Risk Adjustment Coder

locations

Remote

Full time

Position: Risk Adjustment Coder

Department: Clinical Documentation

Schedule: Full Time

POSITION SUMMARY:

The Risk Adjustment Coder determines the appropriate ICD10-CM diagnoses codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for risk adjustment and Hierarchical Condition Categories (HCC). Risk adjustment coding relies on ICD-10-CM coding to assign risk scores to patients. The incumbent reviews retrospective medical record documentation and ensures that the codes are appropriately assigned. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of both the facility and the physicians. The Risk Adjustment Coder utilizes standards of compliance, specifically in OP compliant query processes and clinical knowledge to identify opportunities and to achieve results Also required is advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems.

JOB REQUIREMENTS

EDUCATION:

High school diploma or equivalent medical coding education. Associates Degree preferred (or direct work experience equivalent to at least 2 years)

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) and/or Certified Clinical Documentation Specialist- Outpatient or Certified Documentation Expert Outpatient (CDEO) Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA), or Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) required

EXPERIENCE:

Minimum of two (2) years progressive coding experience in multiple specialties, HCC Risk adjustment Coding

KNOWLEDGE AND SKILLS:

• Willing to work as a team innovation and collaboration is a priority
• Experience with an Electronic Medical Record (EMR), EPIC preferred
• Knowledge of AHA coding guidelines and methodologies: HCCs and other RA methodologies, ICD-10-CM coding guidelines, Office of Inspector General (OIG) and Federal and State regulations
• Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results
• Strong organization and analytical thinking skills detail oriented
• Proficient with Microsoft Office applications (Outlook, Word, Excel)
• Demonstrates critical thinking skills, able to assess, evaluate, and teach
• Self-motivated and able to work independently without close supervision
• Strong communication skills (interpersonal, verbal and written)
• Medical Record audits and review
• Familiarity with the external reporting aspects of healthcare
• Familiarity with the business aspects of healthcare, including prospective payment systems
• Proficient with computer applications (MS Office etc.), Excellent data entry skills
• Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to work with accuracy and attention to detail
• Ability to solve problems appropriately using job knowledge and current policies/procedures.
• Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
• Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Review documentation available in the Medical Record to facilitate workflows that support the clinical picture/severity of illness/complexity of the patient care rendered to patients.
• Reviews medical records to ensure accurate codes are applied to the encounter.
• Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM diagnosis codes mapped to HCCs or other RA methodologies
• Actively participate in and maintain coding quality and productivity processes
• Collaborates with nursing or coding staff on retrospective medical record review for severity, accuracy, and quality issues.
• Ensure documentation in the medical record follows the official coding guidelines, internal guidelines and the
• AHIMA/ACDIS physician query brief.
• Create and analyze reports for coding improvement trending and high-level dashboards for ongoing monitoring and opportunities.
• Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements.
• Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures related to billing.
• Participate in training new coding staff, as needed.

Title: Healthcare Customer Service Representative – Remote

Location: IN-

Job Description:

Teleperformance is a global, digital business services company. We deliver the most advanced, digitally powered business services to help the world’s best brands streamline their business in meaningful and sustainable ways.

With more than 500,000 inspired and passionate people speaking more than 300 languages, our global scale and local presence allow us to be a force of good in supporting our communities, our clients, and the environment.

Benefits of working with TP include:

• Paid Training
• Competitive Wages
• Full Benefits (Medical, Dental, Vision, 401k and more)
• Paid Time Off
• Employee wellness and engagement programs

Teleperformance and You

Through a balanced high-tech and high-touch approach blended with deep industry and geographic expertise, we make people’s lives simpler, faster, and safer. We help companies adapt quickly to changing needs, and are inspired to deliver only the best in all that we do. You will become a key contributor in making that happen.

As the eyes and ears for our team fielding customer inquiries and finding innovative ways to respond, you will work in a collaborative and engaging environment. You will have the chance to interact with people from all walks of life, and no two days will be the same. As you continue to grow and challenge yourself, you will discover your potential can take you anywhere you want to go.

Did you know that our Chief Client Officer started her career at Teleperformance as an agent and advanced to the pinnacle of the company? At Teleperformance, the sky is the limit!

At this time, Teleperformance can only offer employment to iniduals located in the following states: AL, AR, AZ, CT, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, WV, WY

Responsibilities

Your Responsibilities

Healthcare Customer Service Representatives field customer inquiries by finding innovative ways to respond to varying questions, issues, and concerns.

• Connect with customers via phone/email/chat/and or social media to resolve their questions or concerns
• Calmly attempt to resolve and de-escalate any issues
• Escalate interactions when necessary and appropriate
• Respond to requests for assistance and/or possible processing payments
• Track all call related information for auditing and reporting purposes
• Provide feedback on call issues
• Upsell if required

Qualifications

We’re looking for fearless people – people who are inspired to deliver only the best in all that we do.

• Ability to work remotely in a virtual team environment
• 6 months Customer service experience preferred
• Over 18 years of age
• Ability to type 25 wpm
• High School Graduate or GED
• Comfort with desktop computer system
• Proven oral & written communication skills
• Logical problem-solving skills
• Ability to navigate Windows operating systems
• Organization and work prioritization skills

Work from Home Requirements:

• Internet Connection Requirements:
  • Minimum subscribed download rate equal or exceeds 12.0 Mbps
  • Minimum subscribed upload rate equal or exceeds 3.0 Mbps
  • ISP must have no packet loss and ping under 50ms
  • Proof of internet speed required
• Clean and quiet workspace

Be Part of Our TP Family

It is our mission to always provide an environment where our employees feel valued, inspired, and supported, so that they can bring their best selves to work every day. We believe that when employees are happy and healthy, they are more productive, creative, and engaged. We are committed to providing a workplace that is conducive to happiness and a healthy work-life balance. We also believe that to be our best selves, we need to be surrounded by people who are positive, supportive, and challenging. We are committed to creating a culture of inclusion and ersity, where everyone feels welcome and valued.

Title: Nurse Practitioner [Remote / WFH] (Remote)

Location: Winnipeg MB CA

• Part-Time
• Medical
• $70.00- $100.00/ hr

The role:

Cloudcure is looking for a Nurse Practitioner with experience in offering patient facing care. Collaboration and learning are both significant aspects of this role.

This is an exciting role that offers the opportunity to join the team at an early stage with exciting potential for career growth.

Responsibilities:

Performing clinical assessments, evaluations and taking patient history

Offering treatment options and guidance to patients on our platform Order, interpret and perform diagnostic tests Develop plans for care including prescribing medications or therapies Collaborate and consult with care team and stakeholders as needed Embrace and model our culture of treating each patient with respect and enthusiasm, and ensuring that the team delivers client care excellence

Qualifications & Experience:

Masters degree in Nursing and/or accredited as Nurse Practitioner

Hold a valid and active permit to practice in MB as a Nurse Practitioner (Primary care or Adult) Desire to work in an innovative, dynamic environment that encourages professionalism, patient outcomes and experience, and autonomy

Bonus points:

Interest or prior experience in digital health

Registered in additional provinces

Perks:

Join a growing startup and help chart the course

Development and advancement opportunities as an early hire Competitive compensation Flexible work schedule and hours Remote or hybrid work

About us

We are a growing team with a vision to create Canada’s most innovative digital healthcare company, enabling healthier outcomes for our patients.

Our company is proud to be a erse and equal opportunity employer and as such does not discriminate on the basis of race, color, religion, sex, national origins, age, sexual orientation, disability, or any other characteristic protected by applicable laws. Selection decisions are solely based on job-related factors.

If you require accommodation during the interview process, please let the recruiter know when contacted for an interview.

Profee Clinic Coder

Remote – US

Full time

JR100920

The Profee Clinic Coder will handle medical coding and data entry / abstraction for various types of clinic visits.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role may include:

• OUTPATIENT: Correctly assigns modifiers to chargemaster items and coder assigned CPT codes as applicable to outpatient coding, as appropriate.
• Ability to create compliant physician queries
• Accurately review claims for medical necessity
• Update problem lists consistent with client contract
• Ability to provide excellent customer service to our clients and teammates.
• Consistently demonstrates an excellent attitude and works to strengthen the team as a whole.
• Floats between multiple sites and coding specialties with ease and flexibility.

Minimum Requirements:

Education/Experience/Certification Requirements

• 2 year degree or equivalent experience; AHIMA or AAPC certification required
• Profee Clinic Coding experience required
• Indian Health experience preferred, but not required
• Actively holds one or more of the following credentials: RHIA, RHIT, CCS, CPC, COC
• Minimum of 1-3 + years-experience coding preferred
• Floats between multiple sites and coding specialties with ease and flexibility.
• Meets or exceeds Quality and Productivity standards.
• Excellent communication (written and oral) and interpersonal skills.
• Strong organizational, multi-tasking, and time-management skills.
• Must be detail oriented and able to follow through on issues to resolution.
• Must be able to act both independently and as a team member.

Why join our team?

If you join us, you will receive:

• Work remotely with a work/life balance approach
• Robust benefits offering, including 401(k)
• Generous time off allotments
• 10 paid holidays annually
• Employer-paid short term disability and life insurance
• Paid Parental Leave

Certified Coder/Analyst

Location: Carmel, NY, United States

Requisition ID: 8997 Salary Range: 17.07 – 32.47 HOURLY Work Shift: Monday-Friday Day Shift FT/PT/PD: FULL-TIME Exempt/Non-Exempt: Non-Exempt

Description

Remote Coder positions are available in all statesEXCEPT CA and HI

Nuvance Health has a network of convenient hospital and outpatient locations Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York plus multiple primary and specialty care physician practices locations.

Purpose:Accurately codes and abstracts outpatient medical records for reimbursement and statistical purposes using established coding guidelines. Reviews coding and amends coding edits to assure compliance with all applicable regulations.

Essential Responsibilities

• Codes all outpatient medical records in a timely and accurate manner according to department policy – ED (Emergency Department), Facilities, Injection & Infusion Outpatient Coding
• Defines and transforms verbal descriptions of diseases, injuries, and procedures into numerical designations (codes) using ICD-10-CM and CPT-4 according to established coding guidelines
• Initiates a physician/department query when there is conflicting, incomplete, or ambiguous documentation in the record or additional information is needed for accurate coding
• Enters all required information accurately into computer system for reimbursement and statistical purposes
• Remains abreast of all applicable Federal, State, regulatory and hospital-specific coding guidelines
• Applies applicable guidelines to all cases coded to ensure accuracy of selected codes
• Accesses and research applicable reference materials to further support decision-making in code selection
• Participates in Performance Improvement/Quality Assurance activities
• Reports on software and hardware problems
• Attends required educational sessions (webinars, conferences etc.) to maintain and enhance coding certification(s)
• Maintain and Model Nuvance Health Values
• Demonstrates regular, reliable, and predictable attendance
• Performs other duties as required

Education and Experience Requirements:

• Associates degree or equivalent
• 4 years of coding experience in ED (Emergency Department), Facilities, Injection & Infusion Outpatient Coding

Minimum Knowledge, Skills and Abilities Requirements:

• Knowledge of ICD-10, CPT-4, Disease Pathology, Anatomy, Physiology and Medical Terminology
• Advanced knowledge of ED (Emergency Department), Facilities, Injection & Infusion Outpatient Codingguidelines
• Basic familiarity with MS Office applications (Word, Excel. Outlook)
• Usage of coding manuals and regulatory websites for research

License, Registration, or Certification Requirements:

• Required: Certification from the America Academy Professional Coders (AAPC) or the American Health Information Management Association (AHIMA): CPC or CCS

Work Type: Full-Time

Standard Hours: 40.00

Work Shift: Monday-Friday Day Shift

Org Unit: 879

Department: Health Information Management

Exempt: No

Grade: U4

Salary Range: $16.32-$31.05

EOE, including disability/vets.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities

Coding Auditor

General information

Job Title

Coding Auditor

Functional Area

Teammate – Revenue Cycle

City

Remote

Work Location Type

Remote

State

Remote

Employment Type

Full-time (30+ hrs/week)/FULLTIME

Description & Requirements

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Position Description & Requirements

PRACTICE OVERVIEW

Radiology Partners, through its owned and affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare.Radiology is a team sport, and Radiology Partners is building a community of physicians and support teammates who embody our practice values and believe in our bold mission to transform radiology.Our support team is a vital force within the practice, using their gifts and talents to improve the overall healthcare experience.Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.

POSITION SUMMARY

Radiology Partners is seeking a Medical Coding Auditor who will be accountablefor conducting coding and data quality audits of all imaging modalities in the Coding department. The Medical Coding Auditor will be responsible for correcting coding errors, reviewing denials and providing thorough investigation of re-coding for submission. Will work with the Coding Manager on implementing the coding review workflow that includes but not limited to sampling methodology, medical record review/audit approach, validation criteria, audit result reporting, root cause analysis and corrective action plan.

POSITION DUTIES AND RESPONSIBILITIES

Review medical records for the determination of accurate assignment of all documented ICD 10 codes for diagnoses and procedures

Validate and correct coding errors for all aspects of the charge. Perform all other duties as assigned

Investigate and recode any applicable denials after thorough research

Provide real time dictation feedback, audit feedback and/or education/training to physicians, coders and other teammates on coding and clinical documentation and communicate for need for documentation to ensure accurate coding

Demonstrate ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses and procedures

Identify and communicate documentation improvement opportunities and coding issues (lacking documentation, physician queries, etc.) to Coding Manager for follow-up and resolution

Evaluate and prepare as indicated daily, weekly and monthly reports indicating coding quality levels and opportunities for charge capture and revenue integrity

Monitor, prepare and present reports including, but not limited to, coding accuracy, medical record deficiency, coding validation discrepancies or completeness of procedure report

Stay current with AHA Official Coding and Reporting Guidelines, CMS, ACR, AMA and other agency directives for coding

Attend coding seminars on annual basis for outpatient coding

Perform other reasonably related duties assigned by the Coding Manager or other management

Provide coverage when available or needed in the department

Perform other reasonably related duties assigned by the Coding Manager or other management

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE

2+ years related coding audit or medical record review experience

Must be detail oriented and have the ability to work independently

Computer knowledge of MS Office and proficient in internet resources

Extensive knowledge of medical record documentation requirements mandated by AMA, ACR, AHA, State and federal regulations

Excellent verbal/written communication and interpersonal skills

Advanced/Thorough/detailed knowledge of ICD-10 and CPT coding systems

Skilled in performing coding quality assessment/analysis

High School Graduate or GED equivalent preferred, and some level of advance study highly preferred

Previous coding experience a must

Computer software skills and knowledge required

RCC certification or other qualified coding certification required

Must have extensive knowledge of anatomy, medical terminology, CPT, ICD-10, HCPCS, Modifiers & PQRS codes

Radiology Partners is an equal opportunity employer.RP is committed to being an inclusive, safe and welcoming environmentwhereeveryone hasequal access and equitable resources to reach their fullpotential.We are united by our Mission to Transform Radiology and in turn have animportantimpacton the patients we serve and the healthcare systemoverall.We hold that ersity is a key source of strength from which we will build apracticeculturethat is inclusive for all.Our goal is to empower and engage the voice of every teammate topromoteawareness,compassion and a healthy respect for differences.

The hourly range for this position is $27.50 – $30.00. Final determinations may vary based on several factors including but not limited to education, work experience, certifications, geographic location etc. In addition to this range, Radiology Partners offers competitive total rewards packages, which include possible incentive and productivity programs, health & wellness coverage options, 401k benefits, and a broad range of other benefits such as family planning and telehealth (all benefits are subject to eligibility requirements).

• : When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History.

Cardiometabolic Nurse Practitioner

• Remote USA
• Full time
• R1943

At Devoted Health, were on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. Thats why were gathering smart, erse, and big-hearted people to create a new kind of all-in-one healthcare company one that combines compassion, health insurance, clinical care, service, and technology–to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we’ve grown fast and now serve members across the United States. And we’ve just started. So join us on this mission!

Job Description

A bit more about this role:

This position represents an amazing opportunity for a nurse practitioner (APRN) with a big heart and entrepreneurial spirit with extensive clinical experience offering cardiometabolic preventive care. Your primary focus will be delivering world class care to our members with hypertension, hyperlipidemia, diabetes and coronary artery disease.

In this role you will be working in a next generation virtual cardiometabolic clinic that dramatically expands access to care for America’s most vulnerable seniors. The clinic focuses on optimizing hypertension and hyperlipidemia management for Devoted Health members. You will utilize and help improve our home-grown technology and electronic health information platform to carry out virtual visits as well as managing asynchronous prescription refills for patients. On a day-to-day basis you will work closely with our virtual specialty clinic team members at Devoted Medical including physicians and other APRNs as well as medical assistants, clinical guides (nurses, dieticians, health coaches), pharmacists, and pharmacy techs. You will be a key member of our interprofessional team.

The hypertension/ cardiometabolic clinic is one of several of Devoted’s virtual specialty care programs that are designed as micro centers of excellence that deliver highly tailored, specialized care to patients with a specific chronic conditions.

Responsibilities will include:

• Conduct focused and thorough assessments of patients with conditions that impact cardiometabolic health including hypertension, hyperlipidemia, coronary artery disease, and diabetes through virtual consultations including ordering diagnostics as needed, interpreting labs and imaging data, and developing a treatment plan in collaboration with the specialty care clinic team. We expect that 60-70% of your clinical effort will be performing virtual visits.
• Formulate accurate diagnoses and develop inidualized treatment plans for patients with cardiometabolic conditions, including medication management, lifestyle modifications, and monitoring recommendations.
• Mitigate the risk of cardiometabolic conditions by proactively managing medication adherence for patients with hypertension, hyperlipidemia, diabetes and atherosclerotic cardiovascular disease.
• Manage a refill inbox for patients with cardiometabolic conditions in accordance with established protocols and guidelines. We expect that 30%-40% of your clinical effort will be managing a prescription refill queue.
• Identify and evaluate risk factors, comorbidities and possible contraindications for treatment.
• Provide counseling on medication adherence, potential side effects.
• Collaborate closely with other members of the care team including PCPs, endocrinologists, cardiologists and other Devoted team members including pharmacy, clinical nursing, social work, as well as interfacing with family members and caregivers to coordinate holistic care for the member, to ensure continuity of care and deliver a collaborative care plan.
• Serve as the clinical advisor and provide clinical escalation support for the speciality clinic staff and other teams during business hours.
• Utilize our home grown electronic health information system for visits while also providing feedback on how to improve the interface.
• Maintain accurate and up-to-date patient medical records, ensuring compliance with relevant legal and ethical guidelines.
• Participate in quality improvement initiatives and ongoing professional development to stay current on best practices and advancements in cardiometabolic care.
• Adhere to all relevant laws, regulations, and industry standards, including patient privacy and telehealth regulations.
• Conduct urgent visits during on-call shifts to support our clinical nurses who triage calls from our members. At least one four hour on-call shift on a weekend day or holiday is required per quarter.

