As a Quality Improvement Advisor, you will serve as the primary liaison and coach for healthcare facilities within your state, focusing on implementing strategic priorities and healthcare goals. You will collaborate with state healthcare partners, systems, and providers to drive measurable improvements in patient outcomes, while addressing unique state challenges. You will analyze state- and provider-level quality data, facilitate learning collaboratives, and provide technical assistance to facilities as they implement evidence-based practices.
Responsible for overseeing and ensuring the success of quality improvement initiatives within clinician offices across a designated region. Will manage a team of Quality Improvement Advisors (QIAs) to ensure the delivery of effective technical assistance (TA), achievement of project goals, and compliance with deliverables. Acts as the primary point of accountability for the performance of their assigned setting and will work collaboratively with state and regional leadership teams.
This vital leadership role is focused on optimizing performance across specialty clinical departments, where you will oversee teams in Movement Disorders, Cognitive Neurology, and other key neurological specialties, driving clinical excellence, provider productivity, operational efficiency, and accountability across the telehealth platform.
Transform complex healthcare policy into intelligent, automated logic that powers Rialtic’s payment accuracy engine, creating high-impact claims editing rules that help leading payers reduce overpayments and promote transparent, accurate reimbursement practices. This is a high-autonomy, high-impact role for someone who thrives in a collaborative, cross-functional environment and is eager to deepen their technical expertise while shaping a modern healthcare platform.
The Director, Diagnostic Imaging / Imaging Services provides strategic and operational leadership for all diagnostic imaging services across the organization, with a particular focus on echocardiography and ultrasound services. This remote leadership role oversees planning, development, coordination, quality assurance, and evaluation of imaging services. The Director ensures clinical excellence, regulatory compliance and alignment with organizational goals.
The Utilization Management Specialist (UMS) screens patients to determine the appropriate level of care through the use of clinical criteria, the Medicare Inpatient Only List, and individual payer requirements. The Utilization Management Specialist collects data, completes audits, and generates reports based on trends and various improvement initiatives. The Utilization Management Specialist interacts with Care Coordination, Coding, Revenue Integrity, Compliance, Physician Advisors, Physicians, and payers to establish level of care.
The Manager of Enrollment oversees the enrollment program acting as the primary liaison for clinics, payers, the billing office, and practitioners, ensuring accurate healthcare provider enrollment with various health plans. The ideal candidate should have strong knowledge of operational processes, credentialing, and payer enrollment, with a focus on enhancing efficiency and ensuring smooth provider onboarding.
Provides oversight of network strategies and relationship development activities for assigned providers including individualized planning, training and development of providers to align with Presbyterian’s clinical quality initiatives. Will provide the framework for physician/provider performance reporting that will assist providers with objective and quantitative analysis of clinical quality performance measures. The Network Relations Service Executive is a professional accountable for proactively identifying issues, resolving disputes, and coordinating resolutions. Accountable for resolving complex problems, fielding general questions, and acting as a liaison between the provider of service and the health plan.
Under general supervision, the Coder is responsible for reviewing applicable documentation and assigning appropriate procedure and diagnosis codes. Reviews notations, diagnosis, or procedure information in medical record to assign appropriate diagnosis and procedure codes, ensuring accuracy and appropriateness of codes. Ensures documentation supports the level and type of service billed in compliance with billing regulations, provider documentation, procedures and coding guidelines.
This role is a critical member of the SRH team. The Senior Associate will support the day-to-day operations of a small-grants funding mechanism that supports rapid deployment of funds for reproductive health products across low- and middle-income countries. They will support the overall coordination, implementation, and maintenance of a range of activities that underpin the pre-award and post-award life cycle of grant investments.