Conducts training for staff members related to Utilization Review process, clinical guidelines, and workflows.
Creates educational material by collaborating with key resources to incorporate clinical scenarios.
Reviews monthly quality audit findings and provides one-on-one coaching to staff for performance improvement.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, the company combines scale, expertise and execution to create meaningful, measurable impact.
Provide clinical review and correspondence for utilization management, including medical necessity reviews and member communications.
Collaborate with Medical Directors to ensure evidence-based decisions that meet NCQA and CMS standards.
Maintain productivity and quality while working 100% remotely in a fast-paced environment.
Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With over 250 employees, the company fosters a supportive, growth-oriented environment and has been named to the Inc. 5000 list and a Top 5 LinkedIn Startup.
Provide clinical case coverage and train surgical teams on safe and effective device use, ensuring positive patient outcomes.
Manage inventory, perform quality control, and troubleshoot equipment during surgical procedures.
Collaborate with the commercial team to support account management, physician training, and residency education.
Calyxo, Inc. is a medical device company focused on developing innovative treatments for kidney stone disease. The company is led by experienced executives and investors with a proven track record, fostering a dynamic, diverse, and fun team atmosphere.
Manage referrals into and out of the clinic, including prior authorizations and medical records.
Efficiently schedule appointments, verify insurance, and update demographics for patients.
Use strong customer service and communication skills to operate in a fast-paced healthcare environment.
Munson Healthcare is northern Michigan's largest healthcare system with eight award-winning community hospitals serving over half a million residents. The company employs thousands of staff who value excellence, teamness, positivity, and creativity in a beautiful region.
Ensure accuracy of data in iTransplant and DonorNet through comprehensive donor case reviews and timely submission to OPTN.
Audit clinical documentation against SOPs and regulations using EMR systems to correct deficiencies.
Collaborate with clinical and quality staff to resolve data issues and train staff on proper data entry.
Donor Network of Arizona is dedicated to maximizing life through organ and tissue donation. The organization challenges itself to realize Arizona's potential to save and improve lives, with a culture centered on Positive Energy, Passion, and Eagerness.
Provide patient information and education to ensure safe, effective, and appropriate use of Provenge from enrollment to completed infusions.
Collaborate with Patient Services, Sales Teams, and Medical Affairs to support patients and healthcare professionals.
Document all communications and conduct activities within legal and compliance guidelines, with potential field travel.
Dendreon is a biotechnology company focused on developing immunotherapy treatments for cancer, harnessing the power of the immune system to attack cancer cells. Headquartered in Seal Beach, California, with locations in Georgia and nationwide teams, they foster a purpose-driven, value-based culture putting patients first.
Review payer/provider contracts to identify key reimbursement provisions.
Validate and correct reimbursement terms within the Turquoise platform.
Self-QA work to ensure accuracy of loaded rates and share product feedback.
Turquoise Health is a Series C price transparency platform for finance leaders across healthcare. Backed by top venture firms, we power price transparency for over 300 enterprises and are building a more open, efficient healthcare marketplace with a remote-first US-based team.
Reviews patient data for Phase I-IV clinical research and non-interventional studies to ensure compliance with protocols and regulatory requirements.
Communicates and escalates serious issues to the project team and develops action plans as needed.
Maintains working knowledge of ICH/GCP guidelines and company SOPs, documenting activities per project requirements.
Syneos Health is a leading fully-integrated life sciences services organization built to accelerate customer success. We are a global company with over 29,000 employees, dedicated to developing our people and building an inclusive culture.
Deliver da Vinci Surgical System training programs for surgical teams at designated training centers and remote centers.
Support specialized training programs, society events, and new product development initiatives.
Manage training center logistics, inventory, training calendars, and maintain capital equipment.
Intuitive is a pioneer and market leader in robotic-assisted surgery, dedicated to advancing minimally invasive care through intelligent technology. The company fosters an inclusive culture built around diversity of thought and mutual respect, with team members grounded in integrity and a strong capacity to learn.
Codes and abstracts patient encounters for diagnostic and procedural information, analyzing data for reimbursement needs.
Completes final checks on charts ensuring all reports are signed and NCCI edits, CMS, and Joint Commission rules are followed.
Participates in continuing education and communicates with the Manager on training needs.
Plumas District Hospital provides essential health care services to the Quincy, California area and surrounding mountain community. With a population of 5,000 residents, PDH offers an inclusive work environment, competitive compensation, and perks like shift differentials and holiday pay.