Attributes to success:

• Skilled nurse practitioner with thorough understanding of cardiometabolic condition management including disease process, treatment modalities, medication management and lifestyle modification as it pertains to hypertension, hyperlipidemia, and primary care management of coronary artery disease and diabetes.
• You are experienced working on an interprofessional team and enjoy team-based care.
• You have great clinical and non-clinical judgment.
• You are thorough and take the time to address the needs of your patients.
• You are deeply empathetic and humanistic, and want to go the last mile for your patients.
• You enjoy a fast-paced, high-energy, organization. Agility and collaboration are key as we will change and improve quickly.
• You welcome learning and using new technologies that are being developed in parallel. You thrive on knowing your work can help make these technologies better for you and your patients.
• You learn from every experience and are not afraid to fail – that’s how you’re wired.
• Finally and most importantly, you have a passion for making healthcare better, solving complex problems, and supporting the delivery of healthcare that we would want for our own family members.

Desired skills and experience:

• APRN with 5 or more years working in outpatient clinical practice ideally with experience in management of hypertension, hyperlipidemia and primary and secondary prevention of atherosclerotic cardiovascular disease.
• Minimum of 2 years of experience concentrated in primary care or a subspecialty with heavy focus on hypertension and lipid management required (eg. cardiology, nephrology, endocrinology, primary care).
• Proficiency in using telehealth technology and electronic health records (EHR).
• Virtual care experience is preferred along with a strong desire to continue practicing clinical nursing and performing virtual visits – you believe in the mission of bringing care to where the patient lives.
• An understanding of managed care is a plus, including how to appropriately assess STARS/HEDIS measures, code clinical comorbidities, and identify clinical care gaps.
• Proficiency in English and Spanish preferred for this position.
• Multi-state licensure is required in addition to a willingness to obtain, and maintain, additional licensure as requested.

Licensure and Certification:

• Master’s or Doctoral degree in Nursing with a specialization in primary care or cardiovascular care.
• An active and clear RN and APRN license in the state of [MARKET] as well as APRN certification is required at time of hire and must be maintained while employed at Devoted Medical.
• Active BLS is required at time of hire and must be maintained while employed at Devoted Medical.

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the inidual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program
• And more….

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoteds mission to treat our members like family. We are committed to a erse and vibrant workforce.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value ersity and collaboration. Iniduals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoteds Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Corporate Communications Lead

Location:Nationwide

Location Type:Remote

Schedule:Full-time

Become a part of our caring community and help us put health first

Humana’s Corporate Communications organization is seeking a Corporate Communications Lead to join the Associate Communications Team. As the Lead, you will be responsible for the development, planning, and delivery of comprehensive communications strategies that support Humanas healthcare services organization. You will own and execute the overarching communications strategy for the Office of the Chief Medical Officer, with a focus on driving associate engagement within Humanas clinical communities. Additionally, you will provide executive-level communications support to the Office of the Chief Medical Officer and lead large-scale enterprise and segment campaigns in partnership with External Communications, the Chief Nursing Organization, Physicians Collaborative, and other functional workstreams.

Key Role Functions

• Collaborates with teammates within CenterWell, Corporate Communications, Office of the Chief Medical Officer, HR and other key functions to produce integrated communications plans, narratives and tactics aligned to business goals and objectives
• Prioritizes communications thatdrivedeeper engagement and connection within Humanas clinical communities of practice
• Works with cross-functional partners to develop high-impact communications on a variety of topics reaching broad and targeted audiences, including leaders and frontline employees
• Establishes project plans to support an integrated approach, town halls and events, executive visibility, and more
• Leverages data to implement new or enhanced communications practices for improved effectiveness and reach
• Champions new ways of working through digital tools for greater efficiencies
• Maintains brand standards and guidelines for improved quality and communications governance

A successful candidate is highly skilled at strategic planning, employee engagement, executive communications, and translating company goals into effective messaging that reaches a variety of audiences, including frontline clinicians. The inidual must demonstrate a deep knowledge of communications channels and emerging technologies, possess exceptional communication skills (verbal and written), and connect across the business todrivealignment around communications goals, strategies and tactics.

Use your skills to make an impact

Required Qualifications

• Bachelors degree in journalism, communications, public relations, or relevant field
• 10+ years of recent experience in corporate communications focused on healthcare, M&A, executive communications, and/or employee engagement
• Demonstrated history developing, implementing and measuring integrated communications strategies that drive results
• Experience building and maintaining best-in-class communications experiences using a multi-channel approach
• Ability to deploy enterprise communications programs to targeted stakeholders and business functions
• Exceptional interpersonal skills, with the ability to influence and build relationships with key stakeholders and senior leadership
• Ability to work under tight deadlines without compromising quality
• Self-organized can independently plan, lead and implement integrated communications projects

Preferred Qualifications

• Education or Certification in Organizational Change Management
• Experience working at a large, matrixed organization
• Healthcare or insurance communications experience
• Previous experience in project management

Additional Information

To ensure Home or HybridHome/Office employees ability to work effectively, the self-provided internet service of Home orHybridHome/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home orHybridHome/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial securityboth today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humanas secure website.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and inidual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$102,200 $140,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or inidual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, Humana) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Nurse Clinical Care Reviewer

Location: US-Remote

JobDescription:

This position will be filled by a nurse to serve as a Nurse Clinical Care Reviewer for the Medical Benefits and Certifications Unit. The Nurse Clinical Care Reviewer will participate in all aspects of medical benefit decisions for responders and survivors of the 9/11 attacks. These decisions include, but are not limited to; certification decisions for new health conditions and health care benefit prior authorization requests.

In addition, the Nurse Clinical Care Reviewer may provide recommendations for services that are cost-effective and in compliance with Program regulations and guidelines. The Nurse Clinical Care Reviewer will make recommendations based on Program statutes, policy, collaboration with experts, clinical research and their own clinical and professional judgement and analytical skills. Additional duties include managing complex program deliverables, analyzing and manipulating medical claims data and collaborating with occupational health subject matter experts. The Nurse Clinical Care Reviewer will interface with clinicians, medical administrators, and a erse set of federal and contract staff. The work requires excellent organizational, verbal and written communication skills, attention to detail, innovative problem solving, and self-initiation. The WTC Health Program leadership and management team will provide guidance commensurate with the Nurse Clinical Care Reviewer ‘s level of duties.

Essential Functions and Job Responsibilities

• Reviews and makes recommendations on requests for certification of health conditions, in alignment with Program guidelines and policies, permitting member access to treatment benefits.

• Analyzes and makes recommendations in writing against Program regulations and guidelines and evidence-based clinical guidelines for clinical service requests from health care providers. • Appropriately prioritizes and tracks all certification and prior authorization requests, reviewing them for completeness and alignment with Program policy and requirements; makes recommendations to approve or deny these requests using clinical and professional judgement and analytical skills within required timeframe. • Collaborates with subject matter experts when making decisions and recommendations. • Requests additional information from providers in a consistent and efficient manner with superior customer service. • Liaises with denial and appeal coordinators for denial decisions. Creates denial letters and collaborates with the Office of General Counsel to review. • Educates clinical center staff/providers regarding certification requests, authorization requirements, eligibility guidelines, and documentation requirements. • Provides analytic support of cost and utilization reporting. • Understands complex legislative, regulatory, and/or policy guidance for use in executing daily activities. • Monitors, coordinates and tracks multi-functional program deliverables, ensuring deadlines are met.

The work entails both clinical and administrative aspects of health care delivery within a federal managed care system and involves collaboration with both clinicians and medical administrators. The WTC Health Program Medical Benefits and Certifications Unit Chief will provide support and guidance to the contractor in the performance of these deliverables.

Minimum Requirements

Special Considerations or Requirements:

The knowledge, skills and abilities are specific in this task area and shall include: Completion of an accredited Registered Nurse (RN) Program preferred OR a Bachelor’s Degree in a healthcare field, such as social work or clinical counselor may be considered.

Required Experience

• 1-3 years’ experience working in a health care or managed care setting. • Experience working in a managed care/clinical setting or with payer claims data in a health plan preferred, but not required. • Proficient in Microsoft Office Suites, including Excel, Outlook, SharePoint; Proficiency with MS Windows Office programs, including MS Word, Excel, and Outlook to create complex documents, manage schedules, and analyze data.

Company Benefits

PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance. Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses. The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested. We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

EEO Commitment

It is company policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits, and termination, are made without regard to race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, citizenship status, veteran status, protected veteran status, disability, or any other characteristic protected by applicable federal, state, or local law.

Utilization Review Nurse- FT (12a-8a EST)

locations

Remote – Other

time type

Full time

job requisition id

R012827

Responsible for utilization review work for emergency admissions and continued stay reviews.

Responsibilities

• Review electronic medical records of emergency department admissions and screen for medical necessity, using InterQual or MCG criteria.
• Participate in telephonic discussions with emergency department physicians relative to documentation and admission status.
• Enter clinical review information into system for transmission to insurance companies for authorization.

Qualifications

Required

• Current RN licensure
• At least 5 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing
• At least 2 years utilization management experience in acute admission and concurrent reviews
• Intermediate level experience with InterQual and/or MCG criteria within the last two years
• Proficiency in medical record review in an electronic medical record (EMR)
• Experience in MS Office and basic Excel
• Ability to thrive in a fast-paced, dynamic environment and adapt to frequent changing business needs
• Passing score(s) on job-related pre-employment assessment(s)

Preferred

• 3+ years utilization management experience within the hospital setting
• Bachelors of Science in Nursing
• Proficient in InterQual/MCG criteria
• Case Management Certification (CCM, ACM, CMCN, or CMGT-BC

Expectations

• This job operates in a remote environment that must be private. This role routinely uses standard office equipment such as computers, phones, and printers.
• Hours will vary, including two weekends a month.
• Must be able to remain in a stationary position 50% of the time and constantly operate a computer.
• Frequently communicates with internal, external and executive personnel and must be able to listen and exchange accurate information.

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all iniduals. We celebrate ersity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmarts sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the inidual can provide proof of valid prescription to Netsmarts third party screening provider.

If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please use this form to request details which you may be legally entitled.

All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

Title: Senior Director, Strategic Health Systems

Location: Remote US

JobDescription:

Boldly innovating to create trusted solutions that detect, predict, and prevent disease.

Discover your power to innovate while making a difference in patients’ lives. iRhythm is advancing cardiac careJoin Us Now!

At iRhythm, we are dedicated, self-motivated, and driven to do the right thing for our patients, clinicians, and coworkers. Our leadership is focused and committed to iRhythms employees and the mission of the company. We are better together, embrace change and help one another. We are Thinking Bigger and Moving Faster.

About This Role

We are seeking a highly experienced and strategic Senior Director of Health Systems to join our dynamic team at iRhythm Technologies. The Senior Director will play a pivotal role in driving the adoption and integration of our cardiac monitoring solutions within healthcare systems. This inidual will lead the development and execution of strategies to establish partnerships with health systems, hospitals, and other key stakeholders to ensure the successful implementation and utilization of our products. Additionally, the Senior Director will lead a team of Strategic Health System Directors, providing leadership and guidance to drive collective success in expanding our footprint within health systems. This role will report into the Vice President, US Sales.

Responsibilities:

1. Develop and implement comprehensive strategies to drive the adoption and utilization of our cardiac monitoring solutions within health systems and hospitals.
2. Build and nurture strong relationships with key stakeholders, including C-suite executives, cardiologists, electrophysiologists, procurement officers, and IT leaders within health systems.
3. Lead and mentor a team of Strategic Health System Directors, providing guidance and support to facilitate the successful integration and utilization of our products across multiple health systems.
4. Collaborate with cross-functional teams, including sales, marketing, product development, and regulatory affairs, to ensure alignment of strategies and tactics to support health system partnerships.
5. Identify and pursue opportunities for strategic partnerships and collaborations with health systems to enhance market penetration and revenue growth.
6. Serve as the primary point of contact for health systems, providing guidance, support, and resources to facilitate the successful integration and utilization of our products.
7. Stay informed about market trends, competitor activities, and regulatory changes impacting health systems and hospitals within the cardiac monitoring space.
8. Develop and manage budgets, forecasts, and performance metrics related to health system partnerships and revenue goals.
9. Represent iRhythm Technologies at industry conferences, trade shows, and other events to promote our cardiac monitoring solutions and build relationships with key stakeholders.

Qualifications:

1. Bachelor’s degree in business, healthcare administration, or related field; MBA or advanced degree preferred.
2. Minimum of 12+ years of experience in healthcare sales, business development, or account management, with a focus on selling medical devices or technology solutions to health systems, preferably within the cardiac monitoring space. Minimum 3 years of leading a team required.
3. Proven track record of successfully establishing and managing strategic partnerships with health systems and hospitals.
4. Strong understanding of the healthcare industry, particularly in cardiac care, including knowledge of healthcare delivery systems, reimbursement mechanisms, and regulatory requirements.
5. Excellent communication, negotiation, and presentation skills, with the ability to effectively communicate complex concepts to erse audiences.
6. Demonstrated leadership abilities, with experience leading and developing high-performing teams.
7. Strategic thinker with the ability to develop and execute long-term business plans.
8. Ability to travel as needed.

What’s In It For You

This is a regular full-time position with competitive compensation package, excellent benefits including medical, dental, and vision insurances (all of which start on your first day), health savings account employer contributions (when enrolled in high deductible medical plan), cafeteria plan pre-taxed benefits (FSA, dependent care FSA, commute reimbursement accounts), travel reimbursement for medical care, noncontributory basic life insurance & short/ long term disability. Additionally, we offer:

• emotional health support for you and your loved ones
• legal / financial / identity theft/ pet and child referral assistance
• paid parental leave, paid holidays, travel assistance for personal trips and PTO!

iRhythm also provides additional benefits including 401(k) (with company match), an Employee Stock Purchase Plan, pet insurance discount, unlimited amount of Linked In Learning classes and so much more!

FLSA Status: Exempt

#LI-WB-1

#LI-Remote

Actual compensation may vary depending on job-related factors including knowledge, skills, experience, and work location.

Estimated Pay Range $201,600—$283,000 USD

As a part of our core values, we ensure a erse and inclusive workforce. We welcome and celebrate people of all backgrounds, experiences, skills, and perspectives. iRhythm Technologies, Inc. is an Equal Opportunity Employer. We will consider for employment all qualified applicants with arrest and conviction records in accordance with all applicable laws.

iRhythm provides reasonable accommodations for qualified iniduals with disabilities in job application procedures, including those who may have any difficulty using our online system. If you need such an accommodation, you may contact us at [email protected]

About iRhythm Technologies

iRhythm is a leading digital healthcare company that creates trusted solutions that detect, predict, and prevent disease. Combining wearable biosensors and cloud-based data analytics with powerful proprietary algorithms, iRhythm distills data from millions of heartbeats into clinically actionable information. Through a relentless focus on patient care, iRhythms vision is to deliver better data, better insights, and better health for all.

Make iRhythm your path forward. Zio, the heart monitor that changed the game.

Title: Medical Coder – Remote

Location: USA-

JobDescription:

Medical Coder – Remote

Munson Healthcare United States Coding and Data Integrity Svcs Day shift

Requisition #: 59614

Total hours worked per week: 40

Description

Experienced Outpatient Coders

Eligible $5,000 sign on bonus!

Find more than your next job. Find your community.

• We’re northern Michigan’s largest healthcare system and we are deeply rooted in the communities we serve. That means that our patients are often our family, friends and neighbors – and it’s special to be able to care for them. And as one of the top healthcare systems to work for in Michigan by Forbes (American’s Best Employers by State 2022), we’re committed to your ongoing growth and development.
• After work, you’ll find things to do in every season – beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment.

Why work as a Coder Abstractor at Munson Healthcare?

• Flexible remote work schedule
• Our dynamic work environment includes many opportunities for growth and development
• Our efforts directly impact patient satisfaction and outcomes
• Our employees work in positive, supportive, and compassionate environments built on our organizational values.

Summary:

The coding professional is a critical member of the Revenue Cycle Team and is responsible for coding and abstracting patient visit data for performance improvement, statistical research, administrative and facility financial purposes.

Coding is performed using utilizing ICD10-CM, ICD10-PCS and CPT-4 classification systems and is subject to the Official Guidelines for Coding and Reporting, AHIMA Code of Ethics “Standards of Ethical Coding”, AHA Coding Clinic and technical rules outlined by hospital guidelines.

The coding professional works closely with the Coding Analyst, Clinical Documentation Integrity Specialists and the Regional Coding Operations Coordinator. Required qualities include teamwork, ability to code various patient types for a variety of Munson facilities, and flexibility in handling work assignments while maintaining productivity and quality standards. This position supports the timely and accurate submission of facility claims and works to achieve or exceed the established Accounts Receivable goals for the Department.

What’s Required:

• Associate or Bachelor Degree in Health Information. CCS certification with a minimum of 2 years coding experience will be considered.
• Certification as a Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) is required. New graduates must obtain certification as Registered Health Information Technologist (RHIT), or Registered Health Information Administrator (RHIA) within 12 months of hire date.
• One to three years’ previous experience using ICD10-CM, ICD10 PCS and CPT-4 coding systems is required.
• Demonstrated ability to meet productivity and quality standards is required.
• Keyboard entry skills are required.

The Benefits of Working at Munson:

• Eligible for a $5,000 Sign on Bonus
• Competitive salaries
• Full benefits, paid holidays, and paid time off (up to 19 days your first year)
• Tuition reimbursement and ongoing educational opportunities
• Retirement savings plan with employer match and personal consulting
• Wellness plans, an employee assistance program and employee discounts

*Terms and conditions apply

Location:  US Locations Only; 100% Remote

ChartSpan is the largest chronic care management (CCM) managed service provider in the US. CCM programs focus on patients who have multiple (two or more) chronic conditions that are expected to last at least 12 months or more.

An LPN Patient Care Coordinator at ChartSpan plays a key role in caring for the patients in our program while working in conjunction with the patient care team to facilitate and address existing and new chronic health issues.  We provide an essential service that helps providers stay in touch with and meet their patients’ healthcare needs in between office visits.

Your role is to support and assist patients in obtaining the resources they need to improve their health, happiness, and longevity. LPN Patient Care Coordinators are patient advocates who form ongoing, collaborative relationships with patients to help improve their lifestyles for the better. This is a fully remote role.

