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Psychiatric Mental Health Nurse Practitioner – California

Location

Remote – United States

Type

Full time

Department

Clinical

Overview

About Path

Path is a healthcare company powered by technology, dedicated to making mental health care work for everyone. Path takes a patient-first approach, where treatment is more accessible, personalized, and effective. With Path, it’s easy to find a high-quality therapist or psychiatric clinician who accepts insurance and is actively accepting new patients.

We are deeply committed to providing high-quality care that improves the lives of patients, investing in the providers who deliver that care, and always operating in an ethical and compliant manner.

What we’re solving

Over 65 million Americans have a treatable mental health issue that’s 1 in 5 people. Today it’s difficult to find a provider, and for those with complicated conditions, it’s nearly impossible to find coordinated care. There’s a good chance someone close to you could have used the help, even if it wasn’t obvious to the people around them. We’re here to fix this.

Our Mission

Path’s mission is to make mental healthcare work for everyone.

The Opportunity

We’re excited to be expanding our telehealth clinic where providers focus on delivering high-quality care directly, without being overworked. We’re looking for high-quality board-certified Psychiatric Mental Health Nurse Practitioners (PMHNP) to join our erse community.

Salary range: $140,000 to $280,000k*

*Our target compensation is $187,000 for clinicians that are billing 33 clinical hours a week and taking all of their paid time off. The range is a function of how many weekly visits are done, documentation and billing practices reflecting complexity and services provided, and paid time off utilized.

Our Clinic

We’re an organization committed to building a comprehensive, modern psychiatric clinic with a north star of delivering patient care at the highest quality standards. Our clinic was designed with the needs of PMHNPs in mind; at Path, you can count on end-to-end clinical and administrative support that gives you the time, space, and autonomy to care for your patients. We don’t cut corners and we take seriously our responsibilities as a telehealth-based organization to be ethical, compliant, and to put patient safety first.

What sets us apart

• Comprehensive support: Our team of RNs, Medical Assistants, crisis coordinators, Collaborating MDs, and patient schedulers work alongside you to ensure your time is spent on the work only someone at your license level can perform.
• Flexibility: At Path, you get to work as a part of a team while retaining your autonomy. You choose when you work, between 7am and 7pm PST, 7 days a week from the clinical environment that works best for you.
• Work/life balance: We know great patient care starts with healthy, engaged clinicians. We set sustainable clinical hour standards, cap daily intakes, and build in time for meetings and documentation.
• Clinical Leadership: Our leadership team includes multiple licensed, practicing clinicians, so you can feel confident this organization is guided by clinical best practice.
• Innovation: We’re on a mission to raise the standard of care, and are building the technology and tools to empower our clinicians and patients across every step of their care journey.

We equip clinicians with what you need to thrive

• Full administrative support: We manage the administrative tasks, so you can focus on what matters most. We take care of finding patients, getting them scheduled, and handling everything related to insurance and billing. Plus, our dedicated support team is on hand to answer any questions you or your patients have.
• Advanced technology for efficient documentation: Every Path PMHNP gets a subscription to a medical autoscribe to aid in note-taking. With this tool, our team has seen up to an 80% reduction in documentation time.
• Coordinated care: Our in-house team helps to ensure your patients get the help they need. Whether that’s a higher level of care escalation or a rematch to another clinician, you can rely on a dedicated team of experts.
• Investments in your development: We’re building a culture of collaboration and continuous learning. In addition to an annual stipend for continuing education, our team works to share best practice and insights to improve the quality of care for Path patients.

You Will:

• Provide clinical consultations with clients seeking mental health care including diagnostic assessments, psychiatric workup, treatment planning including medication management
• Work with iniduals who are struggling with mental health issues such as depression, anxiety, ADHD, trauma, and addiction
• Have access to our EHR & telehealth platform
• Receive MD Supervision & support from Registered Nurses, Care Coordinators, Scheduling, and Technical Support

• Have adequate time to engage with patients — half-hour sessions for follow-ups and 1 hour for initial consultations.

• Be free to focus on care. Path Mental Health takes care of all the credentialing, billing, and marketing
• Engage in collaborative case conferences and clinical team culture as well as collaborative meetings with an MD
• Abide by our policies and procedures, including timely completion of documentation/charge slips, participation in quality audits, and using measurement-informed care as part of the treatment of your patients

You Are:

• A clinician with 3+ years as a psychiatric Nurse Practitioner with experience with mental health assessment, diagnosis, triage, managing common psychiatric medication and treatment plans, and managing crisis situations
• Certified by the ANCC as a PMHNP
• Looking for a full-time job that requires 33 bookable hours per working week
• In possession of a Master’s or doctoral degree from an accredited university or graduate program in psychiatric mental health nursing
• Actively licensed in the state of California with an active CA DEA number including schedule 2-5 controlled substances
• Willing and able to explore 103B independent practice in California
• Comfortable working independently and proficient with technology, EHR, and telehealth best practices
• Deeply empathetic and skilled at building a rapport with your clients
• No suspension/exclusion/debarment from participation in federal healthcare programs (e.g., Medicare, Medicaid, SCHIP)
• No adverse actions by any nursing board, hospital, or other credentialing body in the past 3 years

As Part Of Our Team, Full-Time Employees Receive

• Competitive pay and benefits that do not change based on location
• 4 weeks of discretionary paid time off annually, plus federal holidays
• Paid parental leave to support you and your family
• Medical, dental, and vision insurance through our employer plan for you and your dependents
• Access to our 401K
• Continuing education stipend
• DEA and licensure renewal coverage
• Short-term disability benefits
• Access to an Employer Assistance Plan (EAP) through our insurance plan
• Tech equipment and $250 stipend to ensure your home office sets you up for success

Our Team

The people of Path are what truly define our mission and determine our impact on the communities we serve. We believe in building not only a team, but a erse community, inspiring each other by taking on big challenges, growing and succeeding together.

Senior Quality Consultant, Ops Excellence

at Cityblock Health

Remote, USA

#communityhealth #healthcare

About the Role:

We are seeking a talented Senior Quality Consultant, Ops Excellence to help manage day to day Quality Assurance/ Strategic Ops responsibilities as we scale. You’ll work closely with internal teams in a collaborative, consultative capacity to drive towards improved outcomes across all Markets within the organization. This is an exceptional opportunity for a process-oriented, hungry self-starter who is interested in a cross-functional role at a rapidly scaling organization.

Responsibilities:

• Manage multiple projects, make judgements around objectives and scope, ensure effective and efficient implementation execution.
• Development and delivery of key strategies, plans, and improvement initiatives for the CM program to include: data pursuit strategy, barrier analysis, interventions and compliance for new market implementations.
• Partnership with internal and external teams to ensure alignment on strategy as well as tactical initiatives.
• Conduct reviews/ assessments against CB P&P’s, industry standards, and best practices.Monitor, analyze data, and identify non-compliance with CB Model of Care
• Act as an operational expert and interventionist through communication, education and design of programs and strategies to assist delegated entities to meet regulatory and accrediting standards.
• Aggregate and analyze audit findings into a reportable format and report to appropriate departments.
• Participate in Care Management/Clinical Committee meetings.
• Assist with planning of formal education sessions to Market Ops teams to address non-compliance issues.
• Develop and maintain policies and procedures.
• Other projects and duties as assigned.

Requirements for the Role:

• Bachelor’s degree in Nursing, or Social Work, or Masters in Healthcare Administration preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements
• Minimum 2 years clinical and non clinical auditing experience
• Strong knowledge of managed care principles and delivery systems, medical management process, accreditation and regulatory standards delegated oversight processes, and workflow systems
• Ability to strategically think and provide solutions for gaps in care delivery
• Experience with implementation or new program development.
• Knowledge of managed care compliance, CMS regulatory and NCQA standards.
• Strong ability to quickly build relationships and trust with our non clinical and clinical ops teams
• Strong understanding of Medicaid and Medicare requirements across multiple states
• Must possess a high level of organizational skills to maintain accurate records and documentation.
• Attention to detail with analytical and problem-solving capabilities.
• Knowledge of audit processes and applicable federal regulatory and accredited standards.
• Excellent verbal and written communication skills and able to maintain positive relations with internal and external partners at all levels.
• Solid presentation and facilitation skills

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s 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, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should 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

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 inidual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The expected salary range for this position is $81,700 to $109,500. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblock’s 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 imacted 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.

