Administer and organize various types of projects within the Healthcare Development team.
Support project teams on meetings and logistics coordinating virtual and in-person meetings and education.
Assist with preparing reports and deliverables per project requirements.
The American Heart Association's mission is to be a relentless force for a world of longer, healthier lives. They have cut cardiovascular disease deaths in half since 1924, and they continue to strive for progress with a team of passionate individuals.
Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.
Provide medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
Perform medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.
Centene is committed to helping people live healthier lives. They provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well. Centene values diversity and is an equal opportunity employer.
Perform medical record analysis for accurate coding and sequencing.
Maintain quality and productivity standards.
CorroHealth helps clients exceed their financial health goals by providing scalable solutions and clinical expertise across the reimbursement cycle. They utilize leading technology and analytics to guide their solutions and achieve goals, building long-term careers by investing in employee development and growth.
Evaluating hospital admissions, continued stays, and post-acute services for Medicare Advantage members.
Guide timely care determinations using CMS regulations and evidence-based practices.
Lead discussions with attending physicians to clarify clinical documentation and support appropriate levels of care.
HJ Staffing is seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. The company has not provided any information about its size/employees and culture but is likely a medium to large medical or staffing company.
Sustains responsibility for timely and accurate coding of all facility outpatient visits and outpatient coding audits.
Develops and implements policies and procedures to achieve organizational goals and assists in the development of operational strategy.
Monitors employee training, productivity, quality, and overall employee performance of all Outpatient Medical Record Coding Specialists.
The Ohio State University is a top-20 public university and its Ohio State Wexner Medical Center is one of America’s leading academic health centers. They set the stage for academic achievement and innovation, where friendships are forged and tradition is brought to life.
Showcase customer service and data entry skills as part of the healthcare team.
Involved in claims adjudication and/or provider credentialing.
Support customers by phone, email and chat.
Sutherland helps customers globally achieve greater agility and transform automated customer experiences. As a digital transformation company they have been in business for over 35 years and are Great Place to Work certified with nearly 40,000 employees.
Oversee the provider performance and escalations team.
Conduct audits and quality assurance reviews to promote quality of care.
Work closely with cross-functional partners to strengthen and improve quality of care systemically through innovation.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. They partner with over 450 companies and provide care for 10 million people and their valuation has reached $3.3 billion.
Source, interpret, and scope new payment integrity policies.
Prioritize policy updates based on savings potential and client impact.
Quantify and communicate policy value through data-driven analysis.
Rialtic, Inc. focuses on healthcare payment expertise, client strategy, and product innovation. They seem to have a culture that values collaboration and impact, although the job post doesn't specify size/employees.
Address the needs of patients with a focus on customer support, coordination of logistics, and problem solving.
Schedule and coordinate the flow of work within or between departments to expedite project efficiencies and resolution to escalations.
Address and resolve assigned inquiries with a sense of urgency; Ensure timely closure of escalation cases using email, phone, or salesforce.com
Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other.
Supervise a team of approximately 10-15 Lead Care Managers.
Oversee the creation of Individual Care Plans.
Drive the team to meet key performance indicators (KPIs) effectively.
Vynca is passionate about transforming care for individuals with complex needs. They are a close-knit community guided by core values, aiming to provide comprehensive care for more quality days at home for their clients.