Responsibilities

• Provides monthly care coordination through a collaborative process of planning, facilitation, and advocacy for options and services to meet patient’s health needs. Communicates resources and services available to patients through the continuum of care.
• Identifies patient-specific problems, goals, and interventions designed to meet the patient’s needs as identified by the clinical assessment/reassessment that are action-oriented and time-specific.
• Maintain patient chart compliance through proper documentation and updates of medical history, medication, immunizations, allergies, surgical history, and family history.
• Demonstrates awareness of circumstances necessitating revisions to the plan of care, such as changes in the client’s condition, lack of response to the care plan, preference changes, transitions across settings, and barriers to care and services.
• Documents relevant, comprehensive information and data using standard assessments and tools supporting the plan of care and organized care coordination systems aimed at improving the outcomes of patients.
• Provide appropriate health education.
• Escalate patient concerns to the triage nurse team.

Qualifications

• Licensure: License and current registration to practice as a Licensed Practical Nurse in a COMPACT state.
• Education: LPN degree from an approved program is required.
• Pass a background check.

Job Type: Full-time (Remote)

Location: US Locations Only

Coding Operations Manager

locations

US – Remote (Any location)

time type

Full time

job requisition id

19524

Job Family:

General Coding

Travel Required:

Up to 10%

Clearance Required:

None

What You Will Do:

• Coding Operations Manager – Multispecialty Surgical Coding Team
• Responsible for the management of health information systems consistent with the medical, administrative, ethical and legal requirements of the health care delivery system. Which may also include monitoring data imports, providing basic system maintenance, documentation of workflow, training and data research.
• Oversees the maintenance of medical records and the coding of data from medical records.
• Participates in the preparation of reports, provides information and prepares correspondence regarding patient admissions, treatment, discharges and deaths in accordance with departmental policies and legal requirements governing the release of medical information.
• Works collaboratively with providers, other health care professionals and coding team to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to each patient, as well as ensuring compliant reimbursement of patient care services.

What You Will Need:

• University Degree and minimum 7 years of prior relevant experience; Relevant 10 years experience may be substituted for formal education or advanced degree
• 5+ years management experience
• Extensive experience working with physicians

What Would Be Nice To Have:

• Proficiency in Multispecialty Surgical Coding

The annual salary range for this position is $75,800.00-$113,600.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a erse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Nurse Practitioner FNP or Physician Assistant PA-C Travel Ambassador

Job Locations US

ID

2024-11403

Category

Nurse Practitioners & Physician Assistants

Type

Full Time

Pay Range

Salary range – Based on experience

How You’ll Make an Impact

We are hiringNurse Practitioner and Physician Assistant Ambassadors with experience in ER, Urgent Care, Internal Medicine to join our growing team of ambassadors for clinical support nationwide atDispatchHealth. Advanced Practice Providers team with DHMTs (Medical Technician)and are equipped with everything needed to treat common to complex injuries and illnesses through comprehensive health assessments, including diagnosis, treatment, and outcome management, for patients of all ages.Our innovative model allows us to provide definitive care in the home, including point of care laboratory studies, minor procedures, splinting, wound care, suturing, IV fluid and medication administration. We providewholeperson care by facilitating timely follow up and care coordination.Our multi-state licensed ambassadors also provide care virtually using our telehealth model partnered with DHMTs(Medical Technician) deployed in markets across the country.

The Ambassadors are a team of multi-state licensed Advanced Practice Providers who are dispatched whether physically or virtually to help new market openings, during rapid growth and market expansion, and in times of need to staff for urgent coverage in established markets. ADispatchHealthAmbassador may also be utilized during peak times of productivity to help meet patient demand. Ambassadors forDispatchHealthwill work closely with the LeadAPPAmbassador who will determine which states the Ambassador should obtain licensure. All assignments for the Ambassador will come from the LeadAPPAmbassador based on the current needs throughout each market and projected market openings. This role requires the ability to travel frequentlyorcovervirtual telehealth visits. This role requires the ability to be flexible and the ability to adaptinnew environments.DispatchHealthAmbassadors are experienced, reliable, compassionate clinicians that understand our processes and champion culture, providingcareTheDispatchWay.

Our providers love working atDispatchHealthbecause of the high-quality care they can provide, the value of the delivery model and the appreciation of our patients.

What You’ll Do

• Ability to travelfrequently, unless providing coverage for telehealth virtual visits.
• All traveland licensureexpenses paid for byDispatchHealth
• Ability to workfull timehours, dependent on staffing needs
• Obtain/maintain multi-state licenses
• Work 4-7 clinical shifts consecutively
• Report to the APP Lead Ambassador for travel assignments and state licensing requirements
• Submitting licensure documents in a timely manner in conjunction with Licensing Specialist
• Submitting expenses in an organized and timely mannerin conjunction withpolicy

What You Need

• At least 2 years of experience in the ED, UC, internalmedicineor family practice
• Current unrestricted state licensure as anationally board-certifiedNurse Practitioner or Physician Assistant
• Current BLS required, ACLS certificationpreferred
• Prior Telemedicine experience a plus but notrequired
• Exceptional leadership and multitasking skills
• Work as a teamwith a DHMT (medical technician)physically or virtuallyto deliver care in the patients home. Ability to work both independently as well as collaboratively with others to achieve common goals.
• Perform comprehensive health assessments and diagnose and treat complex illnesses.
• Provide therapeutic interventions, such as splinting, suturing, woundcareand minor procedures.
• Use critical thinking skills and follow evidence-based standards of practice.
• Accurately and thoroughly document patient encounter and ensure accuracy.
• Ability to adopt and champion technological tools to optimize provider workflow.
• Identifyand proactively solve problems.
• Strong interpersonal and written communication skills.
• Critical thinking skills utilizing evidence-based standards of practice.
• Thrive in a patient-focused environment.
• Analyze test data to diagnose, treat and arrange appropriate follow up for the patient to ensure continuity of care.
• Educate patients and families on how to treat their acute illness and manage their health and well-being.
• Effectively navigate difficult conversations related to end-of-life issues and goals of care.
• Communicate effectively with patients, family, the medical power of attorney, primary care provider and all iniduals involved in the patients care.
• Adhere to clinical and safety standards, protocols, and performance metrics.
• Provide care with compassion, empathy, and cultural competency.
• Maintain positive relationships with DHMT partners and remote teams.
• Attend training sessions and clinical team meetings.
• Maintain professional etiquette and serve as ambassadors forDispatchHealth.
• Lead your practice and always do whats right for the patient.
• Ability to lift and carry equipment up to 50 pounds
• Ability to walk up and down several flights of stairs easily while carrying equipment
• Valid drivers license with clean driving record
• Ability to work a varied schedule with evenings, holidays and weekends required

Who We Are

DispatchHealth is redefining healthcare delivery through mobile and virtual healthcare. A rapidly scaling Denver, Colo., startup, we provide right-sized healthcare through the power of technology, convenience, and service. DispatchHealth is creating an integrated, convenient, high-touch care-delivery solution that extends the capabilities of the patient’s care team and ensures that we provide personalized, quality care in the home or at the patients location of need. Our skilled, certified providers arrive onsite with the expertise and tools necessary to administer advanced medical care, supported by our technological infrastructure to ensure quality and to improve outcomes. DispatchHealth brings together experienced professionals with proven success in medicine, engineering and operations and a passion for transforming the healthcare landscape.

DispatchHealth is committed to creating and supporting a erse and inclusive team and serving all communities. All qualified applicants will be considered for employment regardless of race, gender, gender identity or expression, sexual orientation, religion, national origin, disability, age, or veteran status. DispatchHealth offers a comprehensive benefit package, including medical, dental and vision insurance, 401k, paid time off, family, and short-term disability leave.

Our Mission

We deliver trusted, compassionate care to all in the comfort of home.

Our Vision

Building the world’s largest in-home care system.

Our Values are embodied in The DispatchWay

• Courage to advocate for our patients and each other
• Innovation to trailblaze a new path for healthcare
• Integrity to create a respectful and inclusive environment
• Compassion to provide quality, safe and excellent care

Coding Administrative Assistant –REMOTE

Function

Revenue Cycle Management

Location

US-Remote

Employment Status

Full Time

Overview

The incumbent of this role obtains medical record documentation needed for coding from USAP partner facilities, accomplished by accessing various hospital medical record EMR systems, and/or communicating with facilities using e fax, email, or phone requests. This role runs detailed reports from charge capture/coding platforms for use in KPI monitoring, and process improvement.

Job Highlights

ESSENTIAL DUTIES AND RESPONSIBILITIES(include but not limited to):

• Experience with a variety of electronic medical
• EMR Navigation to locate and obtain required medical
• Communicate with external facility staff with a high level of
• Data entry into excel tracking
• Utilize coding platforms as required per isional
• Prepare reports for aging and KPI for coding leadership as assigned or
• Prepare data worksheets for coding
• Communicate daily assignments with vendor
• Assist with maintenance of team playbooks (SOP/Pathways)
• Interact with and respond to physician coding documentation
• Monitors and track clinician responses to documentation deficiencies and provide feedback to Coding Quality andEducation
• Process post op pain rounding
• Entry level coding (post prospective audit)
• Perform other duties as assigned
• Adhere to all company policies and procedures especially HIPAA and

Qualifications

Knowledge/Skills/Abilities (KSAs):

• CPC-A, or CPC with limited experience in anesthesia, RHIT eligible or newly credentialed
• High school graduate or equivalent.
• Experience working in a medical records department, or medical clerical experience is preferred but not required. Healthcare background is a plus.
• Minimal level of coding experience with a basic understanding of documentation guidelines, and the ability understand and keep abreast of coding guidelines.
• Ability to self-motivate and to initiate new projects when the opportunity presents itself.
• Ability to work independently, but under the direction of the team lead or supervisor.
• Excellent organization and time management capabilities.
• Intermediate knowledge and working experience with Microsoft Word, Excel, and Outlook.
• Ability to type 50 words per minute.
• Communicates well with all levels of USAP employees and vendors.
• Ability to read, write and speak English.
• Excellent computer skills.

*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

• Occasional Standing
• Occasional Walking
• Frequent Sitting
• Frequent hand, finger movement
• Use office equipment (in office orremote)
• Communicate verbally and in writing

Full-Time Telehealth Nurse Practitioner – All states

Remote, US

About Us:

Tens of millions of Americans are unable to manage their chronic conditions with commercial medications. Using specialized compounded formulas tailored to inidual patient needs, Henry helps people who have been left behind by the commercial market, all while remaining easy, accessible, and affordable. Our customers get access to the care they need, and save thousands of dollars on out-of-pocket healthcare expenses per year!

Apply today to make a direct, daily impact in one of the fastest-growing startups in the country – we are excited to meet you!

Henry Meds is now recruiting providers with a Nurse Practitionerto service our existing and growing patient database and help millions of Americans.

Duties and Responsibilities:

• Conduct virtual patient visits and assess health remotely through telehealth platforms to evaluate medical conditions, symptoms, and concerns.
• Apply medical expertise and clinical insight to formulate thorough treatment strategies, and prescribe medications when necessary.
• Provide clear and concise explanations of medical conditions, treatment options, medication instructions, and preventive healthcare measures to patients.
• Conduct follow-up appointments to assess patients’ progress, adjust treatment plans as needed, and address ongoing concerns or issues.
• Maintain accurate and up-to-date electronic medical records of patient encounters and treatment plans.
• Adhere to legal and ethical standards of nursing practice, as well as telehealth regulations and HIPAA guidelines, to ensure patient safety, privacy, and confidentiality.
• Maintain open and effective communication with patients, colleagues, and the Clinical Management Team, seeking input and guidance as needed to optimize patient care.
• Demonstrate adaptability and flexibility in response to changing patient and organizational needs, and pharmaceutical advancements, contributing to a dynamic and responsive telehealth practice.

Requirements:

• Must possess an active NP license in at least 5 states.
• Must hold an active DEA license.
• Experience in treating obesity, weight loss, or HRT is an advantage.

Company Offers:

• Comprehensive Professional Liability Insurance.
• Telehealth-focused Cybersecurity Insurance.
• Collaborative Practice Agreement.
• Reimbursement for additional state licensure.

Please note that Henry Meds cannot provide sponsorship at this time. Applicants must be legally able to work in the US without sponsorship.

Equal Opportunity Statement

Henry Meds is committed to promoting an inclusive work environment free of discrimination and harassment. We value a erse and balanced team where everyone can belong.

Important note:

There’s no need to apply more than once. It doesn’t enhance your chances, likelihood, or possibility of being considered for the role.

Please be aware that the review process may take longer than usual due to a significant surge in applications. We appreciate your patience and understanding during this time, and are enthusiastic about the potential opportunity to work with you in the future!

Location:  US Locations; 100% Remote; Part-time; Freelance

On this contract, you’ll play a pivotal role in managing calls from the client’s customer member-base Your responsibilities will include handling various requests such as order placement, card registration, account assistance, card support member complaints, program overviews, and troubleshooting. Additionally, you’ll conduct outbound calls as necessary to ensure transaction complettion. You’ll provide efficient and personalized assistance, ensuring seamless customer experiences and satisfaction. 

• Earnings:
  • $19 per hour for all hours serviced the first week of every month
  • $16 per hour for all hours serviced weeks 2-4 of every month
  • $400 in incentives available if requirements are met
• Hours of Operation: 8am-11pm Eastern Time Mon-Sunday
  • Min of 25 hours are required to be serviced the first week of every month
  • Hours will be as few as 10 hours per week for weeks 2-4 of every month
• Certification: – 6 classroom dates with a Live Facilitator & 5 days of Earn & Learn
• Tech Specs –
  • You will be shipped a thinclient but you are required to supply the following:
    • 2 monitors
    • Keyboard & Mouse
    • Corded USB Headset
    • Must be hard-wired with a physical cord (ethernet cord) from your internet source to your work computer

Omni CANNOT accept registrations for this contract from GBAs who have lived, worked, or gone to school in the following states: Alabama, Alaska, Connecticut, DC, Delaware, Idaho, Illinois, Louisiana, Nevada, New Jersey, New Mexico, New York, Ohio, South Dakota, West Virginia, Wyoming

Location: US Locations Only

CRNA Test Prep Writer

Job Description

Position Summary:

We are looking for a smart, motivated CRNA to create exceptional new practice questions that will help test-takers succeed on the NBCRNA National Certification Exam.

Role Qualifications:

• A CRNA credential
• Strong working knowledge of the topics covered on the exam.

Detail of Responsibilities:

• Perform diligent research, supporting and bolstering personal understanding of the content in order to communicate it effectively and thoroughly
• Write high quality, unique instructional content to help us best serve customers
• Work with our project managers to ensure submitted work meets required standards
• Respond quickly and positively to constructive feedback, making all necessary edits to submitted work
• Provide weekly updates to demonstrate steady progress

Company Description:

Mometrix Test Preparation was founded in 2002 with a simple vision: to help test-takers cut through all of the fluff and distractions in order to get to the heart of exactly what it takes to succeed on the exam. We watched helplessly as too many of our well-qualified friends and relatives struggled to get into the school of their choice or earn the certification necessary to get or keep a job simply because they didn’t test well. We decided there must be a better way to prepare, so we made it our mission to give test-takers exactly what they need in order to maximize their potential. Our goal is for our study materials, coupled with diligent effort, to empower test-takers to attain the highest score within their ability to achieve. We help people achieve their dreams by helping them overcome the testing hurdles necessary for them to get to where they want to be.

Our materials are available on every major digital platform and are distributed worldwide. Every year, millions of test-takers utilize Mometrix materials, including free online resources, study guides, flashcards, digital content, and apps for the web and smartphone.

Mometrix is a privately owned company based in the southeast Texas metropolitan area, with printing and distribution facilities in Tyler County, Texas. An A+ member of the BBB since 2003, we research, develop, produce, and retail our test preparation products to test-takers worldwide. Our products are developed by experts in each test’s field of study to ensure the highest quality, most relevant content possible. We take very seriously that our customers trust us to give them the information they need in order to perform well on the exam and select only the highest qualified writers using a rigorous application process.

Job Type:

Part-time,Contract

Pay:

$20.00 – $40.00 per hour

Expected hours:

10 20 per week

Benefits:

Flexibleschedule

License/Certification:

CRNA credential (Required)

Work Location:

Remote

*This is a CONTRACTOR position open to anyone working in the US remotely.

Title: Coder Abstractor – Remote

Location: USA-

Requisition #: 59557

Total hours worked per week: 40

Find more than your next job. Find your community.

• We’re northern Michigan’s largest healthcare system and we are deeply rooted in the communities we serve. That means that our patients are often our family, friends and neighbors – and it’s special to be able to care for them. And as one of the top healthcare systems to work for in Michigan by Forbes (American’s Best Employers by State 2022), we’re committed to your ongoing growth and development.
• After work, you’ll find things to do in every season – beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment.

Why work as a Coder Abstractor at Munson Healthcare?

• Offers a remote work schedule
• Our dynamic work environment includes many opportunities for growth and development
• Our efforts directly impact patient satisfaction and outcomes
• Our employees work in positive, supportive, and compassionate environments built on our organizational values.

Summary:

Responsible for charge capture process for professional charges within the Munson system, including but not limited to: verifying and/or analyzing medical record and/or encounter form documentation to determine the principle and all secondary diagnoses and procedures; assigning diagnostic codes, procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS) and Munson; performing data entry; and, performing discrepancy resolution. Serves as a liaison between CBO and sites/departments. Assists in the orientation and training of new employees within the coding and charge capture area.

What’s Required:

• Associate’s degree in Health Record Technology or related healthcare field and two to three years of professional coding experience and must obtain the credentials of a certified professional coder (CPC) within 18 months of employment OR three to five years of professional coding experience and has obtained the credentials of a certified professional coder (CPC).

The Benefits of Working at Munson:

• Eligible for a $5,000 Sign on Bonus
• Competitive salaries
• Full benefits, paid holidays, and paid time off (up to 19 days your first year)
• Tuition reimbursement and ongoing educational opportunities
• Retirement savings plan with employer match and personal consulting
• Wellness plans, an employee assistance program and employee discounts

Coder Abstractor

Location: United States

Status (FT/PT): Full-Time Shift: Day shift

Description

Find more than your next job.Find your community.

• Were northern Michigans largest healthcare system and we are deeply rooted in the communities we serve. That means that our patients are often our family, friends and neighbors and its special to be able to care for them. And as one of the top healthcare systems to work for in Michigan by Forbes (Americans Best Employers by State 2022), were committed to your ongoing growth and development.
• After work, youll find things to do in every season beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment.

Why work as a Coder Abstractor at Munson Healthcare?

• Offers aremotework schedule
• Our dynamic work environment includes many opportunities for growth and development

• Our efforts directly impact patient satisfaction and outcomes
• Our employees work inpositive, supportive, and compassionateenvironments built on our organizational values.

Summary:

• Responsible for charge capture process for professional charges within theMunson system, including but not limited to: verifying and/or analyzing medical record and/or encounter form documentation to determine the principle and all secondary diagnoses and procedures; assigning diagnostic codes, procedural codes and modifiers using coding guidelines established by the Centers for Medicare andMedicaid Services (CMS) and Munson; performing data entry; and, performing discrepancy resolution. Serves as a liaison between CBO and sites/departments. Assists in the orientation and training of new employees within the coding and charge capture area.