RN/NP Clinical Educator 

Location: Remote

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).

We’re looking to add to our team of experts who care deeply about our mission.

Our team is passionate, driven, collaborative, intellectually curious, and excited about the opportunity to transform our healthcare system. We’re inspired by caregivers and seek to create a platform that recognizes, utilizes and supports the vital role they play. We strive to continuously learn, explore, experiment and achieve results. We are 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 registered nurse leader who is passionate about educating our members, teammates, and clients and can leverage technology to create new programs, systems, and processes to drive exceptional clinical team performance
• Someone who has a proven track record of using an evidence based approach to drive high quality and efficient clinical outcomes
• Someone who has experience in chronic care management, remote patient monitoring, and value based care of vulnerable populations
• Loves learning and helping others learn: you’re excited to bring your wisdom and coach others, and you’re equally energized to learn from other’s experience (such as product managers, software engineers, and data scientists), and then continue improving how Vesta does care management as we learn more together
• Comfortable working in an ambiguous environment within an organization that is growing and changing quickly

The ideal teammate would be able to:

• Achieve continued professional development of the clinical staff through education
• Assess learning needs using formal and informal assessment data, QI data, audit data, and leadership input to plan education programs.
• Design, implement and evaluate high quality and frequently complex educational activities, programs. or projects for staff at all stages of their career development based on identified knowledge and practice gaps, using relevant evidence, adult learning principles, theory, research, innovative process and practical experiences.
• Create and improve onboarding, orientation, and continuing education material
• Provide remedial support to learners when necessary
• Measure program outcomes in terms of learning change, impact and professional role competency and revise future outcomes based on trends, evidence, and changes in stakeholder expectations.
• Provide multidisciplinary health care professionals and clinical support teams with leadership, coaching and development through 1:1 interactions, round table discussions, and formal presentations.
• Perform direct care management activities as assigned
• Implement appropriate member education leveraging software as needed
• Identify needs, develop, and support materials for Member and Caregiver education
• Develop and maintain strong relationships with our team identifying inefficiencies and assisting in creating and implementing process improvement to achieve member and provider satisfaction
• Serve as a subject matter expert for current CCM and RPM programming as well as future clinical programs

Would you describe yourself as someone who has:

• Registered Nurse or Nurse Practitioner with an unrestricted license (required)
• 2+ years of experience educating clinical teams (including MA/CNAs, LPNs, RNs) and overseeing several complex projects simultaneously (required)
• 1+ year of leading orientation classes for groups of 10+ (required)
• Bachelor’s degree from an accredited institution (preferred)
• 4+ years of nursing experience within care management, homecare, and/or outpatient (required)
• An Education Certificate (preferred)
• Digital health or hybrid digital health experience (preferred)
• Experience educating a remote team (preferred)
• Experience in providing education based on adult learning principles
• Passionate about our mission to improve people’s lives
• An ability and humility to roll up your sleeves
• Detail- and process-oriented, ability to context- and mode-switch easily, fast learner
• Excellent communication skills, combined with the ability to collaborate across functions and use available tools
• Self-driven, self-starter and excited to support new technology

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

Pay range is $100,000-$130,000 based on experience. (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).

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.

Medical Coder II (Radiation Oncology)

Remote

locations

US-Remote

time type

Part time

job requisition id

R0018924

At GenesisCare we want to hear from people who are as passionate as we are about innovation and working together to drive better life outcomes for patients around the world.

This is a part-time remote radiation oncology coding role.

PURPOSE:

This position, under limited supervision, reviews, analyzes and assures the final diagnosis and procedures as stated by the practicing providers are valid and complete. Accurately codes office and hospital procedures for providers to ensure proper reimbursement. Responsible for coding, chart compliance, auditing and collections support. The ideal candidate will have 2+ years coding experience in a hospital or medical office setting.

ESSENTIAL DUTIES:

• Confirm patient demographic, insurance and referring physician information is accurately entered into practice management system.
• Confirm insurance verifications and authorizations, as required.
• Communicate with Financial Counselors regarding insurance authorizations and referrals.
• Review daily physician schedules and evaluate Evaluation & Management (E&M) levels for appropriate complexity assigning the correct CPT code.
• Enter all CPT and ICD-10 coding into practice management system timely and accurately for code capture.
• Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.
• Enter all word codes into practice management system per company policy and procedures.
• Follow established check and balance systems to ensure complete and accurate code capture.
• Respond to audit findings and make applicable coding additions or corrections.
• Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates and Medicare NCCI.
• Update practice management system patient’s account notes with any changes made to patient information or as otherwise dictated by company policy and procedure.
• Confirm all documentation required for coding is complete and meets required regulations.
• Attends seminars and in-services as required to remain current on coding issues.

RESPONSIBILITIES/QUALIFICATIONS:

• Perform coding work requiring independent judgment with speed and accuracy.
• Examining and verifying coding errors through audits.
• Required In-services.
• Communicating clearly and concisely, orally and in writing.
• Confidentiality.
• Ability to use the computer.
• Understanding and carrying out verbal and written directions.
• Follow 21st Century Oncology’s policies and procedures.
• Work independently in the absence of supervision.

GenesisCare is an Equal Opportunity Employer.

Title: Associate Director, Trial Start Up Lead

Location: Copenhagen, , Denmark

Utrecht

Princeton, NJ

Full time

At Genmab, we’re committed to building extra[not]ordinary futures together, by developing antibody products and pioneering, knock-your-socks-off therapies that change the lives of patients and the future of cancer treatment and serious diseases. From our people who are caring, candid, and impact-driven to our business, which is innovative and rooted in science, we believe that being proudly unique, determined to be our best, and authentic is essential to fulfilling our purpose.

The Role & Department

The Associate Director, Trial Start Up Lead is key member of the Trial Strategy and Delivery Team, responsible for overseeing and driving trial start up on a compound level in close collaboration with the clinical project lead, the trial start up team and the clinical CROs.

Key responsibilities include

• Provide CPL with operational insights for initial trial strategies related to start-up, including country selection, submission strategy, and site selection/activation
• Oversee delivery of timely site activation across trials within a program
• Oversee planning and execution of start-up activities across trials within a program
• Serve as the point of escalation for start-up managers on trial start-up issues
• Identify underlying causes and develop effective solutions to mitigate or eliminate challenges
• Work with team members to develop and implement solutions to identify challenges
• Contribute to novel collaborations with relevant recruitment companies, site referral networks, and CRO networks
• Collaborate with Genmab legal on country-specific CTA templates and master CTA
• Develop CDA strategy for compound/trial
• Assess Start-Up KPI/KQI from CROs
• Support IRB/EC/CEC submissions
• Ensure learnings from IRB/EC/CEC feedback across clinical trials within a program but also across different programs are collected and shared
• Drive interactions with CRO for start-up activities and optimization
• Support, identify, and address site activation challenges on a program level and
• Document and share lessons learned across trials and programs
• Line management for up to 7 members of the trial start up team.

Requirements

• A minimum of 12 years of relevant global study start-up experience from biotechnology-/pharmaceutical-, CRO- or healthcare industry
• Solid understanding of trial start up
• Demonstrated ability to leadand collaborate with cross-functional teams to drive operational excellence
• Experience in leading & managing global teams
• Experience in mentoring trial start up managers
• Vendor management experience
• Strong stakeholder management
• Ability to anticipate issues with proactivity to offer solutions & to timely escalate risks and issues when needed
• Ability to foster a “One Team” spirit, inclusive mindset
• Confidence to challenging status-quo thinking and behaviour; can work with agility and an innovative mindset
• Excellent written and oral communication skills
• Bachelor’s Degree within life science or equivalent combination of education, training, and relevant experience
• Experience in Clinical Operations and a thorough understanding of GCP, relevant ICH standards, and FDA/EMA guidelines would be beneficial
• Experience in line management (preferred)
• Strong organizational skills, including the ability to prioritize and handle a high volume of tasks within a given timeframe
• Ability to proactively identify risks, develop mitigations & resolve issues
• Good understanding of the operational structure within CRO
• Strategic mindset

Moreover, you meet the following personal requirements

• You can work independently as well as in teams
• You are capable of prioritizing work in a fast paced and ever-changing environment
• You have a quality focus and an eye for detail
• You are result and goal-oriented and committed to contributing to the overall success of Genmab

This role can be located in Copenhagen, Denmark or Princeton, NJ or Utrecht, the Netherlands; and is hybrid or can be remote.

