportive environment where individual growth is nurtured.
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.
Lead and develop a team of 10–12 operations professionals in a fully remote environment.
Oversee operational execution, process optimization, and implementation of new programs.
Drive talent management, compliance, and cross-functional project coordination.
Jobgether is a platform that uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, fair recruitment processes and support a diverse range of job opportunities.
Lead and mentor the Service Delivery team in all Tier 1 and 2 consulting initiatives, providing product education and subject matter expertise on healthcare payment methodologies and operations.
Manage escalated client issues by acting as a liaison between clients and internal support teams to ensure accurate problem resolution.
Develop and maintain capabilities and tools, conduct scoping sessions, and collaborate with cross-functional teams to enhance client outcomes.
HealthEdge is a healthcare technology company specializing in payment integrity and claims adjudication software. The company prides itself on a collaborative, user-driven culture with a focus on impact over ego.
Coordinate and support CMS Hospital Quality Reporting Program activities, including work plans, timelines, and contractor oversight.
Develop training materials, presentations, and reports while facilitating cross-functional meetings and stakeholder communication.
Identify workflow improvements using AI tools in accordance with data privacy and quality standards.
HSAG is a healthcare consulting firm dedicated to improving the quality of healthcare delivery in the United States. As a growing team, we foster a collaborative culture focused on making healthcare better for everyone while having fun at work.
Lead Medicaid operations and serve as the subject matter expert shaping service delivery and regulatory compliance.
Own client relationships, drive operational excellence, and implement process improvements across the team.
Develop and coach a high-performing remote team, fostering accountability, collaboration, and continuous growth.
Model N is the leader in revenue optimization and compliance for pharmaceutical, medtech, and high-tech innovators. With over 150 customers in more than 120 countries and 25+ years of experience, the company fosters a culture of innovation and customer success.
Monitor and interpret CMS guidance for Medicare, Medicaid, and other healthcare programs.
Partner with internal teams to ensure compliance with regulations and contract obligations.
Maintain regulatory tracking documentation and support development of training materials.
HealthEdge provides healthcare software and services to payers and providers. It is a growing company with a focus on compliance and innovation, fostering a collaborative and remote-friendly culture.
Direct audit service delivery and manage teams to meet client needs and exceed expectations.
Drive audit productivity, cost management, and continuous improvement through metrics and innovation.
Lead staffing, people management, and contract negotiations to ensure compliance and growth.
Cotiviti provides payment accuracy and analytics solutions for healthcare and retail industries. The company is an equal opportunity employer and offers competitive benefits to a diverse team of professionals.
Drive provider quality initiatives through data-driven decision making and high-impact operational programs.
Lead scalable quality initiatives by identifying gaps, sizing opportunities, and executing quarterly programs.
Partner cross-functionally to align priorities and measure outcomes with strong analytical horsepower.
Rula is a remote-first mental health company dedicated to providing evidence-based and compassionate care, aiming to destigmatize mental health and treat the whole person. It hires in most U.S. states and fosters an inclusive culture for its team.
Lead Omada's Clinical Quality department with end-to-end accountability for program integrity, performance, and continuous improvement across cardiometabolic programs.
Define and drive the near-term roadmap for program quality, accreditation readiness, quality analytics, and AI bias monitoring.
Build durable quality infrastructure that supports a growing portfolio of clinical products and care experiences, partnering across teams.
Omada Health is a virtual-first healthcare company on a mission to bend the curve of chronic disease by combining human-led care teams, connected devices, and AI-enabled technology. The company has served over two million members across 2,000+ employers and health plans, and fosters a culture of trust, context, boldness, and collaboration.
Lead and develop a high-performing claims organization across rideshare property, auto, and bodily injury lines.
Own the end-to-end customer claims experience, driving service quality, efficiency, and regulatory compliance.
Partner with product and engineering teams to enhance claims systems and automation tools.
This company is a partner of Jobgether, offering a modern, technology-enabled claims organization focused on rideshare-related claims. They are a remote-first, high-growth firm with an inclusive culture and a focus on automation and customer-centric innovation.
Provide executive oversight of all clinical programs, including Behavioral Health and EAP services, establishing strategic direction and quality frameworks.
Lead and supervise AVP-level clinical leaders, ensuring accountability and cross-functional alignment across clinical operations.
Develop clinical strategies, policies, and procedures, oversee utilization management, and drive quality improvement initiatives.
Uprise Health transforms the delivery and accessibility of mental and behavioral healthcare, bringing whole person care to individuals worldwide. The company values compassion, integrity, collaboration, velocity, and advocacy, and seeks to foster a culture of care and support.
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.
Obtain and manage insurance authorizations for residents receiving skilled nursing and rehabilitation services.
Monitor authorization status, track expiration dates, and submit timely extension requests to prevent coverage gaps.
Collaborate with clinical, admissions, and payer representatives to ensure timely approvals and accurate documentation.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging a global network, they connect clients with qualified professionals and offer tailored services to meet unique business needs.
Lead one or more client policy initiatives with a team, including policy analysis, facilitating client meetings, and deliverable development.
Drive your development through an annual process with your supervisor and BerryDunn's learning and development team.
Participate in new business development through research, supporting proposal content, or developing marketing materials.
BerryDunn is a client-centered, people-first professional services firm that helps businesses, nonprofits, and government agencies solve their greatest challenges. Founded in 1974, the firm is recognized for its diverse and inclusive workplace culture and focus on learning, development, and well-being.
Direct AR and analytics teams to improve revenue cycle financial performance across multi-entity environments.
Bridge data-driven insights with operational support, partnering with RCM, Finance, HIM, IT, and executive leadership.
Manage daily billing/collection activities, mentor staff, and implement strategies to reduce AR and increase cash collections.
Ovation Healthcare strengthens independent community healthcare by providing support, guidance, and tech-enabled shared services. Partnering with 375+ hospitals across 47 states for over 45 years, the company fosters a collegial atmosphere of professionalism and teamwork.
Lead analysis and delivery of coding, billing, and policy solutions from requirements to implementation.
Translate complex medical coding concepts into clear documentation and actionable deliverables.
Act as a key liaison between operations, technical teams, and client stakeholders to ensure alignment.
Partner company focused on healthcare operations, medical coding, and policy. They offer a fully remote environment with comprehensive benefits and professional development opportunities.