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Key Responsibilities:
- Supervise and direct day-to-day operations of clinical compliance auditors and specialists.
- Assist in developing coordinated companywide team processes and managing UM/PHM plan adherence.
- Serve as clinical services liaison to senior management and ensure timely documentation.
Qualifications:
- Active RN license in IL and 3-5 years leading UM and PHM plan changes.
- Experience in managed care environment with multiple clients.
- Strong organizational, analytical, and computer skills.
Benefits Overview:
- Fully remote work environment and flexible PTO plans.
- Comprehensive medical, dental, and vision coverage.
- 401(k) with 3% employer match and paid parental leave.
Guidehealth
Guidehealth is a data-powered healthcare company focused on operational excellence and value-based care. They emphasize empathy, AI, and collaboration, with a remote-first culture.