About You

• You are passionate about our purpose and genuinely care about our mission to transform the lives of patients through innovative cancer treatment
• You bring rigor and excellence to all that you do. You are a fierce believer in our rooted-in-science approach to problem-solving
• You are a generous collaborator who can work in teams with erse backgrounds
• You are determined to do and be your best and take pride in enabling the best work of others on the team
• You are not afraid to grapple with the unknown and be innovative
• You have experience working in a fast-growing, dynamic company (or a strong desire to)
• You work hard and are not afraid to have a little fun while you do so

Locations

Genmab leverages the effectiveness of an agile working environment, when possible, for the betterment of employee work-life balance. Our offices are designed as open, community-based spaces that work to connect employees while being immersed in our state-of-the-art laboratories. Whether you’re in one of our collaboratively designed office spaces or working remotely, we thrive on connecting with each other to innovate.

About Genmab

Founded in 1999 in Copenhagen, Denmark, Genmab is an innovative biotech company that has become a leader in antibody biology and innovation. Our product pipeline and next-generation antibody technologies are the result of our strong company culture, a deep passion for innovation, and desire to transform cancer treatment and serious diseases.

When you work with us, you’ll be part of a warm, fun, dynamic community, and team up with some of the best, most authentic iniduals in locations around the world, who care deeply and share in a relentless drive to innovate and create transformational medicines. People who are candid, impact-driven, and a little unconventional; who seek out and embrace the opportunity to build new and bold futures within a rapidly growing and innovative biotech company; who bring their full selves to work and show up for each other – rolling up their sleeves to get the job done. This translates into a place where you can be authentically you; are empowered to innovate, build solutions, and execute; feel cared for and supported in growth; and are a critical part of changing the lives of patients around the world through transformative cancer treatment.

Our commitment to ersity, equity, and inclusion

We are committed to fostering workplace ersity at all levels of the company and we believe it is essential for our continued success. No applicant shall be discriminated against or treated unfairly because of their race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, or genetic information. Learn more about our commitments on our website.

Genmab is committed to protecting your personal data and privacy. Please see our privacy policy for handling your data in connection with your application on our website https://www.genmab.com/privacy.

Virtual Triage Nurse

locations

Remote USA

job requisition id

R1466

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re 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:

Our Care OnDemand services span the continuum of acute care, beginning with helping members navigate new or urgent symptoms with a nurse triage line, delivering best-in-class virtual urgent care services, and (when needed) connecting our members to high value urgent and emergency care providers in the community, and following up with them after an acute event. We are building a novel, intensely patient-centered virtual front door that provides access to immediate health care in a way that has never been done before.

As a Clinical Guide: Care OnDemand RN you’ll be responsible for providing telephonic advice to members when they call Devoted for clinical needs. By providing clinical advice and triaging clinical concerns when members call Devoted, you can help members achieve better health outcomes. You’ll serve as an advocate for these members, helping them get the care they need, and connecting them with necessary resources.

Our ideal clinical guide is caring, compassionate, solution-oriented and enthusiastic about providing an outstanding experience for Devoted Health’s members. They have excellent clinical judgment and triage skills. They are ready to innovate, adaptable to a continuously evolving startup environment, and willing to start scrappy, working with the whole Devoted family to create a revolution in how care is delivered.

A day at Devoted could include:

Working with members

• Engaging with members via telephonically and/or video to provide clinical advice, in response to member reported clinical concerns.
• Connecting members with the care they need, whether it be primary care or urgent/ emergent care.
• Explaining complicated medical terms in plain language.
• Educating members on their conditions including teaching red flags

Working with other providers and resources

• Working closely with our PCP partners, as well as Devoted Medical Group, to coordinate care and deliver evidence based, effective, and accessible health care.

Improving how we work

• Providing feedback and advice to help improve the operational processes, software tools, and data capabilities to improve how Devoted does transitions of care case management

Attributes to success:

• You have a desire to make a change in the healthcare experience: you love to serve and make a difference.
• You enjoy being on the phone caring for patients.
• You have strong clinical skills that will help you understand over the phone what a patient needs to help her avoid poor health outcomes.
• You can articulate and break down complex information to ensure patients and caregivers are able to absorb and act on your guidance.
• You are comfortable working with technology and in a dynamic, startup environment.
• Comfort or interest in working remotely post COVID
• 4 – 10 hour shifts per week 9 AM-7:30 PM EST -OR- 10 AM-8:30 PM EST, with rotating weekend and holiday requirement.
• 3 -12 hour shifts, alternating 3 and 4 days worked per week. 8:00pm – 8:00am EST.

Skills and experience:

Must haves:

• A compact RN license and willingness to obtain additional licenses as needed (for non-compact states)
• A minimum of 4 years of RN experience (preferably ER or ICU).
• Prior clinical triage experience– either through a helpline or provider office.
• Team player mentality with a can-do attitude.

• BSN Degree
• BLS Certification

Nice to haves:

• Bilingual in English and Creole or Spanish.

Salary Range: $80,000 – $95,000 annually

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.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member’s base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

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 Devoted’s 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.

Nurse Clinical Informaticist

at Amwell

Remote

Company Description

Amwell is a leading telehealth platform in the United States and globally, connecting and enabling providers, insurers, patients, and innovators to deliver greater access to more affordable, higher quality care. Amwell believes that digital care delivery will transform healthcare. We offer a single, comprehensive platform to support all telehealth needs from urgent to acute and post-acute care, as well as chronic care management and healthy living. With over a decade of experience, Amwell powers telehealth solutions for over 150 health systems comprised of 2,000 hospitals and 55 health plan partners with over 36,000 employers, covering over 80 million lives.

Brief Overview:

The Senior Clinical Informaticist serves as the hub of information management for program development within our clinical chat platform. They support the development of complex clinical chat programs within our conversation platform. They play an essential role adapting and repurposing existing clinical design frameworks for new program development.

As a cross-functional role, the Senior Clinical Informaticist works closely with both client clinicians and internal teams – clinical informaticists, clinical modelers, conversation design and implementation teams to design an evidence-based clinical framework for chat programs, as well as maintain the clinical chat program library. This role also partners with product and engineering teams to support platform efficiencies.

The Senior Clinical Informaticist plays an essential role in gathering and documenting clinical workflows and chat program requirements from clinical clients. They partner with internal informatics, modelers, conversation designers, and implementation teams to ensure coordinated and efficient program development.Guided by client clinical workflow, goals, and the patient journey, the Senior Clinical Informaticist also systematically compiles knowledge from research papers, published guidelines, client clinicians, and clinical and informatics advisors to create a chat program framework that leads to actionable data and informs conversation design.

The Senior Clinical Informaticist helps manage the clinical chat program library a repository of knowledge artifacts and documents that provide a framework for creating or adapting programs. They are responsible for maintaining the specification documentation that tracks and outlines program iterations, overseeing change management, defining best practices and supporting standardization across programs.

The Senior Clinical Informaticist role will report to the Sr. Manager, Clinical Program Design, with oversight from our physician informaticists.

Core Responsibilities:

• Work with client clinicians and internal clinical informatics to define and design clinical frameworks for clinical chat programs.
• Ensure clinical framework and program scope is appropriately and effectively communicated and maintained in specification documentation.
• Partner with conversation design team to translate clinical frameworks. Ensure clinical accuracy and appropriateness of chat program content.
• Assist with coding of data elements and provide oversight of interoperability aspects of a program (e.g., coding and selection of data elements for Epic Flowsheet integration)
• Organize knowledge artifacts/documents and reconcile with chat scripts and other assets.
• Create visualizations and summaries of program proposals to facilitate stakeholder decision-making.
• Stay abreast of current clinical evidence and update existing programs and patient education in a erse set of clinical domains.
• Work with the analytics/operations team to incorporate user feedback and drive program improvement.
• Lead a testing group in testing and debugging of programs.

Qualifications:

• Bachelor of Science Degree in a healthcare related role that incorporates patient care
• 3+ years’ experience in delivering healthcare or supporting the delivery of healthcare in a variety of service lines
• 5+ years demonstrative experience with supporting informatics solutions in the context of clinical processes, e.g., support of clinical information flow for decision support, development of patient facing applications, or equivalent academic work
• Experience implementing business rules logic in the operationalization of clinical processes
• Experience working with clinical taxonomies and ontologies, how they are organized and used in organizing health care data
• Experience in designing impactful CDS (Clinical Decision Support) solutions
• Comfort and familiarity with a range of software tools (Microsoft 365, Lucidchart/Visio, Jira, etc.) to produce documentation and figures, manage tasks, etc.
• Ability to work remotely with dynamic teams across a wide range of time zones, and stay on top of multiple projects
• Experience with the display of complex clinical data

Preferred

• Advanced degree in Clinical Informatics (master’s or higher)
• Demonstrative knowledge of programming and coding language, preferably in JavaScript
• Editorial experience, documentation management
• Project management experience

Additional information

Working at Amwell:

Amwell is changing how care is delivered through online and mobile technology. We strive to make the hard work of healthcare look easy. In order to make this a reality, we look for people with a fast-paced, mission-driven mentality. We’re a culture that prides itself on quality, efficiency, smarts, initiative, creative thinking, and a strong work ethic.

Our Core Values include One Team, Customer First, and Deliver Awesome. Customer First and Deliver Awesome are all about our product and services and how we strive to serve. As part of One Team, we operate the Amwell Cares program, which brings needed assistance to our communities, whether that be free healthcare for the underserved or for people affected by natural disasters, support for equality, honoring doctors and nurses, or annual Amwell-matched donations to food banks. Amwell aims to be a force for good for our employees, our clients, and our communities.

Amwell cares deeply about and supports Diversity, Equity and Inclusion. These initiatives are highlighted and reflected within our Three DE&I Pillars – our Workplace, our Workforce and our Community.

Amwell is a “virtual first” workplace, which means you can work from anywhere, coming together physically for ideation, collaboration and client meetings. We enable our employees with the tools, resources and opportunities to do their jobs effectively wherever they are!

Salaried, Exempt Roles:

The typical base salary range for this position is $98,400- $135,300. The actual salary offer will ultimately depend on multiple factors including, but not limited to, knowledge, skills, relevant education, experience, complexity or specialization of talent, and other objective factors. In addition to base salary, this role may be eligible for an annual bonus based on a combination of company performance and employee performance. Long-term incentive and short-term variable compensation may be offered as part of the compensation package dependent on the role. Some roles may be commission based, in which case the total compensation will be based on a commission and the above range may not be an accurate representation of total compensation.

Further, the above range is subject to change based on market demands and operational needs and does not constitute a promise of a particular wage or a guarantee of employment. Your recruiter can share more during the hiring process about the specific salary range based on the above factors listed.

Additional Benefits

• Flexible Personal Time Off (Vacation time)
• 401K match
• Competitive healthcare, dental and vision insurance plans
• Paid Parental Leave (Maternity and Paternity leave)
• Employee Stock Purchase Program
• Free access to Amwell’s Telehealth Services, SilverCloud and The Clinic by Cleveland Clinic’s second opinion program
• Free Subscription to the Calm App
• Tuition Assistance Program
• Pet Insurance

Coding Specialist

at Signify Health

Remote

How will this role have an impact?

Under the supervision of the Manager of Coding, this position is responsible for ICD-10 coding of Health Risk Evaluations of Medicare and Medicaid members that are performed by the Signify Health physicians and reviewing the Health Risk Assessments/Evaluations to insure completeness, accuracy and compliance with CMS guidelines.

What will you do?

• Reviews health risk assessments/evaluations to determine completion and compliance with CMS guidelines on a timely basis.
• Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes identified in the health risk assessments/evaluations.
• Reviews health risk assessments/evaluations to accurately and completely assign all ICD-9/10 codes that are clinically identified and supported in the assessment/evaluation on a timely basis.
• Communicates timely and effectively with supervisor regarding issues with the health risk assessments/evaluations and/or corrections required to the health risk assessments/evaluations.
• Understanding the relationship between IC-9/10 coding and HCC (hierarchical condition category) coding.
• Utilizes advanced, specialized knowledge of medical codes and coding protocol by providing guidance to the Director of Coding to ensure the organization is following Medicare coding protocol for payment of claims.
• Demonstrate a commitment to integrating coding compliance standard into coding practices. Identify, correct and report coding problems.
• Maintain adequate knowledge of compliant coding procedures related top Medicare Risk Adjustment.
• Maintain coding credentials
• Complete special projects as assigned by management, which require defining problems, and implementing required changes.
• Follows all legal and policy requirements for HIPAA protected data.
• Actively demonstrates teamwork at all times.
• Ability to work overtime.
• Is able to meet and maintain required accuracy and efficiency standards.

We are looking for someone with:

• Must hold an active CPC, CPC-A, COC, CCS, CCS-P or CCA
• Current coding certification in good standing.
• CRC required
• ICD-10 Coding Certification will be required
• Minimum of 1 year of experience of ICD-10 coding.
• Prior work experience in the healthcare field specifically related to coding is preferred.
• Experience and knowledge of Medicare HCC coding.
• Experience with medical record documentation.
• Prior medical chart auditing/quality experience preferred.
• Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology

About Us:

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across iniduals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for iniduals who need help the most. This leads to better outcomes and a better experience for everyone involved.

Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million iniduals each year while helping payers and providers more effectively implement value-based care programs.

We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.

Professional Coding Lead

Job LocationsUS-Remote

ID

2023-4024

Category

Revenue Cycle

Position Type

Regular Full-Time

Company Overview

#LI-Remote

Shriners Children’s is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience defines us as leaders in pediatric specialty care for our children and their families.

Job Overview

Shriners Children’s is the premier pediatric burn, orthopaedic, spinal cord injury, cleft lip and palate, and pediatric subspecialties medical center. We have an opportunity for a Professional Coding Lead reporting into our Corporate Headquarters.

The Professional Coding Lead performs at an advanced level medical professional coding position and serves as an expert utilizing International Statistical Classification of Diseases (ICD-10) and Current Procedural Terminology (CPT 4) classification system coding to all diagnoses, treatments and procedures in all types of Hospital, Clinic and Ambulatory Surgical Center (ASC) locations at stated minimum performance levels. The Revenue Integrity Professional Coder Team Lead supervises daily operations specific to professional coding and coder productivity. Develop staff coverage strategies to maintain consistent productivity flow and assists to cover staff PTO/position vacancies. Reviews employee timesheets and validates with timecards in the payroll system biweekly. Monitors the Professional Hold Report weekly to ensure coding is completed timely and to request information from responsible departments as well as develop strategies to minimize un-coded accounts greater than the bill hold period. Supports Professional Coding Team by discussing complex coding cases, answering questions, providing education and interfacing with Leadership. Runs daily and weekly status reports and distributes to appropriate parties. Completes edits in Bill scrubber and CBO and identifies payer specific guidelines and process improvement opportunities. Communicates documentation improvement opportunities and coding issues (lacking documentation, physician queries, etc.) to appropriate personnel for follow-up and resolution. The Revenue Integrity Professional Coder Team Lead will also provide training for all new professional coders and monitors staff progress.

Responsibilities

• Interpret health record documentation using knowledge of anatomy, physiology, clinical disease processes, pharmacology and medical terminology to identify diagnoses and procedures
• Interpret ICD-10; CPT 4; Healthcare Common Procedure Coding (HCPC) and modifier codes for services rendered accurately and completely
• Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
• Identifies trends in documentation deficiencies and presents along with creative solutions
• Acts as a key liaison for the clinical staff as it relates to coding and compliance
• Interacts with Physician and Executive Leadership and other professional staff of documentation issues relating to coding data
• Acts as a mentor to Professional Coding team
• Reviews employee timesheets and validates with timecards in the payroll system biweekly
• Manages Professional Coding Team schedule including PTO and coverage
• Provides onboarding system and workflow training to newly employed coders
• Performs 100% audit for all newly employed coders and provides feedback
• Monitors staff quality performance and provides education to support correct coding
• Prepares and presents education in conjunction with the Revenue Integrity Professional Coding Educator
• Primary contact for Revenue Cycle and Clinical teams throughout Shriners Hospitals for Children (SHC) system to assist with coding questions
• Prepares and distributes queue status reports to Coding Leadership on a daily and weekly basis
• Performs scheduled surgical audits for Provider feedback and communicates results to Surgeons
• Bill Scrubber coding WQ Edits and trends results
• Professional Coding WQ and trends denial reasons

Qualifications

Experience:

• 7 years of professional coding experience required
• Experienced with Surgery Coding Guidelines, E/M Coding Guidelines, CPT coding, ICD-10, HCPCS and NCCI Edits required
• Pediatric, orthopedic and/or injury, and burn coding experience required
• Intermediate Excel skills required
• Advanced knowledge of 3M system or other encoder program required
• Advanced knowledge of Medical Terminology required
• Advanced knowledge of professional coding practice standards required

Education:

• High School Diploma/GED required
• Current certification in one of the following required: CCS (AHIMA), CCS-P (AHIMA) and/or CPC (AAPC)

Nurse Member Advocate

Remote – USA

Full time

JR15936

Teladoc Health is a global, whole person care company made up of a erse community of people dedicated to transforming the healthcare experience. As an employee, you’re empowered to show up every day as your most authentic self and be a part of something bigger thriving both personally and professionally. Together, let’s empower people everywhere to live their healthiest lives.

Summary of Position

The Nurse Member Advocate is an integral part of a cross-functional clinical team comprised of physicians, nurses, medical assistants, pharmacy technicians and support staff that facilitates the 24/7 delivery of whole person healthcare, ensuring the optimal use of internal and external, erse health care resources to improve health outcomes.

The nurses are responsible for care delivery in all Teladoc service lines focusing on ensuring the highest clinical quality, as well as member and client satisfaction.

Essential Duties and Responsibilities

• Works in partnership with clinical team in support of case development and management, care and treatment plans including accurate case documentation, identifying relevant medical data to be collected and providing clear, concise communication to members, internal and external partners.
• Serve as the ongoing coordinator of primary and preventative care, episodic care, expert medical opinion and other service lines
• Obtains a comprehensive health history by leading members through a systematic and dynamic intake assessment to capture all relevant data about their current condition and health history and directs members to most appropriate service line; sets appropriate member expectations for each process
• Resolves prescription issues related to episodic care within established protocols and turn-around times
• Maintains his/her own availability within Outlook for scheduling of member visits and all follow ups
• Utilizes the company’s proprietary database to help connect members to Teladoc Health and external physicians and completes referrals where appropriate, both internal and external
• Conducts member health coaching and provides treatment decision support service via printed educational materials and videos
• Uses clinical judgment in the review of complex medical issues to ensure accuracy of clinical summaries/reports and care plans
• Provides clinical support and guidance to support staff regarding case related inquiries
• Ensures adherence to established processes and compliance with privacy legislation and regulations with all parties encountered in the service delivery
• Is accountable for meeting service standards for speed of case progression, overall quality, and member satisfaction
• Support additional projects as needed

Qualifications Required for Position

• Active Registered Nurse license
• BSN Preferred
• 5 years recent experience in the acute care setting preferred
• Med-surg background preferred
• Quality driven with a focus on flawless customer service
• Strong clinical knowledge base
• Excellent written and verbal communication skills
• Outstanding team player & strong interpersonal skills
• Bilingual-Spanish Speaking a plus
• Strong organizational skills and the ability to multitask with ease
• Ability to work independently but recognize when escalation is warranted
• Proficiency using technology and software including Microsoft Word, Excel, Outlook
• Ability to work required shift: evenings and weekend coverage

The base salary range for this position is $75,000-$85,000. In addition to a base salary, this position is eligible for performance bonus, RSU’s, and benefits (subject to eligibility requirements) listed here: Teladoc Health Benefits 2023. Total compensation is based on several factors including, but not limited to, type of position, location, education level, work experience, and certifications. This information is applicable for all full-time positions.

Why Join Teladoc Health?

A New Category in Healthcare: Teladoc Health is transforming the healthcare experience and empowering people everywhere to live healthier lives. Our Work Truly Matters: Recognized as the world leader in whole-person virtual care, Teladoc Health uses proprietary health signals and personalized interactions to drive better health outcomes across the full continuum of care, at every stage in a person’s health journey. Make an Impact: In more than 175 countries and ranked Best in KLAS for Virtual Care Platforms in 2020, Teladoc Health leverages more than a decade of expertise and data-driven insights to meet the growing virtual care needs of consumers and healthcare professionals. Focus on PEOPLE: Teladoc Health has been recognized as a top employerby numerous media and professional organizations. Talented, passionate iniduals make the difference, in this fast-moving, collaborative, and inspiring environment. Diversity and Inclusion:At Teladoc Health we believe that personal and professional ersity is the key to innovation. We hire based solely on your strengths and qualifications, and the way in which those strengths can directly contribute to your success in your new position. Growth and Innovation: We’ve already made healthcare yet remain on the threshold of very big things. Come grow with us and support our mission to make a tangible difference in the lives of our Members.

As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status or pregnancy.

Teladoc Health respects your privacy and is committed to maintaining the confidentiality and security of your personal information. In furtherance of your employment relationship with Teladoc Health, we collect personal information responsibly and in accordance with applicable data privacy laws, including but not limited to, the California Consumer Privacy Act (CCPA). Personal information is defined as: Any information or set of information relating to you, including (a) all information that identifies you or could reasonably be used to identify you, and (b) all information that any applicable law treats as personal information.

Clinical Recruiter

Remote – United States

About Quartet Health

Quartet is a purpose driven value-based behavioral healthcare company, building the nation’s leading behavioral health home. We deliver integrated care and better outcomes to improve the health of communities across America.

Quartet is a trusted partner of health insurance plans, health systems, community behavioral health centers, certified community behavioral health clinics, and federally qualified health centers in 36 states across the country. We identify people in need of care and connect them directly to high quality behavioral care providers, including Quartet’s own medical group.

At Quartet, our values guide the way that we work together, starting with our commitment to putting patients first, and our shared focus on collaboration and innovation, so that we together can improve lives, one person at a time.

Quartet is backed by top investors like Oak HC/FT, GV (formerly Google Ventures), F-Prime Capital Partners, Polaris Partners, Deerfield Management, Centene Corporation, Independence Health Group, and Echo Health Ventures.

Our Benefits

We’re proud to offer the following benefits to our team members:

• Competitive compensation
• IT equipment and support
• Mental health benefits via our EAP, with up to 7 free counseling sessions per concern
• An unlimited PTO policy and ten paid holidays
• Paid parental leave
• Robust medical, dental and vision insurance plans
• A 401(k) plan with employer match
• 100% employer-paid life insurance, short-term and long-term disability insurance
• Annual learning & development budget

About the Team & Opportunity:

As a member of the Talent Acquisition team, the Clinical Recruiter will partner with InnovaTel’s implementation, Sales and Marketing leaders to understand the unique needs of our partners and identify the best candidates for each service line. You will lead full-cycle recruiting for behavioral healthcare providers, building and executing strategies that deliver an incredible candidate experience to attract the best in the field.

You will source for current and future telepsychiatry opportunities throughout the United States using a variety of resources to source psychiatrists and psychiatric nurse practitioners, licensed clinical social workers and other licensed behavioral healthcare professionals. T

o be successful in this role, you must be able to keep pace in a highly fluid, ever-changing, collaborative workplace. You must also have excellent communication skills, the experience to strategically partner with leadership and the ability to influence/respond to complexities with a high level of professional acumen. We are on a mission to deliver speed to quality behavioral health care for all are you ready to join us?

Accountabilities:

• Build and maintain relationships with telepsychiatry candidates and psychiatric residency and training programs; evaluate and align toward the best opportunities within our organization
• Schedule and facilitate interviews with Psychiatrists, PMHNP’s and LCSW’s to seek best fit for innovaTel
• Meet weekly with Business Development and Operational leaders to understand current priorities, regularly adjust priorities for recruitment and develop creative recruiting campaigns
• Administer day-to-day operations to execute targeted sourcing plan and provide regular reporting on pipeline and outcomes
• Schedule and track administrative and clinical interviews with leadership
  • Transition hired candidates to team members who will begin the onboarding process
  • Convey candidate profile and status in hiring stage to colleagues using database reports and follow up with each lead

Proactively identify, network and contact active and passive job seekers through the following avenues

• Psychiatric residency and training programs
• Follow up on leads through internet searches, job boards, social media
• Physician, nursing and LCSW job boards
• Email blasts, cold calling and various ad campaigns

Minimum Qualifications:

• 3+ years full cycle recruiting experience with at least 2-3 years in the clinical space
• Exceptional written and verbal communication skills to always maintain professionalism with candidates and colleagues
• Comfortable interviewing clinicians on screen
• Experience with Greenhouse ATS & GSuite/Google Workspace

Preferred Qualifications:

• Experience in a high-growth startup environment
• Strong communication skills and the ability to partner effectively across the company
• Experience with Gem or other sourcing tools

Pro Fee Coder – Anesthesia

Remote – USA

Full time

job requisition id

R2891

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder I may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder I performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder I may interact with client staff and providers.

DUTIES AND RESPONSIBILITIES:

• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type.
• Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record.
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
• Complete assigned work functions utilizing appropriate resources. May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
• Maintain strict patient and provider confidentiality in compliance with all HIPPA Guidelines.
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

SKILLS AND QUALIFICATIONS:

• Candidates must successfully pass pre-employment skills assessment. Required:
• An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
• Two years of recent and relevant hands-on coding experience
• Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets
• Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards
• Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files, (Outlook, Word, Excel)
• Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers

PREFFERED SKILLS:

• Recent and relevant experience in an active production coding environment strongly preferred
• Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience
• Experience using Rcx, Cerner, Optum (a plus)

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 – $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

Title: Remote Nurse Practitioner – Pennsylvania Licensed

Location: United States

Type: Contractor Workplace: remote JobDescription:

Are you looking for an innovative primary care practice model that uses technology and healthcare data to empower patients to take greater ownership and accountability over their healthcare? At Forward, we believe that the future of medicine combines the best attributes of healthcare professionals with the efficiency and grace of innovative technology.

We are looking to contract with a motivated Nurse Practitioner who thrives in delivering care in an innovative tech environment. You will support our members via telemedicine, working alongside highly acclaimed, board certified physicians. This is an ideal opportunity for those seeking a flexible opportunity to deliver primary care via telemedicine. This is a 6 month contract opportunity; candidates do not need to reside in the states they are licensed in.

WHAT YOU’LL DO:

• Remotely triage, diagnose and treat patients via our online chat-based platform, including: proactively providing medical and wellness education (facilitated by Forward’s technology), diagnosing and treating patients via our online chat-based telemedicine platform, recommending suitable treatment plans and considering cost-effective treatment modalities, and assisting in care coordination and onsite visit planning for both urgent and wellness member visits.
• Giving and receiving regular feedback on inidual member cases.
• Providing a positive member experience in telemedicine interactions, including quality of care recommended and tone / messaging with which care is delivered.

WHAT WE’RE LOOKING FOR:

• A Board Certified Nurse Practitioner with a minimum of 2 years of primary care experience
• Nurse Practitioners who are motivated by Forward’s mission to make preventive care a bigger part of patient lives, and who enjoy practicing in telemedicine care environments.
• A hardworking, detail-oriented inidual with the ability to problem solve independently, reaching out for help / support on patient cases, as needed.
• A caring, compassionate inidual who enjoys helping others and providing a positive care experience in a telemedicine platform.
• Care providers who are flexible and interested in working in a telemedicine environment with frequent change / product improvements, and who are extremely comfortable using new technology and software.
• Nurse Practitioners who are used to balancing multiple, concurrent patient cases, and who are comfortable giving and receiving feedback to grow in their roles.
• Advanced computer skills including typing speed, email, internet research, downloading and uploading files, and working in multiple browser windows.

TECHNICAL REQUIREMENTS

Contractors will need a self-provided PC with Windows OS. MacOS is not supported.

• Internet: You must have wired or wifi connectivity, with download speed minimum of 5.0 Mbps and upload speed minimum of 3.0 Mbps
• Mobile device: You will need to install a few programs on a personal phone or tablet for authentication purposes. This device should be running Android iOS 8+ or iOS 12+
• Computer: You need to provide your own laptop or desktop with a monitor capable of displaying 1920 x 1080 pixels, and a sound card installed for use with speakers or headphones. Your device should meet the following requirements:
• Processor
• Intel i3, AMD Ryzen, or better
• Memory
• 6 GB of RAM or better
• Operating System
• Windows 10 or better
• Browser
• Google Chrome (latest version), Firefox (latest version ) or Internet Explorer 11

Please let us know during the interview process if you have concerns with any of these requirements.

WHY WORK WITH FORWARD?

We want to rebuild the healthcare industry and change the way iniduals think about taking ownership over their health. You will be working with a team of hardworking, mission-driven people trying to effect change in healthcare as quickly and meaningfully as possible.

California Job Applicants.

Title: Health Plan Operations Associate

Location: Remote

Type: Full-time Workplace: hybrid

About the Role

Lyra Health is looking for a detail-oriented and highly motivated team player to support various processes on our Health Plan Billing Operations team as a Health Plan Operations Associate. This unique role offers a erse opportunity for a well rounded person that enjoys learning and quickly adapts to change. The Health Plan Operations Associate must be comfortable shifting to new tasks assignments as needed within Payment Reconciliation, Patient Billing, and Claims Resolution. Other aspects of the role include following up on claims and working denied claims as needed. Some additional responsibilities on an as needed basis are listed below.

RESPONSIBILITIES

• Reconciliation and balancing of all payments, EFTs, lockboxes and 835 files
• Investigate and apply/reconcile unidentified paymentsAccurate and timely posting of payments and adjustments to patient accounts
• Responsible for completing work queues timely Invoicing patients for cost share balances
• Assist in responding to patient inquiries when neededSetting up payment plans and may be responsible for processing financial assistance applications
• Uses assertive follow-up techniques with payers to drive claims resolution
• Investigate cause of claim submission failures & submit corrected claims to payersIdentifies denial reasons with abilities to decipher and take appropriate next steps to resolve
• Contributes as an effective team member with a problem solving collaborative approach
• Key contributor to process improvement ideas to help streamline efficiencies
• Analyze EOB and remittance information, including co-pays, deductibles, co-insurance, contractual adjustments, denials, etc. to verify accuracy of patient balances
• Other responsibilities as needed including eligibility tasks

Qualifications

• 2+ years of recent experience in medical billing setting in bank reconciliation, payment posting and patient billing
• Attention to detail Ability to read and understand EOBs
• Ability to flourish in a fast-paced, rapidly changing environment
• Collaborates cross functionally
• Comfortable conducting training
• Excellent written and verbal communication skills
• Strong skills in research, troubleshooting & resolving issues
• Experience with Salesforce, SQL, JIRA, Google Sheets, Zendesk, Excel

Ideally, we are looking for a candidate who is open to a hybrid role, who can periodically commute to the office in Burlingame, CA. However, this can be a remote opportunity.

Provider Practice Coding Consultant

Job Locations US-Remote

Requisition ID

2023-33489

# of Openings

10

Category (Portal Searching)

HIM / Coding

Position Type (Portal Searching)

Employee Full-Time

Equal Pay Act Minimum Range

20-28

Overview

Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Architecture Group is comprised of some of the brightest and most talented iniduals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

What we need

Provider Practice Coding Consultant provides consulting and education needs related to coding quality, compliance assessments, external payer reviews, and coding education. Offers meaningful information to meet customer expectations including identifying and proposing solutions for customer issues, develops and maintains account relationships through responsiveness and calm, reflective work practices and works cooperatively with HIM Division leadership and scheduling for optimal services outcome in hospitals and alternative care settings.

Responsibilities

• Reviews medical records and assigns appropriate CPT, ICD-10-CM, ICD-10 procedures, ICD-10-CM and ICD-10 PCS, HCPCS, DSMV codes as appropriate and required by client workflow.
• Conducts data quality reviews of records to assess compliance with official coding and documentation guidelines.
• Communicates professionally with co-workers, management, and hospital staff regarding clinical and reimbursement issues.
• Demonstrates excellent written and verbal communications skills.
• Communicates documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution.
• Typically works remotely, accessing work related tasks via VPN access.
• Reports to work as scheduled.
• Willing and able to travel when necessary, if applicable.
• Complies with all CIOX Health and HIM Division policies and procedures.
• Responsible for tracking continuing education credits to maintain professional credentials.
• Attends CIOX Health mandatory sponsored in-service and/or education meetings as required.
• Adheres to the American Health Information Management Association’s code of ethics.
• Performs other duties as assigned

Qualifications

• 1+ year of coding experience
• Associate or Bachelor’ degree from AHIMA certified HIM Program or Nursing Program or completion of certificate program with CCS, CCS-P, CPC, CPC-A, CRC, CPC-H, CIC or COC preferred.
• Ability to communicate effectively in the English language.
• Experience in computerized encoding and abstracting software.
• Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. Pay range is between $20-28 an hour.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Equal Pay Act Minimum Range

20-28

Clinical Content Specialist – Nursing

locations

USA-MN-Remote

time type

Full time

job requisition id

R0037543

R0037543

Clinical Content Specialist – Nursing

MN or Remote in the U.S.

We are looking for a Clinical Content Specialist – Nursing to facilitate our mission to provide faculty and leadership with best-in-class educational resources. We are known as innovators in the Nursing Education market and are constantly looking for new and inventive ways to engage faculty to adopt best practices for curricular success. If you are an analytical thinker and passionate about developing nurse educators, we want to hear from you!

The Clinical Content Specialist Nursing will work closely with the Senior Clinical Content Specialist to plan and deliver high quality products and consultation services by identifying and assessing client needs and developing evidence-based, best practice, engaging content for faculty to support role development from onboarding to expert.

The Clinical Content Specialist – Nursing will work cross-functionally with internal and external stakeholders to provide educational services and coordinate efforts with the nursing education team. The ideal candidate will be passionate about nursing education, pedagogy, mentoring, analysis, and process improvement. The person will be able to work collaboratively in a team-based approach to achieve goals and initiate action. This candidate should have a strong understanding of nursing education and the importance of program success to prepare future nurses for the innovative and dynamic world of nursing.

ESSENTIAL DUTIES & RESPONSIBILITIES

The Clinical Content Specialist’s primary responsibilities include:

Consultations and Workshops Team Member

• Support the collaborative process of securing, planning, processing, and evaluating consultations.
• Triage client needs and offer viable solutions.
• Proposals
• Write consultation proposals for client review and signature.
• Make revisions as needed to reflect client’s needs.
• Track and stores proposals and document client communication.
• Follow up on unsigned proposals to gauge the client’s level of interest.
• Follow up with clients, responding to questions/concerns from decision makers.
• Align consultation topic and timeline with potential consultant’s expertise.
• Serve as a liaison between the consultant and internal and external key stakeholders.
• Serve as a resource to consultants throughout the planning and implementation process, such as reviewing presentations, brainstorming strategies, addressing issues, and providing constructive feedback after observing consultants during consultations.
• Contribute to the process of customized projects through mentoring, reviewing, or editing support.
• Serve as the final reviewer for all customized test writing projects, curriculum development projects, program review reports, and other consultation reports prior to submitting to client.
• Collaborate with the team to support problem solving, continuous quality improvement, and strategic growth, including review of surveys and feedback.
• Review client data that may prompt the development of new products or services.
• Collaborate with the Sales Team to provide joint product and service marketing opportunities for consultations.
• Plan and deliver select consultations, webinars, conference and institute presentations, New Faculty Orientation (NFO), and workshops.
• Monitor the evidence base and scholarly work that supports the work of the team.

Nurse Planner with the NurseTim NCPD Planning Unit

• Work collaboratively with the Accredited Provider Program Director (AP-PD) during the ANCC process and serve as liaison between the AP-PD and the consultant.
• Submit documentation requesting contact hours to include contract details, consultant information, description of the professional practice gap, description of the problem or opportunity for improvement, and evidence to validate the professional practice gap.
• Participate in the planning, implementation, and evaluation of NCPD workshops, conferences, institutes, NFO, and webinars.
• Present sessions for webinars and conferences.
• Collaborate with stakeholders to identify and meet organizational needs.
• Complete the NCPD planning and documentation for assigned events.

Assessment and Mentoring

• Assist with mentoring item writers and reviewers to help develop their skills to produce high-quality test items.
• Review test items for clinical accuracy, alignment with current research and best practices, and adherence to established NurseThink item-writing standards.
• Write traditional, alternate format, or Next Generation NCLEX style test items based on areas of experience and expertise.
• Analyze item or assessment-level data for the Clinical Judgment Exams and participate in quality improvement and exam development processes.
• Write for company and client produced resources that may include developing podcasts, books, manuals, videos, learning activities, and other learning related materials.
• Contribute to the identification, planning and implementation of new or revised initiatives that impact team mission and vision.
• Collaborate with the nurse educator team to evaluate practices and processes in place.
• Travel as needed for conferences, consultations, nurse meetings, and training.

Other Duties

• Be flexible to work on other product development as needed.

QUALIFICATIONS:

Education:

• Master’s Degree in Nursing required. Doctoral degree in nursing, higher education, or related field preferred.

• Active RN licensure (unencumbered).

Required Experience:

5+ years of experience in nursing education practice and administration including:

• Teaching experience in academic nursing to understand the role of faculty, curriculum design and assessment, teaching strategies, learning styles, and learning platforms.
• Leadership and administrative experience to understand team dynamics, organizational and budget processes, and regulatory considerations.
• Experience with accreditation at the program and institutional levels.
• Experience with Nursing Continuing Professional Development

Other Knowledge, Skills, Abilities or Certifications:

• Strong written, verbal, collaboration, and presentation skills.
• Strong interpersonal skills to develop professional relationships with key stakeholders including clients, consultants and NTI nurse educators and staff.
• Independent and autonomous in work/self-management, professionalism, and integrity.
• Ability to prioritize and manage complex tasks simultaneously.
• Organizational, analytical, and planning skills.
• Ability to be attentive to details and meet project deadlines.
• Welcomes change and innovation in the organization and educational process.
• Strives to build efficiencies and standardized processes to best serve the client, consultant, and company.
• Ability and willingness to travel to meet business goals and objectives.

Travel Requirements: 30 – 40% as needed for conferences, consultations, mentoring, and training.

Outpatient Coder

locations

Remote – Nationwide

time type

Full time

job requisition id

R018134

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

Advanced outpatient coding position that reviews medical record documentation and accurately assign ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA,) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications. Utilizing Coding Applications in accordance with established workflow. Follows Policies and Procedures and maintains required quality and productivity standards.

Job Responsibilities:

• Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types (Ancillary, ED Charge/Code, Same Day Surgery, and Observation. The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management, (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third party software systems such as LYNX.
• Correctly abstract required data per facility specifications.

• Perform “medical necessity checks” for Medicare and other payers as required per payment guidelines.

• Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensure timely, compliant processing of outpatient claims in the billing system.

• Responsible for maintaining established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards.

• Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS,) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through.

• Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC,) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy.

Experience We Love:

• Previous outpatient coding experience

Certifications:

• RHIA, RHIT or CCA Certification Required

CRCR Required within 6 months of hire

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble Health Partners provides reasonable accommodations to qualified iniduals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [email protected].

Title: Assistant Nurse Manager (Remote)

Location: Remote

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a specialized medical group focused on people 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 nursing leader who is passionate about caring for our members, teammates, and clients and can leverage technology to create new programs, systems, and processes to drive exceptional clinical team performance. Someone who has a proven track record of using data to drive high quality and efficient clinical outcomes. Someone who ideally has experience in chronic care management, remote patient monitoring, and valuable based care of vulnerable populations. Love learning and helping others learn: you’re excited to bring your wisdom and coach others, and you’re equally energized to learn from other’s experience (such as product managers, software engineers, and data scientists), and then continue improving how Vesta does care management as we learn more together. They are comfortable working in an ambiguous environment within an organization that is growing and changing quickly. Curious about changing regulations within the space and how they can be leveraged to create additional revenue streams

The ideal teammate would be able to:

• Provide leadership, coaching, and development to a team of nurses and other multidisciplinary iniduals performing care management
• Identify inefficiencies and opportunities for quality improvement. Create process improvement to achieve member and clinician satisfaction
• Partner with Vesta’s data analytics team and clinical leadership to develop ongoing reporting and analysis to drive the efficiency, quality, and effectiveness of the clinical team and outcomes
• Serve as a subject matter expert for chronic care management (CCM), Transitions of Care (TOC) and remote patient monitoring (RPM)
• Continue to push the boundaries of what technology can do to empower our caregivers and clinicians to improve health outcomesfor our patients
• Support the development of strategies to help scale the program. Assist in evaluating capacity planning, hiring, training, and measuring and managing productivity including creating operational metrics and benchmarks
• Collaborate with cross departmental leads in analytics, product/engineering and business operations to drive efficiencies and quality improvement
• Assist manager with making sure team is appropriately staffed and find coverage when needed
• Assist in implementing new clinical programming across our clinical pods
• Support team to address escalated member challenges

Would you describe yourself as someone who has:

• Registered Nurse with unrestricted license within the United States (required)
• 4+ years of nursing experience within acute care, care management, and/or homecare (required)
• 2-3 years of experience leading/managing a clinical team of at least 15+ reports overseeing several complex projects simultaneously (required)
• Experience managing a remote team (preferred)
• Passionate about our mission to improve people’s lives
• An ability and humility to roll up your sleeves
• Detail- and process-oriented, ability to context- and mode-switch easily, fast learner
• Excellent communication skills, combined with the ability to collaborate across functions and use available tools
• Self-driven, self-starter and excited to support new technology

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

Pay range is $100K-$110K based on experience. (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).

