Support Hazel’s Physical Health provider team with phone calls to families in both English and Spanish. Provide interpretation and translation services for phone calls, telehealth visits and written medical documentation. Troubleshoot minor technical difficulties and escalate to Hazel’s IT team, when needed.
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- Lead the modernization of WW’s nutrition system, ensuring it reflects the latest science and industry best practices.
- Collaborate with Product, Engineering, and Data Science teams to co-develop AI-driven recommendation engines.
- Provide direct leadership and coaching to a small, high-performing team, establishing clear goals and feedback structures.
The Upstream Senior Clinical Program Manager will design and execute pre-market feasibility and pivotal clinical studies, ensuring regulatory compliance while supporting marketing claims. This role requires close collaboration with physician collaborators and internal stakeholders to collect, analyze, and interpret clinical data. The role offers remote flexibility, with occasional travel for on-site meetings and conferences.
- Plans, directs, coordinates and supports the activities of MSLs within a designated geographic region.
- Coaches and mentors medical level professionals (MSLs) in a therapeutic region.
- Works cross-functionally within U.S. Medical Affairs to identify, develop, implement, and monitor MSL strategies and tactics.
- Assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types.
- Review medical records to code diagnoses, procedures, and evaluation and management services.
- Resolve NCCI, NCD/LCD or other outpatient edit claim failures.
- Support health plan partnerships and strategy.
- Drive innovative research initiatives.
- Work collaboratively with cross functional teams.
Primarily responsible for the accurate assignment of CPT, HCPCS, modifiers, and diagnosis codes. Utilizes expert knowledge and application of CPT, HCPCs, and ICD-10 coding guidelines to ensure accuracy of coding and charge capture. Communicates effectively with providers or other teams to resolve CPT, ICD-10, HCPCs, or modifier discrepancies and resolve complex coding-related denials.
- Conduct thorough audits of medical records and coding practices.
- Develop and deliver educational programs on coding best practices.
- Collaborate with billing, clinical, and revenue cycle teams.
- Identify documentation and coding improvement opportunities.
- Provide guidance around operational and clinical best practices in the risk adjustment methodology.
- Perform analysis of performance indicators and put together a formal presentation for reporting out to providers.
- Assesses member needs in various areas including physical and mental health.
- Oversees the development of client care plans and goal settings.
- Connects clients to social services and supports that are needed.