Lead strategic planning and execution of Medical Affairs initiatives aligned with corporate objectives.
Drive operational excellence through process improvement, change management, and performance tracking.
Partner with cross-functional stakeholders to ensure seamless integration of medical strategies.
Kardigan is a heart health company working to make cardiovascular disease preventable and curable. They're driven by patients and their families, deeply committed to improving lives and prioritizing patient needs, authentic, always learning, winning as a team, and enabling the impossible.
Build and operationalize a scalable clinical trial site management model leveraging IVX Health’s clinical and operational infrastructure.
Lead execution of clinical trials across multiple sites, ensuring protocol adherence, predictable study start‑up, and high‑quality administration and documentation.
Serve as the senior accountable leader for regulatory compliance, quality, SOP governance, training, documentation integrity, and CAPA.
IVX Health is a national leader in high‑quality infusion and injection therapy, operating 150+ ambulatory centers across the U.S. They are backed by Linden Capital Partners and continue to scale rapidly—expanding services, accelerating growth, and building the leading ambulatory infusion platform in the country.
Monitor incoming faxes for authorization requests, enter UM authorizations review requests, and verify eligibility and claims history.
Ensure all necessary documentation is submitted, contact providers for required medical records, and generate correspondence for notifications.
Initiate appeal cases, meet deadlines, assist UM Nurses, and handle inquiries from call centers and other sources.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly and fairly. While the company size is not mentioned, they seem to have a modern approach by utilizing AI tools in the hiring process to identify top-fitting candidates for their client companies.
Conduct quality audits of inpatient clinical determinations to ensure alignment with clinical guidelines and quality standards
Analyze QA findings and translate insights into actionable recommendations for operational leaders and cross-functional partners
Provide coaching and feedback to improve clinical decision accuracy, guideline adherence, and overall team performance
Cohere Health delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. They work with over 660,000 providers and are backed by leading investors such as Deerfield Management. The coherenauts who succeed there are empathetic teammates who are candid, kind, caring, and embody their core values and principles. Cohere is deeply invested in ensuring that they have a supportive, growth-oriented environment that works for everyone.
Own high-volume inbound patient and provider communication queues.
Serve as the first point of contact for patients, resolving inquiries in real time.
Act as a reliable liaison between patients and their care teams.
Oshi Health is revolutionizing GI care with a digital clinic model, providing convenient access to an integrated and multidisciplinary care team. They are dedicated to creating a workplace that prioritizes their team and fosters inclusivity, reflected in their "Best Place to Work" awards.
Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues.
Proactively identify overpayments to ensure accurate claims payments on inpatient services.
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.
They are reinventing health insurance by combining data with human empathy to keep members healthier. Clover Health believes the healthcare system is broken, so they've created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most. They are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
Serve as the authoritative SME on technical CARC/RARC codes, mapping, and workflows.
Define product requirements for auto-scrub, intelligent resubmission, documentation-request automation, and worklist prioritization for soft denials.
Design root-cause prevention logic that feeds denial patterns upstream to SmarterPrebill, SmarterUM, and Patient Access.
Smarter Technologies is a healthcare technology company focused on transforming how healthcare services are delivered, managed, and reimbursed. They bring together Access Healthcare, SmarterDx, Thoughtful AI, and Pieces, combining deep healthcare services expertise with advanced data, automation, and AI capabilities.
Evaluate hospital admissions, continued stays, and post-acute services for Medicare Advantage members.
Guide timely care determinations using CMS regulations and evidence-based practices while collaborating with care management teams and external providers.
Conduct timely medical necessity determinations for inpatient admissions and post-acute settings.
HJ Staffing is urgently seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. This physician leader will play a critical role in ensuring the clinical integrity of inpatient and post-acute care reviews, evaluating medical necessity to support optimal outcomes and regulatory compliance.
Represent HEOR function in Medical Strategy Teams to develop integrated evidence plans (IEPs).
Proactively generate and communicate evidence to optimize patient access to products.
Effectively partner with internal stakeholders to shape research partnerships.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates and share this shortlist directly with the hiring company.
Lead the planning/execution of clinical studies, aligning with regulatory/business objectives.
Manage relationships with CROs, vendors, and external partners for timely/cost-effective study delivery.
Project manage clinical trials, overseeing timelines, budgets, and deliverables.
Jobgether is a platform that helps connect job seekers with companies. They use AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements.