Review and audit clinical documentation for accuracy, timeliness, and regulatory compliance.
Ensure documentation meets Medicare Conditions of Participation, state regulations, and accreditation standards.
Lead and support Quality Assurance and Performance Improvement initiatives, tracking key clinical and operational indicators.
They are fixing US healthcare by building an AI-native physical care platform, starting with home health. The company is automating administrative work with AI to create a fundamentally different cost structure than incumbents, enabling them to serve more patients.
Management and oversight of a quality team conducting quality assurance activities.
Responsible for the successful execution of the Quality Improvement Program in accordance with CMS requirements.
Plans, organizes, and directs activities of Clinical Quality, including planning, training, and staff development.
HealthEdge is committed to workforce diversity and actively encourages all qualified persons to seek employment. They provide effective and efficient solutions to complex business problems.
Leads a team of clinicians and serves as a senior clinical owner for care delivery workflows.
Provides clinical support for program development and customer-facing clinical work.
Partners closely with Operations, Product, Member Success, Clinical Outcomes, Legal, Commercial, Customer Success, Solutions Consulting, and Marketing.
Carrot is a global, comprehensive fertility and family care platform, supporting members and their families through many of life's most memorable moments. Its award-winning products serve all populations, from preconception care through pregnancy, IVF, male factor infertility, adoption, gestational carrier care, and menopause.
Supervise day-to-day operations of assigned Utilization Management staff.
Provide full people management for assigned Utilization Management teams, including hiring and performance management.
Drive team performance against key metrics, including engagement, productivity, and quality scores.
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.
Drive quality, safety, and compliance through systems by identifying issues and implementing process improvements.
Execute order management and EMR workflows by reviewing and approving new orders and supporting clinical escalations.
Manage end-of-episode processes, hospital holds, and monitor patient status and quality compliance through dashboards and alerts.
They are building an AI-native physical care platform to fix US healthcare, starting with home health. The company has assembled a team of AI experts from leading firms and paired them with healthcare veterans to operate at the speed of an AI company.
Review clinical documentation and treatment trajectory to ensure care meets medical necessity standards.
Synthesize clinical documentation, medical record information, and outcomes data to make recommendations on next steps in care.
Partner cross-functionally to support high-quality, clinically appropriate care across the network.
Rula is dedicated to treating the whole person and aims to create a world where mental health is no longer stigmatized. They are a remote-first company committed to providing quality, evidence-based, and compassionate care, empowering individuals to take charge of their mental health.
Lead Headway's clinical quality strategy, developing protocols and processes that uphold safety, efficiency, and effectiveness standards for the practice.
Build and scale our Professional Practice Evaluation programs, directly improving clinical outcomes across our provider network of NPs and MDs/DOs.
Conduct routine chart reviews and monitoring, providing feedback to clinicians and creating remediation plans for documentation concerns
Headway is building a new mental healthcare system everyone can access by solving the biggest barrier to care: insurance. They are a Series D company with $325M+ in funding, looking for exceptional people to help them achieve their mission.
Review patient charts and documentation against defined coverage criteria.
Work with internal AI software that enables review productivity and apply structured processes to determine documentation sufficiency.
Produce clear, standardized written summaries of review outcomes and meet daily throughput and quality targets.
Verse Medical is building the modern software infrastructure to make hospital-quality care accessible everywhere. They're a well-funded Series C company, backed by notable investors, on a mission to heal a fragmented system by connecting providers, payors, and patients.
Serve as the lead clinical liaison for partner providers across multiple regions.
Partner with PRMs on clinic visits and ongoing relationship management to strengthen long-term program engagement.
Translate field insights into actionable intelligence for clinical, product, and engineering teams, directly informing service improvements and care model refinement.
Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions. They pair patients with a dedicated clinical team and integrate deeply into health system EMRs and workflows.
Works with field staff and Manager, Clinical Services (MCS) to appropriately schedule clinicians for cases in assigned areas of responsibility.
Communicates appropriately regarding changes in schedule or service delivery.
Demonstrates the ability to be efficient and productive by organizing job duties and responsibilities.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, we are committed to finding new ways to improve the health of our patients and the health of the communities we serve.
Lead and manage multi-level Clinical Specialists for clinical support and case coverage.
Develop and deliver clinical education to sales, clinical specialists, and OR staff.
Work cross-functionally with Quality, Regulatory, Marketing, and R&D to develop clinical education.
Calyxo, Inc. is a medical device company that addresses the profound need for improved kidney stone treatment. They are led by executives and investors with a proven track record of commercializing paradigm-shifting devices to meet unmet needs within urology.
Own clinical quality strategy for a rapidly scaling network spanning 20+ states, 400+ clinicians, and multiple care models.
Build clinical compliance policy infrastructure that anticipates growth rather than reacts to it.
Lead and develop a team that grows with the organization.
Cartwheel builds a new kind of mental health program for kids that puts schools at the center, supporting school staff. They are an early-stage company backed by top investors and looking for mission-driven teammates.
Coordinate care and collaborate with multiple disciplinary team members to improve the quality of care and clinical outcomes.
Conduct thorough assessments to determine unmet needs and develop individualized care plans.
Promote quality cost-effective outcomes with the goal of improved care coordination.
Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Performs utilization review to determine medical necessity criteria compliance and facilitates resolution of escalated cases.
Collaborates with clients and physician reviewers, ensuring adherence to all HIPAA, state, federal, and regulatory standards like URAC & NCQA.
Utilizes various computer systems to manage cases, engages in provider communication, and participates in quality management programs while prioritizing independent work.
WNS, part of Capgemini, is an AI-powered leader in intelligent operations and transformation, serving over 700 clients across industries like Healthcare and Financial Services. It is a large global company with over 66,000 employees, combining deep domain expertise with AI platforms to create lasting business value.
Lead and inspire a team of Patient Support Specialists.
Establish and refine team KPIs related to outreach volume and scheduling conversions.
Partner with clinical, engagement, and product teams.
Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos. They are developing a new approach to care that is designed around shared and lived experiences and brings care to the community. The company was founded in 2021 and is backed by leading healthcare and social impact investors.
Conduct synchronous video visits with patients navigating perimenopause and menopause.
Assess symptoms, develop and adjust treatment plans, including medications.
Maintain timely and accurate documentation and follow clinical standards.
Pomelo Care redefines healthcare for women and children as a virtual medical practice. They provide continuous support, leveraging technology for personalized, 24/7 virtual care to improve outcomes for families nationwide.
Develops and systematizes current practice with standardized outcome measurements in therapy for core clinical pathways
Collaborates with Shriners Children’s Medical Group for guidelines and protocol development for seamless patient care transitions through multiple venues of care
Leads rehabilitation and therapy services departments in outcome usage specific to patient diagnoses
Shriners Children’s provides excellence in patient care, embracing multi-disciplinary education, and research with global impact. They foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking.
Provide clinical care and education asynchronously to members within the scope of RN practice.
Assist clinicians in reviewing and preparing prescriptions, ordering labs, and checking state PDMP.
Collaborate with clinicians to provide lab and imaging results, and respond to medical requests from members and outside entities.
FOLX Health aims to be the leading health and wellness platform for LGBTQIA care, providing end-to-end services virtually and in person. They foster innovation by creating joyful, affirming healthcare and building community around individual needs.