Whats Required:

• Associatesdegreein Health Record Technologyor related healthcare fieldandtwo to three years of professional coding experience and must obtain the credentials of a certified professional coder (CPC) within 18 months of employment ORthree to five years of professional coding experience andhasobtained the credentials of a certified professional coder (CPC).

The Benefits of Working at Munson:

• Eligible for a $5,000 Sign on Bonus
• Competitive salaries
• Full benefits, paid holidays, and paid time off (up to 19 days your first year)
• Tuition reimbursement and ongoing educational opportunities
• Retirement savings plan with employer match and personal consulting
• Wellness plans, an employee assistance program and employee discounts

*Terms and conditions apply

Title: Registered Nurse

Weekends (Remote)

Location: Remote

JobDescription:

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a specialized medical group focused today on aging adults with long-term home care needs. We help these iniduals live happier, healthier lives by partnering with their aides and caregivers, as a key part of the care team. We use a combination of virtual care, home-based and mobile technologies, data integrations and partnerships with home care agencies to make the home an integrated setting of care with patients, and their Caregivers at the center.

Vesta is the Roman name for the goddess of home, hearth and family. She is the caregiver. Often unseen yet greatly revered, she puts others’ needs ahead of her own, keeping the hearth warm so the home and family can function.

We see Caregivers and recognize the power and potential they embody. More than just assistance, Caregivers are eyes, ears and hands in the home. Caregivers play the role of Doctor, Nurse, Pharmacist, EMT and more, but without support or guidance. That is where Vesta comes in. Our program provides Caregivers with a personalized clinical team in their pocket. Our team links Caregivers to the people they care for and the other providers involved in their care. It’s an insurance covered benefit, so it’s available to most adults with Caregivers free of charge to them.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing what’s best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal candidate would be able to:

• Plan and conduct intervention opportunity evaluations, respond to urgent alerts and remote patient monitoring alerts as needed to help drive high quality care at a lower cost
• Have the ability and skill to recognize clinical scenarios that require escalation to the internal team nurse practitioner
• Work directly with the member, via various forms of communication, texting, virtual visits, and telephone, to develop and achieve patient centered chronic care management goals
• Develop and update care plans for members while keeping a close eye on caregiver and/or family support
• Apply clinical experience and judgment to the utilization management/care management activities
• Be responsible for day to day work with patients related to interventions needed for quality outcomes to reduce avoidable admissions, readmissions and ED utilization.
• Collaborate with engagement and product teams to promote quality outcomes, optimize service experience, and promote effective use of resources for complex or elevated medical issues

Would you describe yourself as someone who has:

• Can commit to a full-time opportunity working weekends and some weekdays (required)
• Has a New York nursing license (required)
• Has a Compact nursing license (preferred)
• Graduated from an accredited nursing program (required)
• At least 2 years of nursing experience providing care to adult and geriatric patient populations (required)
• Confidence with clinical skills in performance of telephonic triage/assessment (required)
• The ability to work remotely and has a private area in their home/workspace (required)
• Bilingual and fluent in English AND Spanish/Russian/Mandarin (preferred)
• A genuine, compassionate desire to serve others and help those in need
• High speed home WiFi/data connection to support company provided IT equipment

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• 12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k plus match
  Pay range is $85,000 – $101,000 per year for full-time opportunities based on experience and location. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level.)

If yes, then we look forward to speaking to you!

Vesta Healthcare is committed to leveraging the talent of a erse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.

At Vesta, we are constantly searching for the most dynamic and best talent to join our team with a mission of empowering caregivers in the home!

If you are ever contacted by e-mail from any domain other than https://vestahealthcare.com, please do not respond, as there is a likelihood it could be a scam as it is not a legitimate Vesta email. You might see things from a similar domain address, but with a slight misspelling, for example. We have no responsibility for any communication that does not come from the https://vestahealthcare.com domain, and we strongly advise that you not provide information or respond if not from the legitimate Vesta domain. If you have any concerns that outreach might not be legitimate, please reach out to [email protected] for confirmation.

Patient Accounts Manager

Fully RemoteRemote

Job Type

Full-time

Description

Soleo Health is seeking aPatient Accounts Managerto support our Specialty Pharmacy OperationsRemotely (USA). Join us in Simplifying Complex Care!

Soleo Health Perks:

• Competitive Wages
• 401(k) with a Match
• Referral Bonus
• Paid Time Off
• Great Company Culture
• Paid Parental Leave Options
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• HSA & FSA (including dependent care) Options
• Education Assistance Program

The Position:

This position is responsible for managing the billing and collection functions for the Companys Patient Accounts Receivable. This position will directly oversee the patient account specialists in the department.Responsibilities include:

• Generates billing statements for patients with balances remaining after all third party payments are received
• Works in tandem with the branches to identify exceptions or special circumstances related to the patients outstanding balance
• Communicates with patients regarding overdue balances, payment arrangements, and other billing concerns or inquiries
• Establishes and documents payment arrangements for patients with outstanding balances and monitors adherence to agreed upon collection schedules
• Manages the Patient Accounts Receivable including balances for copay/deductibles, Soleo Financial Assistance, and self-pay patients
• Performs necessary adjustments to invoice balances after all collection efforts have been exhausted
• Prepares patient refunds, as necessary
• Identifies and transfers delinquent patient accounts to the Companys collection agency
• Creates and develops procedures for the efficient management of the Patient Accounts Receivable
• Develops strategies and new techniques to reduce bad debt losses, including recommended changes to billing and collection practices
• Manage the Mfg Co Pay A/R for prompt collections
• Manage the Soleo Financial Assistance Program, review incoming applications for final approval or denial and maintain the SAP Master Log
• Work with the Procurement Department to identify lost/missing DME and track the products though the collections process
• Ensures compliance with federal, state, and local governments, third party contracts, company policy, and general accounting practices
• Manages the patient accounts team by approving payroll, completing perfomance reviews, hiring and training

Schedule:

• Monday-Friday, 8:30am-5p
• Overtime as needed
• Travel may be necessary for training

Requirements

• Bachelors Degree preferred
• Minimum 3-4 years Reimbursement Management and/or Supervisor experience in an Infusion setting
• Knowledge of financial accounting, HIPAA guidelines, federal, state, and local regulations related to healthcare providers, billing and collections
• At least 3 years of experience with reimbursement processes (Billing, collections, receivable analysis, and audit techniques)
• Experience taking initiative and executing processes resulting in expected outcomes
• Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
• Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
• CPR+ systems experience a plus

About Us:Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

Soleos Core Values:

• Improve patients lives every day
• Be passionate in everything you do
• Encourage unlimited ideas and creative thinking
• Make decisions as if you own the company
• Do the right thing
• Have fun!

Soleo Health is committed to ersity, equity, and inclusion. We recognize that establishing and maintaining a erse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring erse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our erse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating ersity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: Billing manager, reimbursement manager, collections manager

Salary Description

$62,000-$75,000 per year

Title: Patient Access Specialist

Location: FL-Lockhart

JobDescription:

Description

AssistRx has engineered the perfect blend of technology and talent to deliver best in class results. We believe that access to therapy transforms lives and is achieved through the powerful combination of our people and technology. We leverage advanced custom software, data analytics, and a patient-centered approach to transform medication management into a seamless and efficient process.

As we continue to experience rapid growth and expansion, we are excited to announce multiple openings for talented iniduals to join us in our mission. If you are driven by innovation, thrive in a collaborative setting, and are eager to contribute to cutting-edge solutions that transform lives, we want to hear from you.

Join us in making a difference in healthcare technology. At AssistRx, you’ll be part of a team that’s shaping the future of patient care. Apply today and embark on a rewarding journey with us!

About The Role:

The purpose of this position is to help patients get access to the medications and therapies that they need.

This role works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications.

• Ensure cases move through the process as required in compliance with company requirements and the organization’s defined standards and procedures; in a manner that provides the best level of service and quality
• Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
• Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
• Identify any coverage restrictions and details on how to expedite patient access
• Document and initiate prior authorization process and claims appeals
• Report any reimbursement trends or delays in coverage to management
• Act as a liaison for field representatives, health care providers and patients

**VOTED one of Orlando’s BEST PLACES TO WORK two years in a row**

***NEW CONVENIENTLY LOCATED MAITLAND OFFICE***

****WORK FROM HOME AVAILABLE AFTER 120 DAYS****

Why Choose AssistRx:

• Work Hard, Play Hard: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary. Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary.
• Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications.
• Flexible Culture: Many associates earn the opportunity to work from home after 120 days after training. Enjoy a flexible and inclusive work culture that values work-life balance and erse perspectives.
• Career Growth: We prioritize a “promote from within mentality”. We invest in our employees’ growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization.
• Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry.
• Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what’s possible. Tell your friends about us! If hired, receive a $750 referral bonus!

Requirements

• In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage
• 2 to 5 years of benefit investigation involving the analysis and interpretation of insurance coverage
• 3 to 5 years of experience interacting with healthcare providers in regard to health insurance plan requirements
• Excellent verbal communication skills and grammar
• Salesforce system experience preferred

Benefits

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance

AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.

All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.

AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire.

Apply for this job

Medical Coder – Remote

Location:

Status (FT/PT): Full-Time Shift: Day shift Req ID: 59029

Description

**Outpatient Surgery Coding Experience Required

Find more than your next job.Find your community.

• Were northern Michigans largest healthcare system and we are deeply rooted in the communities we serve. That means that our patients are often our family, friends and neighbors and its special to be able to care for them. And as one of the top healthcare systems to work for in Michigan by Forbes (Americans Best Employers by State 2022), were committed to your ongoing growth and development.
• After work, youll find things to do in every season beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment.

Why work as a Coder Abstractor at Munson Healthcare?

• Flexible remote work schedule
• Our dynamic work environment includes many opportunities for growth and development

• Our efforts directly impact patient satisfaction and outcomes
• Our employees work inpositive, supportive, and compassionateenvironments built on our organizational values.

Summary:

Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications. Insure compliance with PRO data reporting and other regulatory licensing and accrediting agencies.

Whats Required:

• High school graduation (or equivalent) and RHIA, RHIT eligible, or Certified Coding Specialist (CCS).
• Associates degree in related field with six to twelve months experience in a hospital Medical Records Department or equivalent training through a formal coding education program and demonstrated knowledge of medical terminology, various types of diseases and surgical procedures, and knowledge of ICD-10-CM and CPT-4 classification manuals.
• Analytical ability to interpret data contained in records.
• Ability to accurately determine and assign ICD-10-CM and CPT-4 codes.

The Benefits of Working at Munson:

• Competitive salaries
• Full benefits, paid holidays, and paid time off (up to 19 days your first year)
• Tuition reimbursement and ongoing educational opportunities
• Retirement savings plan with employer match and personal consulting
• Wellness plans, an employee assistance program and employee discounts

*Terms and conditions apply

Inpatient Rehab Coder- PT

remote type

Fully Remote

locations

Remote – Other

time type

Part time

job requisition id

R012778

Responsible for daily coding, auditing and DRG validation of assigned encounters is accurate and compliant.

Responsibilities

• Conduct reviews and provide recommended corrections of billed services as it relates to clinical documentation
• Assist in the reviews and responses to payor and governmental audits of billed services.
• Review and research new coding guidelines and codes.
• Maintain expertise in ICD-10 and CPT coding as well as ICD10 PCS coding and credentials.
• Meet daily accuracy and production standards as per established department policy.

Qualifications

Required

• High school diploma or GED
• One or more of the following:CCS credential through AHIMA; or a CPC and CICcredential from the AAPC.
• At least 1 year of experience in medical coding along with DRG validation.
• Strong analytical skills, excellent interpersonal and communication skills
• Must be capable of producing detailed, comprehensive documentation and reports

Preferred

• Associates or Bachelors degree
• Experience in coding or medical billing quality control is preferred.

Expectations

• Normal office environment including but not limited to long periods of sitting, typing, analyzing data, telephone communication, use of standard office equipment and daily personal interaction.

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all iniduals. We celebrate ersity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmarts sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the inidual can provide proof of valid prescription to Netsmarts third party screening provider.

If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please contact[email protected] to request the details to which you may be legally entitled.

All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

Title: Nurse Care Manager Remote (Oregon)

Location: Gresham OR US

JobDescription:

Join Signallamp Health: Empower Patients from the Comfort of Your Home

We’re on a mission to redefine the healthcare experience for chronically ill patients, and we need passionate RN’s & LPN’sto join our journey.

Our clients are based all over the United States: Eastern/Pacific/Mountain time zones. We are looking for team members throughout the Mid- West and West Coast to serve our clients. Work schedule M-F 8-4:30pm US/Pacific. M-F 9-530pm US/MT

Imagine this: Most people only see their doctors when they’re unwell, face the stress of booking appointments, and endure lengthy waits in crowded waiting rooms. But what happens in those critical moments between visits? Who’s there when they grapple with medication side effects, need assistance with transportation, or are torn between a trip to the ER or waiting it out?

At Signallamp, we’ve transformed remote care management to ensure that these vulnerable iniduals are never alone. As a part of our team, you’ll work comfortably from your home, maintaining consistent connections with patients, offering them the guidance they need to navigate their health challenges, and ultimately bridging the gaps that traditional healthcare often overlooks.

Join us, and be at the forefront of compassionate, innovative care.

Nursing on Your Terms: Home-Based, Tailored Schedules, Meaningful Relationships

As a Chronic Care Manager with Signallamp, you’ll deliver the compassionate care and patient education you’re renowned for, but with the added benefit of working from home. Skip the daily commute, save on gas, be there for your family when they need you, and enjoy the simple pleasures, like your pet’s company or flexibility for personal appointments.

After your first 6 months, choose a schedule that fits YOU:

4 days x 8 hours

4 days x 9 hours

4 days x 10 hours

Pick the rhythm that suits your life. And guess what? Your benefits stay the same!

Our nursing team is the backbone of long-lasting patient relationships. Engaging with the same iniduals monthly, our nurses offer the consistent, personalized support that is often missing in busy doctor’s offices. This level of attention not only makes patients feel valued but also empowers them to take better care of themselves, ensuring a longer, active, and safer life.

A Day in the Life of a Chronic Care Manager

– Engage in regular check-ins with patients: Discuss changes since the last conversation, follow up on appointments, and understand any new instructions from their doctor.

– Delve into rich conversations and bond with patients, understanding their unique personalities and challenges.

– Establish and nurture trust with new patients and their families.

– Act as a vital link within the patient’s care team: Communicate seamlessly with providers and in-office staff.

– Harness your expertise to:

– Guide patients in prioritizing their health and understanding their conditions.

– Advocate for patients, providing answers and addressing medical concerns promptly.

– Use technology to manage and coordinate care, from gathering resources to setting care goals.

– With familiarity in Electronic Medical Record (EMR) systems:

– Review recent office visits.

– Liaise with the care team.

– Accurately document all actions taken for patients.

Hear more about working at Signallamphttps://signallamphealth.com/learnaboutus/

You’re a Great Fit If Your Qualifications include:

Compassion: At the heart of everything, you provide heartfelt care to patients.

Location: You reside in or around the surrounding areas;Gresham, OR ; ( Must be willing to work Pacific/MT zone).

Licensing: You’re an RN/LPN licensed in any U.S. state. If your role involves caring for out-of-state patients, we’ll cover your licensing fees.

Experience:

– Minimum of 4 years in nursing care for chronically ill patients.

– Background in home health or primary care settings is a plus.

– Proficiency in using Electronic Medical Records (EMR).

Tech-savvy: Confidence in learning and adapting to new technology tools.

Time Management: Proven skills in managing your time effectively, especially when remote working.

Communication: Exceptional active listening skills, along with clear written and verbal communication.

Privacy and Conduct: A thorough understanding of privacy policies, ensuring the confidentiality of patient health information, and adherence to the highest standards of professional conduct.

Benefits

• Medical
• Dental
• Vision
• Free access to mindfulness apphttps://www.studiobemindfulness.com/
• Continuing Education Credits (CEU) paid for
• Additional State licensure paid for
• Employee Assistance Program (EAP) -free and confidential
• 401k with company match
• Vacation / personal days
• Holiday pay (your Birthday andBlack Friday and Christmas Eve Day too)
• Sick pay
• Potential to flex time
• Short-term disability
• Long-term disability
• Life insurance
• Productivity bonus payments monthly-on average, earn between $5-10,000 annually in addition to your hourly wages!
• Retention bonuses
• Referralbonuses

Title: Psychiatric Mental Health Nurse Practitioner (1099 Contract) – South Carolina

Location: Remote (United States)

JobDescription:

Our Company:

At Cerebral, we’re on a mission to democratize access to high-quality mental health care for all. We believe that everyone everywhere deserves to get the care they need, and are striving to make care convenient and accessible, while tackling the stigmas that surround mental illness.

Since launching in January of 2020, Cerebral has scaled to provide mental health services to more than 700,000 people in all fifty US states. With support from investors like SoftBank, Silver Lake, Access Industries, Bill Ackman, WestCap, and others, and impactful leaders like you, well continue to democratize mental health care and double down on clinical quality and deliver exceptional client outcomes for years to come. With a heavy focus on clinical quality and safety in all that we do, weve accomplished excellent outcomes for hundreds of thousands of clients:

• 82% of clientsreport an improvement in their anxiety symptoms after using Cerebral.
• 75% of clientswho report improvement in their depression see improvement within 60 days.
• 50% of clientswho initially report suicidal ideation no longer harbor suicidal thoughts after treatment with Cerebral.

This is just the beginning for Cerebral, and we wont stop building, growing, and iterating until everyone, everywhere can access high-quality, evidence-based mental health care without high costs and/or long wait times. Were looking for mission-driven leaders who share these values, and we need your help as we transform access to high-quality mental health care in the United States and beyond.

The Role:

We are hiring a contract Psychiatric Mental Health Nurse Practitioner! Cerebral provides evidence-based treatment for adults seeking mental health care. Our telemedicine prescribers collaborate with Therapists and Psychiatrists to support clients during their mental health journey. This PMHNP role provides direct patient care for a panel of clients and allows for flexibility when client sessions can be scheduled. You can see clients during traditional business hours, evenings, or on weekends.

We are looking for clinicians with state licenses from the following states: California, Illinois, and/or South Carolina.

This is a 1099 contract position offering up to 25 hours per week based on availability. Full practice and full prescriptive authority is required for Illinois.

Who you are:

• You are PMHNP licensed and in good standing
• Board certification (AANP or ANCC)
• Minimum of a Master’s degree in nursing, specializing in psychiatric mental health
• Comfortable assessing and formulating evidence-based treatment plans for clients with mental illness
• Maintain a strong evidence-based clinical skill set while practicing & implementing outcome-focused care within the clinical coverage team
• Empathetic and intuitive listening
• Strong verbal and written communication
• Knowledgeable in crisis response
• Comfortable working autonomously in a telemedicine environment
• Tech-savvy with the ability to navigate various systems & tools with ease (this includes, but is not limited to Google Workspace, proprietary EMR, etc.)
• Passionate about our mission of improving access to high-quality mental health care
• An entrepreneurial spirit or previous experience within a startup or fast-paced environment is preferred

How your skills and passion will come to life at Cerebral:

• Hold thoughtful and engaged sessions with clients; 30 minute initial sessions and 15 minute follow up sessions
• Maintain and provide direct care to a panel of clients
• You will work collaboratively with other mental health care partners at Cerebral to ensure the most beneficial level of evidence-based treatment plans for our clients
• Work alongside other like-minded clinicians that have a common goal to positively impact the lives of others, and create an environment that leads to favorable outcomes for clients

What we offer:

• Mission-driven impact:
  • Shape the future of the #1 largest and fastest growing online mental health care company in the world
  • Build a platform that is improving the lives and well-being of hundreds of thousands of people
  • Join a community of high achievers who have a passion for promoting mental health
• Path to develop & grow:
  • Readily available psychiatrists and clinician leadership for case consultations to ensure you always receive the support you need
  • Access to innovative technology to support you in delivering the highest quality of care to your clients
  • Access to UpToDate for continued education (free CEU offering)
• Remote-first model:
  • Flexibility to choose the hours and schedule that work best for you
  • Work virtually from anywhere in the United States
• Culture & connectivity:
  • Highly-responsive and supportive team of clinical and operational management
  • Decreased administrative time for clinicians through ongoing technology improvements and automations
  • Fully integrated, data-enabled EMR with embedded clinical decision support, monthly prescriber metric reports, and task management system
  • Opportunity to participate in strategic development initiatives to improve our clinical quality and safety and/or clinical processes across the organization

Who we are (our company values):

• Client-first Focus– relentless focus on advancing the quality of care, clinical experience, and patient safety
• Ethics & Integrity– do what is right and demonstrate ethical principles, even when no one is watching
• Commitment– accountable for fully delivering on commitments to our clients and each other
• Impact & Quality– make a positive impact and deliver high quality outcomes, based on data and evidence
• Empathy– act compassionately, listen to seek understanding, and cultivate psychological safety with clients and colleagues
• Collaboration– achieve our goals together as a united team, strengthened by mutual openness, trust, and ersity of thought
• Thoughtful Innovation– continuously evolve our ability to deliver on our mission, prioritizing long-term, strategic bets over short-term gains

Cerebral is committed to bringing together humans from different backgrounds and perspectives, providing employees with a safe and welcoming work environment free of discrimination and harassment. As an equal opportunity employer, we prohibit any unlawful discrimination against a job applicant on the basis of their race, color, religion, gender, gender identity, gender expression, sexual orientation, national origin, family or parental status, disability, age, veteran status, or any other status protected by the laws or regulations in the locations where we operate. We respect the laws enforced by the EEOC and are dedicated to going above and beyond in fostering ersity across our workplace.

___________________

Cerebral, Inc. is a management services organization that provides health information technology, information management system, and non-clinical administrative support services for various medical practices, including Cerebral Medical Group, PA and its affiliated practices (CMG), who are solely responsible for providing and overseeing all clinical matters. Cerebral, Inc. does not provide healthcare services, employ any healthcare provider, own any medical practice (including CMG), or control or attempt to control any provider or the provision of any healthcare service. Cerebral is the brand name commonly used by Cerebral, Inc. and CMG.

Contract Clinical Coder

Remote

Watertown, Massachusetts, United States

Operations

Contract

Description

Firefly Health is building a revolutionary new type of comprehensive health “care and coverage, powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform.

Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver clinical and financial health through joyful, always there care. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members.

We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, we would love to hear from you.

Contract Position:

We are looking for a Certified Professional Coder to join our team in a contract role through the end of the year, working approximately 30 hours per week. As a Certified Professional Coder, you will ensure the accuracy and integrity of medical coding for billing and reimbursement.

Contract Role and Responsibilities:

• Assign accurate medical codes to diagnoses, procedures, and services in accordance with coding guidelines and regulations
• Ensure compliance with insurance eligibility requirements, fee for service and capitated coding standards, and billing regulations
• Perform risk adjustment coding to optimize reimbursement and accurately reflect patient acuity
• Collaborate with healthcare providers to improve clinical documentation to support accurate coding and billing
• Conduct regular audits to ensure coding accuracy and compliance with regulatory requirements
• Provide education and training to healthcare providers and staff on coding best practices and documentation improvement strategies
• Stay current with updates to coding guidelines, regulations, and industry trends

Contractor Requirements:

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS) credential or Certified Coding Specialist- Physician-based (CCS-P) required
• Minimum of 2 years of experience in medical coding and billing
• Minimum of 1 years of experience in risk adjustment coding
• Proficiency in ICD-10-CM, CPT, HCPCS
• Strong understanding of medical terminology, anatomy, physiology, and disease processes
• Excellent analytical and problem-solving skills
• Detail-oriented with a high level of accuracy in coding and documentation
• Effective communication and interpersonal skills
• Ability to work independently and as part of a team in a fast-paced healthcare environment
• Commitment to maintaining confidentiality and adhering to ethical standards

Contractor Preferred Qualifications:

• You thrive in a multidisciplinary environment and are skilled at collaborating with professionals from various sectors within healthcare to enhance the coding process and overall patient care
• You are proficient with the latest healthcare technology platforms and have a knack for leveraging digital tools to streamline coding processes and improve accuracy
• You are committed to continuous professional development and are always looking for opportunities to learn more about the latest coding standards, healthcare regulations, and industry best practices
• You have exceptional communication skills, capable of explaining complex coding guidelines to iniduals with non-technical backgrounds, facilitating clear and effective information exchange across the organization
• You are a proactive problem solver who anticipates and addresses issues before they escalate

Firefly is an equal-opportunity employer. We value erse backgrounds and perspectives. We’re committed to building and sustaining an inclusive workplace culture where iniduals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need. Firefly is an E-Verify employer.

Registered Nurse Clinical Specialist

at Transcarent

US – Remote

Who we are

Transcarent is the One Place for health and care. We cut through the complexity, making it easy for people to access high-quality, affordable care. With a personalized app tailored for each Member, an on-demand care team, and a connected ecosystem of high-quality, in-person care and virtual point solutions, Transcarent eliminates the guesswork to confidently guide Members to the right level of care. We take accountability for results offering at-risk pricing models and transparent impact reporting to align incentives towards measurably better experience, better health, and lower costs. At Transcarent, you will be part of a world-class team, supported by top tier investors like 7wireVentures and General Catalyst, and founded by amission-driven teamcommitted to transforming the health and care experience for all. We closed on our Series C funding in January 2022, raising our total funding to $298 million and enabling us to respond to the demand for our offering.

Transcarent is committed to growing and empowering a erse and inclusive community within our company. We believe that a team with erse lived experiences, working together will strengthen our organization, and our ability to deliver “not just better but different” experiences for our members.

We are looking for teammates to join us in building our company, culture, and Member experience who:

• Put people first, and make decisions with the Members best interests in mind
• Are active learners, constantly looking to improve and grow
• Are driven by our mission to measurably improve health and care each day
• Bring the energy needed to transform health and care, and move and adapt rapidly
• Are laser focused on delivering results for Members, and proactively problem solving to get there

About this role

The Registered Nurse Clinical Specialist reports to the Director, Clinical Operations of Care Support Services and is responsible for guiding members through their Transcarent experience in partnership with Transcarents Care Coordinators. This role also supports quality assurance and improvement efforts and operations related to our Centers of Excellence (COE) program in accordance with the Transcarent Quality Tenets. The Registered Nurse Clinical Specialist will reflect the mission, vision, and value statements of Transcarent to internal departments and external plan sponsors, providers, and partners.

What youll do

Support the Care Support Services team with clinical subject matter expertise and guidance relating to inidual cases and in broader strategy and processes. This includes direct support to Plan Members.

• Partner with the Care Support Services Team to manage a caseload efficiently and effectively across a variety of clients and all clinical categories.
• Supports members to introduce, coordinate, and guide members through their Transcarent experience.
• Work effectively with other supporting operational roles and internal departments, to coordinate the member’s case.
• Effectively address and resolve Member barriers to utilizing the benefit including addressing program questions and collecting medical records in a timely and accurate manner to ensure an expedited process.
• Work with cross functional teams to develop new or update existing quality measures, protocols, processes, and policies to minimize risk and ensure compliance.
• Work collaboratively with our COE facility and provider partners in support of achieving the highest quality experience for our Members.
• Support the Provider Relations team with guidance relating to COE facilities and providers for targeting and participation.
• Support the operational needs of the COE program from a clinical perspective including monitoring and support for member complications.
• Lead a cohort of Care Coordinators to ensure cases are effectively progressing through to completion accurately.
• Other duties as assigned.

What were looking for

• Registered Nurse and current licensure, BSN required.
• A minimum of 5 years clinical acute care experience as a practicing RN preferred.
• Compact licensure
• Experience in surgery preferred.

Nice to have

• Flexibility – Openness and understanding that dynamic environments include change, and welcoming that change with a positive attitude.
• Problem Solving – Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
• Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Oral Communication – Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
• Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
• Teamwork – Balances team and inidual responsibilities; Exhibits objectivity and openness to others’ views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone’s efforts to succeed.

Total Rewards

Inidual compensation packages are based on a few different factors unique to each candidate, including primary work location and an evaluation of a candidates skills, experience, market demands, and internal equity.

Salary is just one component of Transcarent’s total package. All regular employees are also eligible for the corporate bonus program or a sales incentive (target included in OTE) as well as stock options.

Our benefits and perks programs include, but are not limited to:

• Competitive medical, dental, and vision coverage
• Competitive 401(k) Plan with a generous company match
• Flexible Time Off/Paid Time Off, 12 paid holidays
• Protection Plans including Life Insurance, Disability Insurance, and Supplemental Insurance
• Mental Health and Wellness benefits

Location

You must be authorized to work in the United States. Depending on the position we may have a preference to a specific location, but are generally open to remote work anywhere in the US.

Transcarent is an equal opportunity employer. We celebrate ersity and are committed to creating an inclusive environment for all employees. If you are a person with a disability and require assistance during the application process, please dont hesitate to reach out!

Research shows that candidates from underrepresented backgrounds often dont apply unless they meet 100% of the job criteria. While we have worked to consolidate the minimum qualifications for each role, we arent looking for someone who checks each box on a page; were looking for active learners and people who care about disrupting the current health and care with their unique experiences.

Title: Coding Operations & Execution

Location: Remote, United States

JobDescription:

Datavant is a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. We are a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners.

By joining Datavant today, you’re stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare. We hire for three traits: we want people who are smart, nice, and get things done. We invest in our people and believe in hiring for high-potential and humble iniduals who can rapidly grow their responsibilities as the company scales. Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs.

The Vice President of HCC Risk Adjustment is responsible for the oversight of risk adjustment and coding, and establishing and managing company coding guidelines, policy and procedures. The VP plays a critical role in the development and execution of business strategy and compliance, overseeing the development, implementation and execution of Medicare advantage and Managed Medicaid risk adjustment strategy.

You will:

• Strategy, planning and execution of the Risk adjustment coding business including ACA/Exchange, Medicare Advantage, and Medicaid plans.
• Demonstrate and pass on expert knowledge in HCC risk adjustment methodologies and industry-leading solutions and strategies to drive optimized results.
• Partner with Analytics to develop new predictive, analytic and reporting tools to glean actionable insights into current performance and new opportunities and leverage a network of experts – internal and external – to enhance Risk
• Adjustment innovation and performance. Integrate NLP (Natural Language Processing) technology with human coding expertise to delivery highest accuracy to clients.
• Monitor risk adjustment submissions as compared to expected revenue and proactively address gaps in data submissions and impacts to forecasting and budgets.
• Improve monitoring and auditing protocols to ensure internal and vendor compliance with all applicable regulations and risk adjustment data validation audits (RADV).
• Leverage market insights to monitor trends and external landscape, and to inform capability strategies and customer use case scenarios.
• Consult with and support Payer Client Services team with all Risk Adjustment programs and initiatives.
• Ensure operational integration of contractual requirements resulting in adherence to quality standards and performance expectations as required and strive to exceed established service level agreements.
• Oversight of the Coding management team and staff in all departmental functions including implementing best practices in talent acquisition for HCC coders, overseeing onboarding, staffing plans and staff performance to ensure optimal talent management and utilization.
• Develop and manage a multi-million dollar department budget.
• Negotiate, direct and oversee the administration of contracts, select and performance manage key vendor partners, and foster new relationships and partnerships with cutting edge service providers.
• Direct oversight of team/department and responsibilities around managing, developing, and handling employment actions of direct staff and manager
• Provide training sessions and educational resources to our client success team on the use of our coding software, coding guidelines, industry update and best practices on how to sell and discuss coding offerings with clients.
• Offer ongoing support and troubleshooting assistance to address client inquiries, issues, and challenges related to coding processes or system usage.
• Conduct regular check-ins and meetings with account managers and coding clients to understand their evolving needs, address concerns, and provide proactive support.

• Client Relationship Management:
  • Serve as the Coding Subject Matter Expert for our client success team, fostering strong relationships and acting as a trusted advisor.
  • Conduct regular check-ins and meetings with account managers and coding clients to understand their evolving needs, address concerns, and provide proactive support.

• Training and Support:
  • Provide training sessions and educational resources to our client success team on the use of our coding software, coding guidelines, industry update and best practices on how to sell and discuss coding offerings with clients.
  • Offer ongoing support and troubleshooting assistance to address client inquiries, issues, and challenges related to coding processes or system usage.

What you will bring to the table:

• Minimum of a Bachelor’s degree in business, finance, analytics, healthcare delivery, public policy or a related field is required. A Master’s degree in a related field of study is preferred.
• Seven (7) or more years’ experience in health plan, health technology for health plans, risk & quality at a plan or vendor, or a consultant in one or more of those areas.
• Five years experience with HCC coding leadership
• Four years experience in a in a client success / client facing role
• AAPC or AHIMA certification preferred.
• Strong analytical skills needed to prepare and analyze data to drive KPIs and process improvements within the department.
• Strong leadership and management skills to directly manage a team/department.
• Strong communication skills; ability to present information in a concise manner to multiple organizational levels including Board of Directors
• Must be able to travel a minimum of 50% of the time (more travel may be required at times)

Bonus points if:

• MBA or similar degree
• Familiarity with NLP, AI and LLM business models related to coding productivity and product differentiation
• Product experience

We are committed to building a erse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks and industry best practices.

We’re building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. The range posted is for a given job title, which can include multiple levels. Inidual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated salary range for this role is $208k-290k.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be anonymous and used to help us identify areas of improvement in our recruitment process. (We can only see aggregate responses, not inidual responses. In fact, we aren’t even able to see if you’ve responded or not.) Responding is your choice and it will not be used in any way in our hiring process.

Clinical Data Coder/Specialist-Temp

Remote

Position Summary:

The Clinical Data Coder/Specialist – Pre Claims is responsible for the accurate and timely work to effect filing of Insurance claims. Qualified inidual will demonstrate clinical claims detailed knowledge, coding and delivering resolutions to missing/ incomplete order data. This person will identify invalid clinical values to help drive clean claims and revenue pull through on all products and services.

This position will support the Revenue Cycle function and report to the Front End Manager of Revenue Cycle.

Note: This is a temp position.

Essential Duties and Responsibilities:

– Identify order and reimbursement deficiencies – both clinical and code related

– Investigate and correct, where appropriate, deficient clinical claim information

-Identify and escalate missing, and sometimes invalid, clinical order data for timely contact resolution with supporting cross functional teams

– Partner with multiple internal cross-functional teams and successfully manage multiple product projects simultaneously.

-Research claim and account information using various systems and portals internal and external

-Stay current with relevant medical billing regulations, rules and guidelines

-Complete position responsibilities within the appropriate time frame while adhering to quality standards

-Ability to interact with various insurances/ third party payors accurately and timely to ensure that authorizations are obtained and necessary documents are available for claim support based on internal and external policies and regulations

– Participate in clinical data management activities including leading clinical data initiatives, analysis and optimization of our clinical data capture workflows

– Translate data into meaningful information and knowledge that supports decision making or determining action that drives performance improvement and quality

– Identifies and uses internal and external sources of information for benchmarking and comparative performance, which includes networking with clinical communities, researching literature and agencies, and staying current on new indicators and other requirements

-Act as SME for multiple purposes where coding and clinical operations data is relevant

– Support and comply with the companys policies and procedures.

-Maintains strictest confidentiality, and adheres to all HIPAA guidelines/regulations

– Regular and reliable attendance. – Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.

-Perform analytical and special projects, prepare ad hoc reports/data queries as may be assigned/requested, working with leadership

Qualifications:

Minimum Qualifications:

– Bachelor degree in relevant field is preferred

– 3+ years professional coding experience with current certification including International Classification of Diseases (ICD-10) and Coding Procedure Terminology (CPT) and HCPCS coding. – Authorization to work in the United States without sponsorship.

– Certified coder designation/certification by AHIMA or AAPC required

– Superior organization skills, detail oriented, and ability to be persistent and follow through

– Problem-solving, ability to adapt, flexibility in approaches to accomplishing tasks, and ability to independently arrive at creative solutions to problems

– Excellent communication skills, both verbal and written, particularly the ability to convey technical information in an accessible and understandable manner

– Ability to work both independently and in collaboration with iniduals from various disciplines

Preferred Qualifications:

– 5+ years of experience coding in the medical/healthcare billing area- Lab a plus

– Any years of experience in the revenue cycle function to include third party payer experience. – Thorough understanding of professional coding, documentation, medical billing processes. – Deep familiarity with payer/insurance Medical policy, Prior Auth, claims, appeals and reimbursement processes. – Knowledge and familiarization with Medicare billing regulations and reimbursement methodologies for Laboratory

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.

Remote USA

$18$25 USD

OUR OPPORTUNITY

Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, womens health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

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. When you join Natera, youll work hard and grow quickly. Working alongside the elite of the industry, youll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits – Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

For more information, visit www.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a erse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Link: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.comemail domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

Clinical Appeals Nurse (RN) Remote

Molina Healthcare Job ID 2025531

JOB DESCRIPTION

Job Summary

Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance standards.

We are seeking a Registered Nurse with previous Inpatient/outpatient appeals knowledge/experience. The candidate should have MCG criteria knowledge, critical thinking skills, and strong organizational skills. Experience with Medicare review UM/Appeals and skilled computer skills highly preferred. Must be able to work independently in a high-volume environment. Further details to be discussed during our interview process.

Remote position.

Work schedule M-F 8:30 AM to 5:00 PM, weekend overtime eligibility. There is weekend and holiday rotation in the appeals department.

KNOWLEDGE/SKILLS/ABILITIES

• The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals request has been made or upon request by another Molina department to reduce the likelihood of a formal appeal being submitted.
• Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of all relevant and applicable Federal and State regulatory requirements and guidelines, knowledge of Molina policies and procedures, and inidual judgment and experience to assess the appropriateness of service provided, length of stay and level of care.
• Applies appropriate criteria on PAR and Non-PAR (contracted and non-contracted) cases and with Marketplace EOCs (Evidence of Coverage).
• Reviews medically appropriate clinical guidelines and other appropriate criteria with Chief Medical Officer on denial decisions.
• Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues.
• Identifies and reports quality of care issues.
• Prepares and presents cases in conjunction with the Chief Medical Officer for Administrative Law Judge pre-hearings, State Insurance Commission, and Meet and Confers.
• Represents Molina and presents cases effectively to Judicial Fair Hearing Officer during Fair Hearings as may be required.
• Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals.
• Provides training, leadership and mentoring for less experienced appeal LVN, RN and administrative staff.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.

Required Experience

• 3-5 years clinical nursing experience, with 1-3 years Managed Care Experience in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as needed or equivalent experience (such as specialties in: surgical, Ob/Gyn, home health, pharmacy, etc.).
• Experience demonstrating knowledge of ICD-9, CPT coding and HCPC.
• Experience demonstrating knowledge of CMS Guidelines, MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare, CHIP and Marketplace, applicable State regulatory requirements, including the ability to easily access and interpret these guidelines.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license in good standing.

Preferred Education

Bachelor’s Degree in Nursing

Preferred Experience

5+ years Clinical Nursing experience, including hospital acute care/medical experience.

MCG criteria knowledge

Critical thinking skills

Strong organizational skills

Medicare review UM/Appeals experience

Skilled computer skills

Preferred License, Certification, Association

Any one or more of the following:

• Active and unrestricted Certified Clinical Coder
• Certified Medical Audit Specialist
• Certified Case Manager
• Certified Professional Healthcare Management
• Certified Professional in Healthcare Quality
• other healthcare certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $54,373.27 – $117,808.76 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time

Title: Behavioral Health Crisis Coordinator

Location: Remote

JobDescription:

About us:

Grow Therapy is on a mission to serve as the trusted partner for therapists growing their practice, and patients accessing high-quality care. Powered by technology, we are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients. Following the mass increase in depression and anxiety, the need for accessibility is more important than ever. To make our vision for mental healthcare a reality, were building a team of entrepreneurs and mission-driven go-getters. Since launching in February 2021, weve empowered more than ten thousand therapists and hundreds of thousands of clients across the country and insurance landscape. Weve raised more than $178mm of funding from Sequoia Capital, Transformation Capital, TCV, SignalFire, and others.

What Youll Be Doing:

We are looking for a Behavioral Health Crisis Coordinator to provide support to mental health practitioners contracted with Grow Therapy. Youll help us expand the Clinical vertical at Grow Therapy by launching workflows for HLOC coordination (step up and step down) and clinical case consultation for providers who have a client in crisis. This role will serve as a clinical SME to assist our internal, non-clinical Escalation team to problem solve using best practices for crisis risk management. This is a fully remote position reporting directly to our Grievance Coordinator as part of the Clinical Excellence Team. Your responsibilities will include:

• Conduct real-time case consultations with providers related to their clients who are experiencing a crisis
• Meet SLAs to coordinate resources for IOP level of care and FUH appointments upon receipt of a provider or payor referral
• Partner with our Escalation team to provide asynchronous clinical guidance to address acute behavioral health needs of clients
• Review and respond to billing exceptions due to crisis care needs
• Serve as an internal SME with non-clinical teams on topics related to risk management and crisis intervention

Salary range: $90,843 – $118,750

Youll Be a Good Fit If:

• You have 5+ years of experience providing crisis intervention as a licensed clinician (LCSW, LMFT, LPC/LMHC, Licensed Psychologist in any state)
• Youre highly competent working in a fast-paced remote environment using asynchronous communication and a range of software tools
• You have experience working in a high volume telehealth environment and understand the nuances and challenges of being an independent telehealth provider
• Youre known as someone who is a problem solver, kind, patient and able to remain calm amidst a crisis
• Youre able to commit to working 9am-6pm or 10am-7pm MT Monday-Fridays

If you dont meet every single requirement, but are still interested in the job, please apply. Nobody checks every box, and Grow believes the perfect candidate is more than just a resume.

Note: Please upload your resume in PDF format

Benefits

• The chance to drive impact within the mental healthcare landscape from day one
• Comprehensive health insurance plans, including dental and vision
• Our dedication to mental health guides our culture. Wellness benefits include (but are not limited to):
  • Flexible working hours and location (remote OR in-office, your choice!)
  • Generous PTO
  • Company-wide winter break
  • Mental health mornings (2 hours each week)
  • Team meditation
  • Wellness Stipend
  • In-office lunch and biweekly remote lunch on us!
• Continuous learning opportunities
• Competitive salary
• The opportunity to help build a rapidly scaling start-up organization by taking strong ownership of your work, mentorship, and our unbounded leadership opportunities

#LI-REMOTE

Grow Therapy is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.

Title: Comprehensive Medication Review Medical Assistant

Location: Remote

Job Description:

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a specialized medical group focused today on aging adults with long-term home care needs. We help these iniduals live happier, healthier lives by partnering with their aides and caregivers, as a key part of the care team. We use a combination of virtual care, home-based and mobile technologies, data integrations and partnerships with home care agencies to make the home an integrated setting of care with patients, and their Caregivers at the center.

Vesta is the Roman name for the goddess of home, hearth and family. She is the caregiver. Often unseen yet greatly revered, she puts others’ needs ahead of her own, keeping the hearth warm so the home and family can function.

We see Caregivers and recognize the power and potential they embody. More than just assistance, Caregivers are eyes, ears and hands in the home. Caregivers play the role of Doctor, Nurse, Pharmacist, EMT and more, but without support or guidance. That is where Vesta comes in. Our program provides Caregivers with a personalized clinical team in their pocket. Our team links Caregivers to the people they care for and the other providers involved in their care. It’s an insurance covered benefit, so it’s available to most adults with Caregivers free of charge to them.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing what’s best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal teammate would be…

A customer focused inidual who is responsible for assisting the team in coordinating the care of members enrolled in Medicare’s chronic care management program during each calendar month. This will primarily entail periodic telephonic outreach calls to members, caregivers, and other care team members as directed with documentation in the appropriate platform to ensure compliance. The Medical Assistant will collaborate with the supervising provider and staff to conduct outreach, assessment and service planning to coordinate care for the CCM patients.

The ideal teammate would be able to:

• Conduct patient interviews and create accurate, comprehensive medication lists
• Coordinate clinical service visits between pharmacists and members and/or caretakers
• Provide practice support including: contacting members, caregivers, and care team members as directed, work closely with the clinical team to improve the health and care of our members
• Coordinate care for members of the program
• Enter data within operating dashboards, reporting and workflow platforms
• Ensure call resolution by discussing purpose of call, effectively address all concerns, and escalate calls as necessary according to protocol
• Manage challenging member and/or caretaker situations and be able to respond promptly to member needs and service requests
• Embrace a continuous quality improvement approach by proactively identifying areas of improvement and communicating those ideas to the clinical services team
• Participate in other activities as assigned

Would you describe yourself as someone who has:

• A current Medical Assistant (CMA) certification (required)
• Fluency in English and Spanish (writing, reading and speaking) (required)
• At least two years of experience as a medical assistant with at least 1 year experience as a medication reconciliation medical assistant (required)
• The ability to work Monday – Friday, 9:00 am – 6:00 pm EST and rotating holiday shifts (required)
• Knowledge and understanding of chronic care management processes (required)
• Comfort using technology like Google Workspace, multiple EMRs, Slack (required)
• Worked with multiple platforms to provide a seamless experience for the patient (required)
• The ability to be focused and productive while working from home with a private area in their home/workspace with a reliable internet connection (required)
• A positive attitude and genuinely enjoys talking to patients
• Demonstrated ability to work effectively as a member of an interdisciplinary team, displaying good judgment and decision-making skills
• The ability to perform duties as assigned or requested

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• ~12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k with match

Pay rate is $22-23 hourly. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

If yes, then we look forward to speaking to you!

Vesta Healthcare is committed to leveraging the talent of a erse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.

At Vesta, we are constantly searching for the most dynamic and best talent to join our team with a mission of empowering caregivers in the home!

If you are ever contacted by e-mail from any domain other than https://vestahealthcare.com, please do not respond, as there is a likelihood it could be a scam as it is not a legitimate Vesta email. You might see things from a similar domain address, but with a slight misspelling, for example. We have no responsibility for any communication that does not come from the https://vestahealthcare.com domain, and we strongly advise that you not provide information or respond if not from the legitimate Vesta domain. If you have any concerns that outreach might not be legitimate, please reach out for confirmation.

Orthopaedic Medical Coding Specialist II

at Surgical Notes

Remote, United States

Surgical Notes is hiring for aOrthopaedicMedical Coding Specialist IIto provide accurate and timely coding for our ambulatory surgical clients. The ideal candidate has excellent organizational skills, communication skills, with the desire and ability to learn quickly. Working as a part of the team to meet deadlines, but also being able to work independently is crucial to the success in this position. Our organization prides itself on being built upon a set of strong core values. We are looking for candidate who will actively exhibit these core values: Service Excellence, Transparency, Teamwork, Accountability, Hardwork, and Positive Attitude.

External Title:ASC Medical Coding Specialist II

Internal Title:US Coding Inidual Contributor II

Reports to:Manager, Coding

Responsibilities:

• Review operative reports to abstract information and apply CPT, HCPCS, and ICD-10-CM codes
• Provide coding for all Level 2 and some Level 3 procedures (ASC) as well as Level 1 as needed
• Perform coding for pro fee surgical encounters
• Verify LCD/NCD information as appropriate
• Utilize NCCI edits, AMA CPT Assistant, AHA Coding Clinic, and other resources as needed
• Initiate physician queries as needed
• Escalate coding/documentation problems when appropriate
• Participate in ongoing coding education
• Perform other related duties as required/assigned

Role Information:

• Full-Time or Part-Time
• Hourly
• Non-Exempt
• Eligible for Benefitsif Full-Time
• Quarterly Bonus (based on quality and productivity)
• Remote: The minimum bandwidth requirements are 10 Mbps upload and 50 Mbps download speeds. The recommended bandwidth requirements are 20 Mbps upload and 100 Mbps download speeds.

Job Requirements:

Required Knowledge, Skills, Abilities & Education:

• High School Diploma or equivalent
• Coding certification through AAPC or AHIMA (CPC, COC, RHIT, CCS, etc., no apprentice designation)
• 2 years outpatient surgical coding
• 2 years of Ambulatory Surgical Center coding experience
• Extensive knowledge of medical terminology, anatomy and physiology
• Ability to work independently and as part of a team
• Flexibility to assume new tasks or assignments as needed
• Strong attention to detail and speed while working within tight deadlines
• Exceptional ability to follow oral and written instructions
• A high degree of flexibility and professionalism
• Excellent organizational skills
• Outstanding communications skills; both verbal and written

Preferred Knowledge, Skills, Abilities & Education:

• Associate Degree in healthcare related field
• Experience working in an/Ambulatory Surgery Center (ASC)
• Strong Microsoft Office skills in Excel, Outlook, and Teams

Physical Demands:

• Sitting and typing for an extended period of time
• Reading from a computer screen for an extended period of time
• Speaking and listening on a telephone
• Working independently
• Frequent use of a computer and other office equipment
• Work environment of a traditional fast-paced and deadline-oriented office

Key Competencies:

1. Job Knowledge/Technical Knowledge
2. Productivity
3. Initiative/Execution
4. Flexibility
5. Quality Control

US Pay Ranges

$21$28 USD

About Surgical Notes

Surgical Notes is the premier ASC revenue cycle management and billing services partner. Our expert teams with ASC-specific experience provide scalable billing, transcription, coding, and document management services and solutions that fully integrate with all leading ASC practice management systems. The largest management companies and hundreds of ASCs that partner with Surgical Notes experience and benefit from immediate operational and financial improvements that exceed industry performance levels.

Surgical Notes is an equal opportunity employer. We celebrate ersity and are committed to creating an inclusive environment for all employees.

Clinical Administrative Coordinator

QualityRemote, United States

Description

Job Title: Clinical Administrative Coordinator (REMOTE)

Department: Quality Clinical Operations

About the Role:

We are looking for a Clinical Administrative Coordinator to join a team that is passionate about the health of our patients. As part of the Quality Department, the Clinical Operations team leads the effort to improve health outcomes by coordinating and delivering key clinical care. Through outreach and education, we inspire patients to take a preventive approach to maintaining their health and to be active in their management of chronic diseases. Together, we strive to achieve healthy living for all through all stages of life.

As a Clinical Administrative Coordinator, you will support the operations of the Quality Clinical Operations team. Your role helps carry out the clerical duties of our various programs. Your assignments help us to not only better serve our members, but also provide Primary Care Providers with timely updates regarding the services their patients have received. You may also be asked to carry out other duties in support of department programs and goals.

What Youll Do:

• Send reports and notes to providers, and confirm receipt
• Upload and download medical records
• Receive incoming calls, emails, and faxes
• Input patient information accurately into electronic health record system
• Call patients to remind them of their appointment date and time
• Follow up with patients who missed their appointments
• Assist patients with health questionnaires
• Prepare screening kits
• Oversee inventory of office and medical supplies
• If applicable, provide translation assistance in department programs
• Uses, protects, and discloses our companys patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Other duties may be assigned

Qualifications:

• Associates Degree
• At least one year of experience in a clerical or administrative role
• Experience using Microsoft applications such as Word, Excel, and Outlook
• Must have respect for confidentiality
• Must have ability to plan, prioritize, and complete tasks

Youre great for the role if:

• Experience in clinical/medical settings
• Experience using EHR systems
• Basic understanding of medical conditions and specialties
• Speak Chinese and/or Spanish and/or Vietnamese (not required)

Who We Are:

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.

Our platform currently empowers over 10,000 physicians to provide care for ~1 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.

Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

Environmental Job Requirements and Working Conditions:

• This is a REMOTE position with occasional requirement to report to the office as needed. The office is located at 568 W. Garvey Ave, Monterey Park, CA 91754.
• The total compensation target pay range for this role is: $17-20 per hour. The salary range represents our national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an inidual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us [email protected] request an accommodation.

Additional Information:

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Title: Psychiatric Mental Health Nurse Practitioner (1099 Contractor) – Illinois

Location: Remote (United States)

Job Description:

Our Company:

At Cerebral, we’re on a mission to democratize access to high-quality mental health care for all. We believe that everyone everywhere deserves to get the care they need, and are striving to make care convenient and accessible, while tackling the stigmas that surround mental illness.

Since launching in January of 2020, Cerebral has scaled to provide mental health services to more than 700,000 people in all fifty US states. With support from investors like SoftBank, Silver Lake, Access Industries, Bill Ackman, WestCap, and others, and impactful leaders like you, well continue to democratize mental health care and double down on clinical quality and deliver exceptional client outcomes for years to come. With a heavy focus on clinical quality and safety in all that we do, weve accomplished excellent outcomes for hundreds of thousands of clients:

• 82% of clientsreport an improvement in their anxiety symptoms after using Cerebral.
• 75% of clientswho report improvement in their depression see improvement within 60 days.
• 50% of clientswho initially report suicidal ideation no longer harbor suicidal thoughts after treatment with Cerebral.

This is just the beginning for Cerebral, and we wont stop building, growing, and iterating until everyone, everywhere can access high-quality, evidence-based mental health care without high costs and/or long wait times. Were looking for mission-driven leaders who share these values, and we need your help as we transform access to high-quality mental health care in the United States and beyond.

The Role:

We are hiring a contract Psychiatric Mental Health Nurse Practitioner! Cerebral provides evidence-based treatment for adults seeking mental health care. Our telemedicine prescribers collaborate with Therapists and Psychiatrists to support clients during their mental health journey. This PMHNP role provides direct patient care for a panel of clients and allows for flexibility when client sessions can be scheduled. You can see clients during traditional business hours, evenings, or on weekends.

We are looking for clinicians with state licenses from the following states: California and/or Illinois

This is a 1099 contract position offering up to 25 hours per week based on availability. Full practice and full prescriptive authority is required for Illinois.

Who you are:

• You are PMHNP licensed and in good standing
• Board certification (AANP or ANCC)
• Minimum of a Master’s degree in nursing, specializing in psychiatric mental health
• Comfortable assessing and formulating evidence-based treatment plans for clients with mental illness
• Maintain a strong evidence-based clinical skill set while practicing & implementing outcome-focused care within the clinical coverage team
• Empathetic and intuitive listening
• Strong verbal and written communication
• Knowledgeable in crisis response
• Comfortable working autonomously in a telemedicine environment
• Tech-savvy with the ability to navigate various systems & tools with ease (this includes, but is not limited to Google Workspace, proprietary EMR, etc.)
• Passionate about our mission of improving access to high-quality mental health care
• An entrepreneurial spirit or previous experience within a startup or fast-paced environment is preferred

How your skills and passion will come to life at Cerebral:

• Hold thoughtful and engaged sessions with clients; 30 minute initial sessions and 15 minute follow up sessions
• Maintain and provide direct care to a panel of clients
• You will work collaboratively with other mental health care partners at Cerebral to ensure the most beneficial level of evidence-based treatment plans for our clients
• Work alongside other like-minded clinicians that have a common goal to positively impact the lives of others, and create an environment that leads to favorable outcomes for clients

What we offer:

• Mission-driven impact:
  • Shape the future of the #1 largest and fastest growing online mental health care company in the world
  • Build a platform that is improving the lives and well-being of hundreds of thousands of people
  • Join a community of high achievers who have a passion for promoting mental health
• Path to develop & grow:
  • Readily available psychiatrists and clinician leadership for case consultations to ensure you always receive the support you need
  • Access to innovative technology to support you in delivering the highest quality of care to your clients
  • Access to UpToDate for continued education (free CEU offering)
• Remote-first model:
  • Flexibility to choose the hours and schedule that work best for you
  • Work virtually from anywhere in the United States
• Culture & connectivity:
  • Highly-responsive and supportive team of clinical and operational management
  • Decreased administrative time for clinicians through ongoing technology improvements and automations
  • Fully integrated, data-enabled EMR with embedded clinical decision support, monthly prescriber metric reports, and task management system
  • Opportunity to participate in strategic development initiatives to improve our clinical quality and safety and/or clinical processes across the organization

Who we are (our company values):

• Client-first Focus– relentless focus on advancing the quality of care, clinical experience, and patient safety
• Ethics & Integrity– do what is right and demonstrate ethical principles, even when no one is watching
• Commitment– accountable for fully delivering on commitments to our clients and each other
• Impact & Quality– make a positive impact and deliver high quality outcomes, based on data and evidence
• Empathy– act compassionately, listen to seek understanding, and cultivate psychological safety with clients and colleagues
• Collaboration– achieve our goals together as a united team, strengthened by mutual openness, trust, and ersity of thought
• Thoughtful Innovation– continuously evolve our ability to deliver on our mission, prioritizing long-term, strategic bets over short-term gains

ENT/Plastics Physician Coder

locations

US – Remote (Any location)

time type

Full time

job requisition id

17351

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

• Responsible for the management of health information systems consistent with the medical, administrative, ethical and legal requirements of the health care delivery system. Which may also include monitoring data imports, providing basic system maintenance, documentation of workflow, training and data research. Oversees the maintenance of medical records and the coding of data from medical records.
• Participates in the preparation of reports, provides information and prepares correspondence regarding patient admissions, treatment, discharges and deaths in accordance with departmental policies and legal requirements governing the release of medical information.
• Works collaboratively with providers, other health care professionals and coding team to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to each patient, as well as ensuring compliant reimbursement of patient care services.

What You Will Need:

• High school diploma and 1-3 years of ENT with Plastics experience in surgical coding
• AAPC Certification CPC

What Would Be Nice To Have:

• Multi-specialty Surgical Coding experience

The annual salary range for this position is $32,600.00-$48,800.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a erse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Faculty Nursing (FNP) Online

Job Category: Academics

Requisition Number: FACUL002338

Posting Details

• Full-Time
• Locations

  Showing 1 location

  Remote

Job Details

Description

If you are a current employee, faculty or adjunct instructor at Herzing University (not a Contractor or temporary employee through a staffing agency), please click here to log in to UKG and then navigate to Menu > Myself > My Company > View Opportunities to apply using the internal application process.

Herzing University is currently accepting applications forFull-Time Nursing Faculty(FNP)opportunities for ourOnlineProgram. Nursing Faculty will teach primarily for the FNP program with other nursing undergraduate and graduate teaching responsibilities as needed.

These career focused programs strive to bridge the gap between the theory and practice. Your role will be to prepare your students for a career in nursing by leading them through classes, labs, and real-life clinical settings. For this reason, we are looking for professional nurses who can translate their background, education, and rich experience into an engaging learning environment.

To participate in a remote work arrangement, employees must reside in the United States. No remote work arrangement will be considered for working from outside the United States.

Qualified applicants will be able to demonstrate the following:

• Currently hold WI or Compact RN license
• Master of Science in Nursing, with a PhD, DNP, or Doctorate in Education or related Healthcare field
• Hold an FNP certification
• Minimum of 2 years of experience in online nursing education

Preferred:

• Minimum of 2 years of experience teaching in a graduate nursing program
• Experience with Canvas as a learning management system a plus

Summary of Primary Responsibilities

A full job description will be provided during the interview process when you can discuss what this specific role will be, but the position’s responsibilities fall into eight basic areas.

1. Subject Matter Expertise
2. Effective Communication
3. Pedagogical Mastery
4. Operational Excellence
5. Appreciation and Promotion of Diversity
6. Assessment of Student Learning
7. Utilization of Technology to Enhance Teaching and Learning
8. Continuous Improvement

These competencies, as identified by the Universitys academic community encompass the knowledge, skills, and behaviors essential to a faculty members success in the classroom and provide the basis for the faculty hiring, evaluation and development process.

To learn more about Herzing University and our values, visit us at:https://www.youtube.com/watch?v=FusbVnks_YQ

We offer a comprehensive benefits package including outstanding education assistance programs.

Herzing University is committed to providing a erse environment and is dedicated to fostering a culture and atmosphere of mutual respect.It provides an inclusive and collegial community where iniduals are valued, heard and empowered to contribute to the effectiveness of the institution.

It is the universitys practice to recruit and hire without discrimination because of skin color, gender, religion, LGBTQi2+ status, disability status, age, national origin, veteran status, or any other status protected by law.

Director, Professional Coding & Education

Remote

Full time

job requisition id 34503

The Director of Professional Coding and Education is responsible for the direction and leadership of operational, financial, programmatic, educational, workforce management, for Professional Coding. This includes establishing, meeting and continuously monitoring the goals and objectives while maintaining alignment with the strategic goals and objectives for BMCHS. While the range of duties and responsibilities is broad and varied, the position includes directing the day-to-day operations, budgeting, financial management, and human resource management. The Director works closely with a variety of stakeholders, coordinating the activities of Professional Coding across the enterprise.

Position: Director, Professional Coding Operations & Education

Department: HIM/ Revenue Cycle

Schedule: Full Time

POSITION SUMMARY:

The Director of Professional Coding and Education is responsible for providing coding oversight and creating standards to ensure coding accuracy, compliance and appropriate reimbursement across BUMG, along with managing operational execution of these standards in areas reporting to Revenue Cycle. The Director has responsibility for managing coding operations and overall success of an effective program, including oversight for coding training across BUMG. The Director manages coding staff to ensure compliance with coding guidelines, regulatory agencies and that appropriate reimbursement is received for the level of service rendered. The Director is responsible for a erse, growing department, requiring skills in data-driven decision-making, project and portfolio management, system redesign, process improvement/lean management, and customer relationship management. This position requires a deep knowledge of industry best practices in technology and workflow. The Director will use these skills and experience to partner with physicians, department chairs, department administrators, and other clinical and non-clinical operational stakeholders in a highly complex and decentralized professional coding model, to develop an organization-level roadmap of process and technology improvements to maximize patient and provider experience from a coding perspective, while increasing efficiency.

JOB REQUIREMENTS

EDUCATION:

Minimum: Bachelors Degree in a health-related field. Four (4) years of relevant experience may be considered in lieu of degree in addition to the experience below.

Preferred: Bachelors Degree in Health Information Management

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Minimum: Certified Professional Coder (CPC) or Certified Coding Specialist Professional CCS-P)

Preferred: RHIT, RHIA

EXPERIENCE:

Minimum: of 4 years related experience in professional coding with ICD-9/ICD-10, E/M and CPT. 3 years management experience in Medical Coding medium or large health care facility.

Preferred: 3 years management experience with an academic medical center

KNOWLEDGE AND SKILLS:

• Expertise knowledge of ICD-9/ICD-10, CPT and E&M coding principals and guidelines
• Knowledge of MS, AP, and APR DRG systems APG, EAPGs
• Knowledge of payer reimbursement methodologies, federal, state and payer specific regulations, policies and compliance standards
• Excellent written verbal and communication skills
• Excellent critical thinking skills
• Excellent skill in providing hands-on education to providers including audit finding and improvement opportunities.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to work cooperatively with members of the healthcare delivery team and staff,
• Ability to adapt to changes in workload and priorities, responding quickly to urgent requests.
• Ability to mentor, guide and motivate direct reports through demonstration of best practices and leading by example.
• Excellent communication and interpersonal skills to include the ability to negotiate and resolve conflicts and build teams.
• Demonstrated creativity and flexibility.
• Ability to operate in high-pressure situations.
• Excellent organizational skills.
• Demonstrated innovative approach to problem resolution.
• Ability to work collaboratively across BMCHS entities and disciplines.
• Demonstrated commitment to patient- and family centered care.
• Broad knowledge of modern health care administration practices and principles within a managed care environment and/or an academic medical center.
• Effective analytical ability in order to develop and analyze options, recommend solutions to and solve complex problems and issues.
• Demonstrated effective managerial and administrative leadership of clinical operations
• Knowledge of principles and techniques used in negotiation as applied to service contracts and equipment purchasing.
• Effective organizational, planning and project management abilities.
• Experience in financial and programmatic presentations.
• Ability to function independently and deal with multiple, simultaneous projects.

ESSENTIAL RESPONSIBILITIES / DUTIES:

Administrative Leader

• Contribute to the success of BMCHS by providing leadership, direction and coordination of operations, finances, and human resources for Professional Coding
• Manage and direct all Professional Coding activities within areas of responsibility.
• Continually assesses all services, identifies problems, utilizes data to analyze and propose innovative approaches for solutions.
• Maintain records related to operations and services that are complete, accurate, available, and in compliance with all legal, regulatory, and policy requirements.
• Engages staff and other stakeholders in continuous improvement of systems and processes; manages resources for staff participation in improvement work activities.
• Ensures effective facilitation of improvement teams and development of leadership skills to ensure overall effectiveness of the meetings.
• Organizes and prioritizes time and resources to manage efficiency and appropriately delegates.
• Remains current of new trends and best practices and incorporates into Professional Coding practices and programs.
• Articulates and enforces standards for quality/productivity
• Identify trends in documentation and coding concerns and collaborate with Leadership and Compliance to assess and implement corrective action
• Demonstrates achievable and measurable results and develop action plans for improvement
• Initiates, monitors, and enforces regulatory requirements
• Holds self and others accountable to policy, standards and commitments and provides timely follow through on questions and concerns.
• Ensures development Professional Coding initiatives to improve patient satisfaction and family centered care.
• Develops and implements clinical outcome measures for quality improvement Incorporates the use of evidence-based practice and appreciative enquiry into program development and improvement activities
• Actively listens to staff ideas and concerns, assesses others communication styles and adapts to them.
• Effectively facilitates meetings within Coding, CDI, and Revenue Cycle Operations and organizational level.
• Creates bi-directional systems that effectively communicate information and data, utilizing multiple methods.
• Articulates and presents data, information, and ideas in a clear and concise manner.
• Participate in rejections, denials and claims review process with billing team to ensure compliance and accurate reimbursement
• Communicates with physicians, academic department leaders, and senior administrators to maintain coordination with BMCHS programs.
• Demonstrates empathy and concern while ensuring goals are met.
• Manages the complex interdepartmental and interdisciplinary relationships to assure collaboration and effective/efficient operations within Coding and Revenue Cycle.
• Creates an environment that encourages erse opinion, recognizes differences, and incorporates into process and services.
• Exhibits awareness of personal attitudes and beliefs, recognizing its effect on response to others.
• Creates a culture and systems for recognizing and rewarding staff

Resource Manager

• Creates and maintains a satisfying workplace that fosters professional growth and job satisfaction for all members of the healthcare team.
• Interviews to select top talent, matching Professional Coding Operations needs with appropriate skill sets.
• Develops and implements recruitment and retention strategies that support a culture of leadership.
• Identifies and addresses own professional growth needs.
• Assesses manager and staff development needs, identifies goals and provides resources.
• Identifies lack of competency in performance and establishes a plan which includes goals, interventions, and measures.
• Maintains membership in professional organization(s) to develop knowledge and resources through networking, continuing education, and participation in national, regional, and/or local activities.
• Ensures integration of ethical standards and core values into everyday work activities.

Educator/Research Facilitator

• Facilitate accurate representation ofprofessional coding and clinical documentation through interaction with physicians, coders and practice staff by providing ongoing education
• Contributes to a learning environment by providing educational opportunities to staff, cross-functional departments, students, residents, fellows, and faculty.

Critical Interfaces

• Leads and/or serves on a variety of appropriate internal and external committees to represent the Professional Coding

Departmental Leader

• Must adhere to all of BMCs RESPECT behavioral standards.
• Interprets impact of broad scope organizational change for staff and develops change strategies for successful implementation.
• Models Respect for People commitments through all interactions.
• Leverages Leadership Competencies to develop themselves and others
• Develops and manages operational initiatives with measurable outcomes.
• Formulates objectives, goals and strategies collaboratively with other stakeholders.
• Prepares and delivers reports to operational leadership outlining progress toward meeting annual goals and objectives, to include performance related to finance, clinical activity, quality, and human resources. IND123

Equal Opportunity Employer/Disabled/Veterans

PAC Nurse

Remote

Min

USD $28.85/Hr.

Max

USD $38.46/Hr.

Overview

ThePAC Nurseis a telephonic position responsible for managing the length of stay (LOS) for Long Term Acute Hospital (LTACH), Skilled Nursing Facility (SNF), and Institutional Rehab Facility (IRF) for their assigned post-acute care facilities through collaborationPAC Nursewill also collaborate with key facility personnel as well as with CareCentrix internal Medical Directors, Market Engagement Directors and Nurse Managers to develop and maintain a timely discharge plan.

Responsibilities

In this role, you will:

• For assigned post-acute facilities:
  • Establish scheduled telephonic touch points with each facility point person to review each member within that facility and confirm appropriateness for continued stay.
  • Authorize continued stay at SNF, IRF, LTACH and Home Health care (if delegated) using approved medical care guidelines and collaboration with key facility personnel within the healthcare setting.
  • Use clinical expertise, review clinical information and clinical criteria to determine if the service/device meets medical necessity for the member.
  • Ensure case review and elevation to complete the determination is rendered within the contractual and regulatory turnaround time standards to meet both contractual and regulatory requirements.
• Interact with the PAC Medical Director as needed to ensure proper medical necessity decisions are being rendered. Partner closely with the PAC Medical Director in care planning and goal setting, reviewing discharge plans and length of stay status to ensure optimal outcomes.
• Act as a clinical resource for unlicensed Post-Acute Care Coordinators, providing clinical expertise and helping to clarify referral source directives. Receive/respond to requests from unlicensed staff regarding scripted clinical questions and issues.
• Act as the primary contact to the post-acute facility or facilities to which they are assigned to obtain all clinical information required and to proactively obtain patient status updates.
• Through the Supervisor, work closely with Market Engagement Directors to efficiently address potential facility concerns, pushback or gaps in process.
• Communicate customer service/provider issues to supervisor for logging and resolution.

Support the following additional duties as requested:

• • • • • Participate in performance and operational improvement activities.
        • Participate in and contribute to ongoing quality assessment/improvement activities, ensures the collection of data for improvement analysis and prepares reports as requested.
        • Assist team in implementing and maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
        • Participate in special projects and performs other duties as assigned.
        • Participate in an annual Inter-rater reliability Testing Process.
        • Schedule options vary with this role based on business needs, currently we need nurses willing to work weekend schedules.

Qualifications

You should reach out if:

• You hold a current and unrestricted license as a Licensed Practical Nurse or Registered Nurse
• You have Associate’s Degree or Diploma in Nursing/Practical Nursing or the equivalent
• You possess a minimum of 2 years clinical experience in a clinical setting
• You are an expert in Utilization Management and knowledge of URAC & NCQA standards
• You have a broad knowledge of health care delivery/managed care regulations and experience with evidence based care guidelines (i.e. MCG/Milliman, InterQual)
• You have excellent negotiation, influencing, problem solving and decision making skills required
• You possess organizational skills and are able to effectively manage and prioritize tasks
• You can work independently, utilizing sound clinical judgment and critical thinking skills under minimal supervision
• You must have a strong commitment to quality and standards

What we offer:

• Salary Range: $32.00 – $36.00 / hour plus Annual Corporate Bonus incentive
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
• Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more
• Advancement Opportunities, professional skills training, and tuition /exam reimbursement
• PayActiv – access earned income in between pay checks
• Walgreens Discount – receive up to 25% off eligible items
• Great culture with a sense of community

CareCentrix maintains a drug-free workplace

(TEMP) Risk Adjustment Coder

at Cityblock Health

Remote, USA

#communityhealth #healthcare

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needsbringing better care to where its needed most, block by block. Founded in 2017 on the premise that health is local and based in Brooklyn, we are backed by Alphabets Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, well grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe thateveryoneshould have good care for what matters to them, in their community.

Our work is grounded in a belief in the power of a erse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team erse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from erse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:

• Aim for Understanding
• Be All In
• Bring Your Whole Self
• Lean Into Discomfort
• Put Members First

About the Role:

As the Risk Adjustment Coding Specialist, you will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. You will work closely with our Value Services, Clinical, and Compliance teams to leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation.The role is a temporary role lasting approximately 4-5 months.

• Serve as the subject matter expert on Medicare HCC documentation requirements and ICD-10-CM coding guidelines
• Maintain professional communication with provider teams
• Ensure adherence to Cityblocks coding guidelines and any necessary updates are shared across the teams.
• Develop a foundational understanding of the coding tool and processes to assign proper Risk Adjustment codes.
• Comply with all legal requirements regarding coding procedures and practices

Requirements for the Role:

• 2+ years of Risk Adjustment (HCC) coding experience required
• AAPC or AHIMA certified coder a must (i.e. CPC, CCS, etc.)
• Strong knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures
• Ability to follow ICD-10 CM, Coding Clinic, internal coding guidelines and documentation for CBH aligned beneficiaries
• Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology
• Ability to flourish in fast-paced environments, work independently, and can identify inidual opportunities for success
• Excellent attention to detail, data-driven, and tech-savvy
• Demonstrates excellent written and verbal communication and critical thinking skills
• Strong ability to effectively build relationships and collaborate with coworkers and clinicians
• Strong technical skills using Google Workspace including Google Meets, Google Sheets, Google Docs as well as Slack communication platform

What Wed Like From You:

• A resume and/or LinkedIn profile

Cityblock values ersity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.

We take into account an iniduals qualifications, skillset, and experience in determining final salary.This role is eligible for sick leave.The expected salary range for this position is$31.88/hr to$37.88/hr. The actual offer will be at the companys sole discretion and determined by relevant business considerations, including the final candidates qualifications, years of experience, skillset, and geographic location.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblocks medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

Covid 19 Update – Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any iniduals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

The COVID-19 pandemic has severely impacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.

Title: Nurse Case Manager – RN (Remote U.S.)

Location: Remote Remote US

JobDescription:

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the companys mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes making this a great time to join our team of passionate iniduals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Nurse Case Manager RN (Remote U.S.) to join our growing team.

** Contractually Required Work Hours: Monday – Friday 8:00 AM to 5:00 PM Pacific. **

** This is a full-time, direct hire, exempt (salary), remote-based opportunity with Benefits. **

Job Summary:

The Nurse Case Manager RN:

• Utilizes clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements, critical thinking, and decision-making skills to determine medical appropriateness while maintaining production goals and QA standards.
• Ensures day-to-day processes are conducted in accordance with NCQA, URAC, and other regulatory standards.

Job Responsibilities:

• Contacts and performs initial interviews with patients who need health coaching programs.
• Provides necessary coaching to reduce or eliminate behaviors that are considered high-risk.
• Identifies the required goals that each patient must fulfill and advises of feasible options for achieving the goals.
• Educates members on health issues/concerns and the way in which one could combat them.
• Utilizes appropriate motivational interviewing techniques necessary for coaching and assisting the patient to complete a self-management goal/action plan.
• Maintains current knowledge regarding CHF, HTN, COPD, asthma, and diabetes, as well as related treatments and complex medications.
• Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
• Conducts clinic one-on-one visits with Disease Management Chronic Care Program participants, utilizing the Chronic Care Model, to assess patient needs for DME, home health, value-added services, and any other necessary resources.
• Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process.
• Always maintains medical records confidentiality through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
• Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Acentra Health policies, procedures, and guidelines.
• Actively cross-trains to perform duties of other contracts within the Acentra Health network to provide a flexible workforce to meet client/consumer needs.

The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Requirements

Required Qualifications/Experience:

• Active unrestricted RN Oregon State clinical license per contract requirements.
• Graduation from an accredited Bachelors Degree Nursing Program.
• 1+ years of clinical experience in an acute or med-surgical environment.
• 1+ years of case management and/or disease management experience.
• Medical record abstracting skills.
• Knowledge of the organization of medical records, medical terminology, and disease process.
• Excellent communication, problem-solving, and decision-making skills.
• Ability to effectively manage and prioritize tasks.
• Ability to work in a team environment.
• Flexibility and strong organizational skills.
• Must be proficient in Microsoft Office and Internet/web navigation.

Preferred Qualifications/Experience:

• Case Management Certification (CCM).
• Knowledge of current National Committee for Quality Assurance (NCQA)/Utilization Review Accreditation Commission (URAC) standards.
• Utilization Review (UR) and/or Prior Authorization or related experience.
• Knowledge of InterQual criteria.
• Familiarity with ancillary services, including HHC, SNF, Hospice, etc.
• Experience in managing complex or catastrophic health cases.
• Experience helping iniduals change health behaviors.
• Working toward or completion of CCM/CCP/CDE certification or Advanced degree.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people’s lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is $80,000-90,000 annually.

Based on our compensation philosophy, an applicants placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

Supv, Ins Billing Order Entry

Remote

Position Summary:

Supervising Prior Authorization Specialists in a high production and quality environment.

Job Responsibilities:

Supervise PA Coordinators.

Train, develop, and coach Prior Authorization specialists

Provide daily operational work planning and organization to ensure operational efficiency and effectiveness of the department .

Demonstrate expertise in researching and trouble-shooting issues that arise and provides assistance to prior authorization specialists to resolve issues.

Ensure staff handle submissions per specified payor guidelines and follow up with payors for timely and accurate processing.

Evaluate performance and address performance issues of prior authorization specialists.

Participate in the identification and execution of operational performance improvement opportunities and activities.

Assist in developing reports and conduct analysis to help improve processes to meet provider and regulatory requirements.

Collaborate with our Quality team to improve process and insure compliance of company and regulatory requirements;

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.

San Carlos, CA

$63,800$7,970,000 USD

OUR OPPORTUNITY

Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, womens health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

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. When you join Natera, youll work hard and grow quickly. Working alongside the elite of the industry, youll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits – Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

For more information, visitwww.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a erse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Link:https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.comemail domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

For more information:

-BBB announcement on job scams -FBI Cyber Crime resource page

Lead Coding Specialist, Health Information Management, FT, 08A-4:30P-141254

Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 24,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Healthhasinternationally renowned centers of excellencein cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence,Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the Worlds Most Ethical Companies.

Everything we do at Baptist Health, we do to the best of our ability. That includes supporting our team with extensive training programs, millions of dollars in tuition assistance, comprehensive benefits and more. Working within our award-winning culture means getting the respect and support you need to do your best work ever. Find out why were all in for helping you be your best.

Description

The position will serve as the primary support to the Coding Supervisor. Assist in the supervision of coding, abstracting and reimbursement supporting billing ensuring compliance along with efficient operations for all Baptist Health facilities. Ensures established goals and ICD-10-CM/PCS guidelines, CPT, and coding conventions are adhered to. Assist with monitoring reports and workflows identifying opportunities for improvement, work volume and distribution, reviewing and reconciling reports, providing coding training within the Coding Department and performing research on coding issues. Monitors coding personnel activities ensuring accurate and timely processing in accordance with state and federal regulations. Assist with monitoring reports and workflows identifying opportunities for improvement.

Qualifications

• Degrees: Associate’s
• Licenses & Certifications: AHIMA Certified Coding Specialist
• Additional Qualifications: Prefer RHIA or RHIT or equivalent experience.
• At least five years Inpatient or Outpatient Surgery, Ancillary and Emergency Room coding experience in a large healthcare institution required.
• Excellent verbal and written communication skills with ability to communicate clearly with both internal and external customers, problem-solving and personnel management skills.
• Knowledgeable in health information systems, database management, spreadsheet design, and computer technology.
• Strong computer proficiency (MS Office Word, Excel and Outlook).
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service.
• Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.

Job

Corporate

Primary Location

Remote

Organization

Corporate

Schedule

Full-time

EOE

Title: REMOTE Afternoon/Nights Licensed Nurse Practitioner (NP) – 3pm-11pm ET

Location: Remote

Job Description:

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a specialized medical group focused today on aging adults with long-term home care needs. We help these iniduals live happier, healthier lives by partnering with their aides and caregivers, as a key part of the care team. We use a combination of virtual care, home-based and mobile technologies, data integrations and partnerships with home care agencies to make the home an integrated setting of care with patients, and their Caregivers at the center.

Vesta is the Roman name for the goddess of home, hearth and family. She is the caregiver. Often unseen yet greatly revered, she puts others’ needs ahead of her own, keeping the hearth warm so the home and family can function.

We see Caregivers and recognize the power and potential they embody. More than just assistance, Caregivers are eyes, ears and hands in the home. Caregivers play the role of Doctor, Nurse, Pharmacist, EMT and more, but without support or guidance. That is where Vesta comes in. Our program provides Caregivers with a personalized clinical team in their pocket. Our team links Caregivers to the people they care for and the other providers involved in their care. It’s an insurance covered benefit, so it’s available to most adults with Caregivers free of charge to them.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing what’s best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal teammate would be able to:

• Conduct video visits for chronic care management and remote patient monitoring to create an appropriate care plan for the member
• Conduct care coordination and recommend/identify cost effective research based treatment and intervention
• Utilize strong clinical skills in physical assessment and chronic disease management for at risk adults and apply member specific Care Management and inidualized care planning
• Be comfortable with advanced care planning discussions with caregivers and members
• Serve as a consulting resource on care management practice as needed
• Attend meetings, training sessions and participates on committees as needed
• Possess a strong knowledge of clinical procedures, standards and quality control checks
• Possess a strong knowledge of medical conditions, interventions and treatment
• Provide members, caregivers and facility education
• Monitor the quality of member’s care and updates plan of care

Would you describe yourself as someone who has:

• Certified and licensed as a Nurse Practitioner in good standing (required)
• The ability to work Monday-Friday, 3pm-11pm ET (required)
• Master’s or doctoral degree from an accredited institution for nurse practitioners (required)
• Medicare participation and ability to have the company bill for services on your behalf (required)
• Certification from ANCC (or equivalent) as an Adult, Family, Geriatric, and/or Acute Nurse practitioner (required)
• 1+ years of Nurse Practitioner Experience (required), qualified for independent practice in your licensed jurisdiction (preferred)
• 1+ years of telephonic triage or equivalent experience (required)
• 2+ years of clinical experience working with complex adult populations (required)
• Ability to practice independently with little clinical support (required)
• Comfort using technology like Google Suite, multiple EMRs, Slack (required)
• The ability to work remotely and has a private area with a computer in their home/workspace (required)
• Experience working in home care and/or family medicine, geriatrics (preferred)
• Experience working within a clinical team environment
• Strong organizational skills, including the ability to prioritize
• Passionate about our mission to improve people’s lives
• Comfortable in a dynamic and always evolving startup environment

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• 12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k plus match

Pay range is $125K – $130K annually. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

If yes, then we look forward to speaking to you!

Vesta Healthcare is committed to leveraging the talent of a erse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.

At Vesta, we are constantly searching for the most dynamic and best talent to join our team with a mission of empowering caregivers in the home! If you are ever contacted by e-mail from any domain other than https://vestahealthcare.com, please do not respond, as there is a likelihood it could be a scam as it is not a legitimate Vesta email. You might see things from a similar domain address, but with a slight misspelling, for example. We have no responsibility for any communication that does not come from the https://vestahealthcare.com domain, and we strongly advise that you not provide information or respond if not from the legitimate Vesta domain.

Title: Data Analyst, Risk Adjustment Coding

Location: Remote, United States

JobDescription:

Datavant is a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. We are a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners.

By joining Datavant today, you’re stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare. We hire for three traits: we want people who are smart, nice, and get things done. We invest in our people and believe in hiring for high-potential and humble iniduals who can rapidly grow their responsibilities as the company scales. Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs.

The Payer Solutions team is actively looking for a detail-oriented and passionate data scientist to become a valuable part of our expanding team. Our focus involves identifying and creating opportunities to expand risk adjustment and quality digital use cases while also assessing and quantifying our programs’ comprehensive efforts and effects on patient health status and revenue. If you are an experienced data analyst with deep understanding of Risk Adjustment data modeling, please consider applying for this role!

You will:

• Analyze large datasets to identify trends, patterns, and insights about Coding reporting needs to enhance productivity and quality, and turn those needs into actionable reporting.
• Provide real-time data insights to business on demand through ad-hoc queries
• Collect, interpret, and aggregate data from multiple data sources for supporting risk adjustment medical record coding and quality processes
• Design, develop, test, and deploy reporting to support risk adjustment business users needs
• Look to automate a vast majority of reporting.
• Identify trends in the reporting and work to partner with the teams to improve productivity and quality.
• Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and return on investment based on historical data and project variables.
• Work closely with cross-functional teams, including clients, to understand business needs, and determine the right methodology for analysis and assumptions to provide data-driven insights into program performance and partnerships.
• Create clear and concise reports to communicate findings and insights to both technical and non-technical stakeholders.
• Stay abreast of industry trends, new technologies, and methodologies to enhance the team’s analytical capabilities.

What You Will Bring to the Table:

• Experienced (3+ years or more) in data analysis, database technologies (Oracle/MS SQL Server), SQL queries, and MS Excel
• Experience in risk adjustment (MA, ACA and MD) data analysis
• Thorough understanding of risk models including HCC, RxHCC, HHS-HCC and CDPS
• System architectural experience building end-to-end risk adjustment solutions and reporting packages
• Experience analyzing risk adjustment data for trends, disease/diagnosis prevalence and hierachy
• System architectural experience building end-to-end risk adjustment solutions and reporting packages
• Experience managing data flows for chart retrieval, RA coding, Hedis abstraction and quality
• Ability to build, architect and deliver robust customer facing reports and internal reports
• Experience in building queries to collect and interpret raw data from databases to support risk adjustment coding and medical record
• Ability to support major transformational program changes such as building new databases, supporting data governance in a cloud-based structure etc.
• Experience in using business intelligence, data visualization, query, analytic and statistical software to build solutions, perform analysis and interpret data (SSRS, Power BI, Tableau)
• Strong problem-solving skills with the ability to think critically and provide data-driven solutions.
• Expertise in the data cleaning, preprocessing, manipulation, integration, processing and interrogation of large datasets.
• Strong understanding of statistical probability distributions, bias, error, and power as well as sampling and resampling methods.
• Exceptional initiative and ability to solve problems independently, seek help when needed, and take ownership when navigating ambiguity.
• Excellent communication skills.
• Well-developed time management skills and demonstrable experience of prioritizing work to meet tight deadlines for client deliverables.

Bonus points if:

• An appreciation of the need for effective data privacy and security methods and an awareness of the relevant legislation.
• Experience with cloud services for storage and computing.
• Experience with machine learning algorithms.
• Knowledgeable in health plan operations and reporting.

We are committed to building a erse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks and industry best practices.

We’re building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. The range posted is for a given job title, which can include multiple levels. Inidual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated salary range for this role is $150,000-170,000.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be anonymous and used to help us identify areas of improvement in our recruitment process. (We can only see aggregate responses, not inidual responses. In fact, we aren’t even able to see if you’ve responded or not.) Responding is your choice and it will not be used in any way in our hiring process.

Title: Nurse Practitioner – Telemedicine (W2, full time)

Location: Remote

Type: Full-Time

Workplace: remote

Category: Nurse Practioners

JobDescription:

Curai Health is an AI-powered virtual clinic on a mission to improve access to care at scale. As the pioneer in deploying machine learning into clinical workflows, Curai Health enables its dedicated, specially trained clinicians to deliver primary care to more people at a fraction of the cost. Easy-to-use and convenient, Curai Health partners with insurers and health systems to keep patients engaged in their care over time, improving health outcomes and reducing costs.

Our company is remote-first, and we consider candidates across the United States. Our corporate office is located in San Francisco. We will consider any candidates that are fully licensed Nurse Practitioners to practice in the United States and carry the required state licenses.

Clinical Operations at Curai

The clinical team at Curai uses Artificial intelligence-empowered electronic records to deliver urgent care and primary care to our patients. Currently, we are searching for Nurse Practitioners who can see both adult & pediatric patients. We operate 24/7 and seek flexible clinicians to meet our patients’ needs. We have day, night, and weekend shift opportunities available.

Who You Are

• Have worked remotely before, or have a strong feeling that you’d work well with a 100% remote team, spread across multiple time zones

• Value a team-based collaborative approach as it relates to providing healthcare

• Passionate about providing empathetic personalized patient care at the scale

• Have informed opinions that you hold lightly but are flexible to meet the needs of patients and the business

• Understand that flexibility and adaptability are key traits to being successful in a start up environment and change is inevitable

What You’ll Do

A day in the life of a Curai Nurse Practitioner is spent doing things like:

• Seeing acute/urgent care patients in our live text-based chat clinic including straightforward chronic care cases requiring refills.

• 90% clinical and 10% administrative tasks. Administrative time is broken down between clinical meetings, EHR/automation product feedback projects, and clinical operations quality improvement projects.

• Being responsible for accurately diagnosing patients using detailed patient history-taking and providing evidence-based treatment recommendations.

• Writing efficient encounter visit notes in a clear fashion that demonstrates strong medical decision-making skills, differential diagnoses, and a well-written and relevant care plan. Closing all notes optimally by the end of the encounter, and the latest by the last shift of the day.

• Providing feedback to the AI/ML and product teams on features that improve provider efficiency and accuracy.

• Staying abreast of EHR feature updates by continuously training and remaining current on the platform.

• Working closely with physicians in collaborative agreements for states that require it.

What You’ll Need

• Board certified in Family Nurse Practitioner (FNP)

• Prior telemedicine experience

• NP License in a compact state or you currently hold multiple state licenses (we will assist in licensing you up to all 50 states)

• You must also have a clear medical history (no nursing board actions or complaints).

• Completed an accredited Nurse Practitioner program in the United States.

• 5 years post NP training

• Digital savviness, excellent typing skills, excellent grammatical construction, and excellent command of English.

• Proficiency in English. Spanish fluency is an added plus.

• Start-up experience in healthcare is a plus.

• Pacific or Mountain Time zone is a plus

Salary is dependent on a scale based on years of experience, coverage of licenses, and work location. Thus, our annual base range is large at $110 – $180k.

Title: Multi-State Full Time Nurse Practitioner

(NP)

Location: Remote

JobDescription:

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a specialized medical group focused today on aging adults with long-term home care needs. We help these iniduals live happier, healthier lives by partnering with their aides and caregivers, as a key part of the care team. We use a combination of virtual care, home-based and mobile technologies, data integrations and partnerships with home care agencies to make the home an integrated setting of care with patients, and their Caregivers at the center.

Vesta is the Roman name for the goddess of home, hearth and family. She is the caregiver. Often unseen yet greatly revered, she puts others’ needs ahead of her own, keeping the hearth warm so the home and family can function.

We see Caregivers and recognize the power and potential they embody. More than just assistance, Caregivers are eyes, ears and hands in the home. Caregivers play the role of Doctor, Nurse, Pharmacist, EMT and more, but without support or guidance. That is where Vesta comes in. Our program provides Caregivers with a personalized clinical team in their pocket. Our team links Caregivers to the people they care for and the other providers involved in their care. It’s an insurance covered benefit, so it’s available to most adults with Caregivers free of charge to them.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing what’s best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal teammate would be able to:

• Conduct video visits for chronic care management and remote patient monitoring to create an appropriate care plan for the member
• Conduct care coordination and recommend/identify cost effective research based treatment and intervention
• Utilize strong clinical skills in physical assessment and chronic disease management for at risk adults and apply member specific Care Management and inidualized care planning
• Be comfortable with advanced care planning discussions with caregivers and members
• Serve as a consulting resource on care management practice as needed
• Attend meetings, training sessions and participates on committees as needed
• Possess a strong knowledge of clinical procedures, standards and quality control checks
• Possess a strong knowledge of medical conditions, interventions and treatment
• Provide members, caregivers and facility education
• Monitor the quality of member’s care and updates plan of care

Would you describe yourself as someone who has:

• Fluency in reading, writing, and speaking English AND Mandarin OR Cantonese
• Certified and licensed as a Nurse Practitioner in good standing (required)
• Master’s or doctoral degree from an accredited institution for nurse practitioners (required)
• Medicare participation and ability to have the company bill for services on your behalf (required)
• Certification from ANCC (or equivalent) as an Adult, Family, Geriatric, and/or Acute Nurse practitioner (required)
• 1+ years of Nurse Practitioner Experience (required), qualified for independent practice in your licensed jurisdiction (preferred)
• 1+ years of telephonic triage or equivalent experience (required)
• 2+ years of clinical experience working with complex adult populations (required)
• Ability to practice independently with little clinical support (required)
• Comfort using technology like Google Suite, multiple EMRs, Slack (required)
• The ability to work remotely and has a private area with a computer in their home/workspace (required)
• Experience working in home care and/or family medicine, geriatrics (preferred)
• Experience working within a clinical team environment
• Strong organizational skills, including the ability to prioritize
• Passionate about our mission to improve people’s lives
• Comfortable in a dynamic and always evolving startup environment

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• 12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k plus match

Pay range is $125K – $130K annually. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

If yes, then we look forward to speaking to you!

Vesta Healthcare is committed to leveraging the talent of a erse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.

At Vesta, we are constantly searching for the most dynamic and best talent to join our team with a mission of empowering caregivers in the home! If you are ever contacted by e-mail from any domain other than https://vestahealthcare.com, please do not respond, as there is a likelihood it could be a scam as it is not a legitimate Vesta email. You might see things from a similar domain address, but with a slight misspelling, for example. We have no responsibility for any communication that does not come from the https://vestahealthcare.com domain, and we strongly advise that you not provide information or respond if not from the legitimate Vesta domain. If you have any concerns that outreach might not be legitimate, please reach out to [email protected] for confirmation.