Remote Healthcare administration Jobs · US

• Review and verify insurance information and patient eligibility for prior authorizations.
• Communicate with healthcare providers to gather necessary medical documentation and information.
• Submit prior authorization requests to insurance companies following established protocols.

Conduct outreach to educate members on available clinical programs and screenings, ensuring they remain connected to care. Schedule initial appointments and reschedule visits for the team, thoughtfully adjusting calendars to meet urgent care needs. Provide inbound call support/call routing for patients with clinical or administrative questions.

• Supervision of Case Managers who assess patient needs and evaluate plan of care.
• Act as a resource for the Case Managers and support staff.
• Identify and address quality issues and participates in quality management activities.

• Seeking a Senior Director to lead global and domestic network operations in fertility and women’s health, overseeing the provider ecosystem. Responsibilities include leading network development and maintenance, overseeing network strategy, and ensuring relationships with fertility network partners.
• Own global fertility network strategy.
• Lead provider partnerships across fertility, women’s health, and ancillary services.
• Oversee network economics and contracting.

Drives clinical and administrative support functions across the market, such as customer service, scheduling, registration, referrals, and prior authorizations. Serves as a Synapticure’s representative to our members, external healthcare organizations, payer partners, and other partners to ensure that our members have the care and assistance they need to thrive.

This role is responsible for delivering compliant payer coverage, coding and reimbursement information regarding Cepheid on market diagnostics. You will cross functionally collaborate with sales, marketing and the value and access team to effectively coordinate and engage targeted regional customers. This highly visible role will play a pivotal role supporting commercial customer engagement and responding to customer inquiries.

Serve as the executive leader for the Health Policy and Patient Access Research (HPPAR) Center of Excellence (COE) within the Global Access Value and Economics (GAVE) organization at Intuitive, managing and providing leadership oversight to the COE and three key supporting functions within the center. This leader will work cross-functionally with various teams to execute strategies and tactics within operating plans, including programmatic development and execution of the COE.

As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case management staff and/or other health care professionals to meet regulatory requirements and, in accordance with the hospital’s objectives for providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely with case and utilization management to discuss selected cases and make recommendations regarding level of care.

The Electronic Health Record (EHR) Specialist will optimize EHR solutions that enable partner practices to improve patient outcomes, reduce healthcare costs, and increase efficiency. The EHR Specialist will collaborate with practice stakeholders along with the multi-disciplinary Aledade team to identify, develop, and implement EHR solutions to support strategic ACO initiatives. Additionally, this role will facilitate the collection of practice-generated data that can be used for population-based analytics.

Oversee initial implementation and support ongoing management of new and existing Strategic Health Plan Alliances (payers and strategic business partners). Work hand in hand with the Strategic Alliance Manager to support go to market efforts and ensure ongoing execution success. Drive key work streams across teams such as technical, marketing, revenue cycle, data, and privacy. Conduct regular business reviews with health plan partners and internal stakeholders to assess progress against plans.