Establish and monitor Medicaid program integrity objectives and KPIs, ensuring policies meet compliance.
Review and audit Medicaid claims for accuracy, legality, and reasonableness, making informed recommendations.
Research Medicaid policies and regulations, advising clients on translating policy into system requirements.
BerryDunn is a professional services firm that provides tax, advisory, and consulting services to businesses, nonprofits, and government agencies across the US. The client-centered, people-first firm is recognized for its diverse and inclusive culture and focus on learning, development, and well-being.
Recruit and contract Medicare-compliant physicians and ancillary healthcare providers within assigned geographies to build a network ensuring care access for seniors.
Clearly communicate contract terms, payment structures, and reimbursement rates to prospective and existing network providers while maintaining up-to-date documentation in tracking systems.
Build and sustain productive, long-term relationships with provider partners, aligning contracting activities with departmental strategy and organizational objectives.
Curana Health is a national leader in value-based senior healthcare, offering on-site primary care, Accountable Care Organizations, and Medicare Advantage plans to senior living communities. The company has over 1,000 clinicians and professionals serving more than 200,000 seniors across 32 states with a collaborative mission to improve health outcomes.
Provide project management and subject matter expertise to help Medicaid agencies design, develop, and implement waiver and state plan amendments.
Build relationships and communicate project status with client contacts, stakeholders, federal partners, and vendor contacts.
Oversee and mentor junior staff while participating in business development activities like writing blog posts and reviewing RFPs.
BerryDunn is a professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies. It is a client-centered, people-first firm recognized for its diverse, inclusive culture and focus on learning, development, and well-being.
Lead utilization management strategy and medical policy development, incorporating regulatory and clinical guideline updates.
Provide medical oversight and expertise to ensure the delivery of cost-effective, quality healthcare services to plan members.
Promote positive relations with the medical community and integrate clinical quality into program development and staff education.
Evry Health is the major medical division of Globe Life, a technology-enabled health plan focused on expanding benefits and increasing transparency. It is part of Globe Life, a large insurance company with over 3,000 corporate employees and a long-standing A (Excellent) rating from A.M. Best.
Conduct all participant facing tasks, ensuring a positive trial experience and excellent data accuracy within our platform.
Oversee data collection and in-person processes, maintain participant trackers, and assist with day-to-day trial implementation.
Collaborate effectively with trial teams to ensure seamless participant experiences and contribute to process improvements.
Lindus Health uses software to help innovative companies run faster, more reliable, and patient-friendly clinical trials. It is a young, VC-funded startup with a collaborative, no-ego culture where team members take on real responsibility and work across different areas.
Provide clinical leadership and oversight for Masters-level clinicians, setting standards and ensuring quality.
Drive organizational performance and team effectiveness through strong leadership, accountability, and clear management practices.
Lead program design, innovation, and quality initiatives to advance an integrated model of care and ensure compliance.
Blackbird Health delivers virtual and in-person mental health services for children across multiple states. It is a mission-driven, collaborative, and innovative team focused on a whole-child approach to pediatric mental health care.
Contribute directly to client engagements alongside AVIA leadership to address complex, real-world healthcare technology challenges.
Work in a flexible, part-time, project-based model as a 1099 contractor on high-impact advisory projects.
Be part of a trusted network deployed quickly to support health systems navigating critical technology and innovation decisions.
AVIA supports healthcare systems and hospitals in evolving their digital, data, and technological capabilities. It is building a vetted network of specialists for high-impact advisory engagements in a collaborative, project-based model.
Responsible for coding and abstracting patient records for professional billing and reimbursement.
Reviews medical records retrospectively and concurrently for accurate diagnosis and procedure coding.
Serves as a resource for coding questions, assists with insurance denials, and makes process improvement recommendations.
Trinity Health is a not-for-profit, faith-based healthcare system providing diverse medical services across 27 states. With 121,000 colleagues and nearly 36,500 physicians, it operates 101 hospitals and numerous care locations, emphasizing compassionate, person-centered care and significant community investment.
Lead life science customers in the rapid installation of clinical trial solutions like eTMF and CTMS for sponsors, CROs, and research centers.
Manage the full implementation lifecycle, including project planning, requirements gathering, configuration, validation, training, and go-live activities.
Serve as the primary customer liaison, managing communication, risks, and project reporting between the project team, customer, and internal stakeholders.
Veeva Systems is a mission-driven pioneer in industry cloud software, helping life sciences companies bring therapies to patients faster. As a fast-growing SaaS company with over $3B in revenue, it is a public benefit corporation (PBC) with values focused on customer and employee success, operating as a 'Work Anywhere' company with a global team.
Define and drive a comprehensive patient engagement strategy and framework rooted in evidence-based behavior change models, leveraging AI for personalization and intervention.
Lead the vision and execution of patient-facing product experiences, applying behavioral design principles to build intuitive and clinically aligned digital platforms.
Build and oversee a content program that educates and motivates patients, grounding all materials in health literacy principles and using AI to scale personalized messaging.
Equip provides virtual, evidence-based eating disorder treatment, building treatments to empower individuals to reach lasting recovery. The company has been fully virtual since its 2019 founding and has a passionate and diverse team, operating in all 50 US states and partnered with major insurers.