The Lead Care Manager serves as the client’s primary point of contact and works with all their providers. The Lead Care Manager manages client cases, coordinates health care benefits, and provides education. The Lead Care Manager collaborates and communicates with client’s caregivers/family support persons, other providers and others in the Care Team.
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- 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.
- Assign appropriate procedure and diagnoses codes according to the AMA coding guidelines.
- Review provider documentation and prepare feedback to the Sr. Coding Manager.
- QA review of charts coded by vendors and the AI coding tool for coding accuracy.
- Lead enterprise-level initiatives that enhance front-end operations.
- Improve patient financial experience, and strengthen the connection between Patient Access and the overall Revenue Cycle.
- Drive measurable outcomes in throughput, cash acceleration, and patient satisfaction.
We are seeking a Site Team Lead to oversee and coordinate decentralized clinical trial operations across Europe. This role requires a proactive and organized professional who can manage multiple priorities, anticipate issues, and implement solutions efficiently. The role offers an opportunity to directly impact trial success and improve patient outcomes in a collaborative and innovative environment.
US
1w paternity
Focuses on clinical data abstraction that directly supports patient care across SSM Health. Reviews patients’ electronic health records and accurately abstract required data elements. Identifies trends for intra- and post-procedure complications.
$120,000–$160,000/yr
- Manage consulting projects for mid- and large-market employers.
- Design advanced benefits strategies in partnership with actuarial, communication, pharmacy, and population health teammates.
- Provide project management and technical expertise to ensure successful execution of client initiatives.
- Conduct audits to ensure proper coding levels and compliance.
- Educate physicians and staff on audit findings and requirements.
- Collaborate with insurance teams to resolve denial trends.
- Lead the strategic development and execution of payer policy analytics to optimize access and reimbursement strategies.
- Oversee the creation and management of proprietary payer knowledge and translates insights into actionable strategies.
- Design and implement dashboards and reporting tools to measure payer policy impact and access metrics.
$68,700–$123,700/yr
- Conduct detailed audits of clinical coding for accuracy, compliance, and reimbursement integrity.
- Develop and deliver engaging training sessions for coding staff and providers.
- Identify trends, risks, and opportunities for process improvement.