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.

Coder 1 (Risk Adjustment)

Job Locations: US-Remote

ID2023-11222

Category

Coding

Position Type

Full-Time

Overview

Cotiviti drives better healthcare outcomes through data analytics. Our payment accuracy, revenue integrity, risk assessment and stratification, and quality improvement solutions help organizations utilize their data so they can efficiently and cost-effectively succeed in the new era of healthcare.

We are currently looking for multiple Remote Risk Adjustment / HCC Coders (Coder 1) for full-time permanent positions.

See what it’s like to work as a Coder at Cotiviti:

Responsibilities

• Ability to review medical records for accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial and Medicaid risk adjustment from various chart types (physician, facility, and non-facility).
• May have special projects that will entail a full coding review.
• Ability to code following the ICD-10-CM Official Guidelines for Coding and Reporting, AHA’s Coding Clinic and well as Cotiviti and client specific coding guidelines.
• Intermediate skills and knowledge of computers with the ability to use the designated coding platform for coding processes with focus on both production and accuracyAbility to regularly and consistently achieve over 95% quality accuracy.
• Appropriately communicate with management regarding workload, production expectations and deliverables.
• Utilizes the Dispute Resolution’ process when disagreement occurs related to a coding determination.
• Stays current on coding guidelines necessary for the position by attending all Cotiviti required trainings, workshops, and personal research as appropriate.
• Professionally communicates finds, errors, and suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process.
• Quick learner with positive attitude.
• Complete all responsibilities as outlined on annual Performance Plan.
• Complete all special projects and other duties as assigned.

Qualifications

Education: Minimum High School Diploma.

Certifications: Nationally certified coder in good standing through AAPC or AHIMA (CRC, CPC, CCS, etc.).

Experience:

• Coder 1: 1-2 years’ experience in medical risk adjustment / HCC coding.
• Experience in HCC record abstraction and coding requirements.

Knowledge, Skills & Abilities:

• Demonstrated high level of quality accuracy and productivity in clinical coding work.
• Adherence to official coding guidelines (including coding clinics, CMS, client specific guidelines and other regulatory compliance guidelines and mandates).
• Excellent written and verbal communication skills with the ability to understand and explain complex information.
• Strong knowledge of medical terminology and anatomy and physiology.
• Skills in organization and time management.
• Comfortable with computers and technology.
• Must be able to work in a fast-paced environment.
• Ability to manage and meet deadlines, adapt to changing priorities, flexible and open to new ideas.
• Must be able to perform duties with or without reasonable accommodation.
• Must participate in all required training.
• Must abide by all HIPAA and associated patient confidentiality requirements.
• This is a home-based position and requires iniduals to work within the continental US, have a place to work that is free from distractions and have a high-speed internet connection.
• This role is aligned to certain productivity and quality requirements.
• Required hours for training: Monday-Friday 8 AM 5 PM ET
• Required working hours: 40 hours per week, Monday-Friday 8-hour days; daytime schedule based on your time zone. This role is not intended to work nights, weekends or part-time.

Base compensation ranges from $20.00 Hr. to $26.00 Hr. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(K) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our careers page.

#LI-SL1

#junior

#LI-Remote

Cotiviti is an equal employment opportunity employer. Cotiviti recruits, hires and promotes iniduals based on their qualifications for a specific job. Cotiviti values its erse workforce and its selection of employees is made without regard to race, color, creed, sex, age, religion, pregnancy, childbirth or pregnancy-related conditions, national origin, sexual orientation, marital status, genetic carrier status, military service, veteran status, disability, or any other category of class protected by federal, state or local laws. All employment decisions and personnel actions, such as hiring, promotion, compensation, benefits, and termination, are and will continue to be administered in accordance with, and to further the principle of, equal employment opportunity.

Certified Coder

Remote

Molina Healthcare United States Job ID 2022215

Job Summary

Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.

Knowledge/Skills/Abilities

• Performs on-going chart reviews and abstracts diagnosis codes
• Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
• Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
• Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
• Builds positive relationships between providers and Molina by providing coding assistance when necessary
• Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
• Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
• Contributes to team effort by accomplishing related results as needed
• Other duties as assigned
• 2 years previous coding experience
• Proficient in Microsoft Office Suite
• Ability to effectively interface with staff, clinicians, and management
• Excellent verbal and written communication skills
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
• Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance

Job Qualifications

Required Education

• Associates degree or equivalent combination of education and experience

Required License, Certification, Association

• Certified Professional Coder (CPC)
• Certified Coding Specialist (CCS)

Preferred Education

• Bachelor’s Degree in related field

Preferred Experience

• Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
• Background in supporting risk adjustment management activities and clinical informatics
• Experience with Risk Adjustment Data Validation

Preferred License, Certification, Association

• Certified Risk Adjustment Coder – (CRC)
• Certified Professional Payer – Payer (CPC-P)
• Certified Coding Specialist – Physician based (CCS-P)

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

Pay Range: $41,264 – $80,465 a year*

*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

Nurse Practitioner Telemedicine

Job Status: Full Time

Job Reference #: 705721

Job Description

Nurse Practitioner – Via Telemedicine

Medical Director Services PC is looking to hire an experienced Nurse Practitioner to provide care via Telemedicine for nursing homes throughout multiple states. The ideal candidate will have previous skilled nursing experience.

Must have previous SNF experience

Mus be license in NY and GA. License in TX is a plus.

Work in the comfort of your home and service nursing homes throughout the U.S.

DUTIES:

• Assuring delivery of quality care services to all patients in a respectful and professional manner.
• Contributes to physician’s effectiveness by identifying short-term and long-range patient care issues that must be addressed; providing information and commentary pertinent to deliberations; recommending options and courses of action; implementing physician directives.
• Assesses patient health by interviewing patients; performing physical examinations; obtaining, updating, and studying medical histories.
• Documents patient care services by charting in patient and department records.
• Performs therapeutic procedures by providing treatments and prescribing medicine
• Instructs and counsels patients by describing therapeutic regimens; giving normal growth and development information; providing counseling on emotional problems of daily living; promoting wellness and health maintenance.
• Provides continuity of care by developing and implementing patient management plans.
• Maintains safe and clean working environment by complying with procedures, rules, and regulations.
• Protects patients and employees by adhering to infection-control policies and protocols.
• Complies with federal, state, and local legal and professional requirements by studying existing and new legislation; anticipating future legislation; enforcing adherence to requirements; advising management on needed actions.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
• Develops health care team staff by providing information, educational opportunities, and experiential growth opportunities.
• Contributes to team effort by accomplishing related results as needed.
• Health Promotion and Maintenance, Thoroughness, Clinical Skills, Informing Others, Medical Teamwork, Bedside Manner, Infection Control, Administering Medication, Pain Management, Self-Development

REQUIREMENTS:

• Must have Skilled Nursing experience as an NP
• 12 Hour Shifts- AM or PM

LOCATION: Remote

ABOUT US:

Medical Director Services PC was founded in 2016 when SNF’s were shifting a focus on value at the same time treating residents with higher level of acuity. MDS PC puts an emphasis on quality and customer service first. Another crucial focus is treating in place when possible and reducing unnecessary hospitalizations.

Pathology Coder – Remote

• Rochester, MN
• Full Time
• Finance

Why Mayo Clinic

Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting ersity, equity and inclusion, and provides the resources you need to succeed.

Responsibilities

Demonstrates expert job knowledge and applies current billing and coding regulations, policies, and procedures along with effective decision-making and problem-solving skills in the Anatomical Pathology physician coding process.

Knowledge of surgical pathology, special stains, consultations, immunohistochemistry, immunofluorescence CPT coding.

*This position is 100% remote work. Inidual may live anywhere in the US.

**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.

During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question – Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.

Qualifications

High School diploma and 4 years pathology coding experience (non-Mayo) or 4 years non-pathology Mayo Clinic coding experience OR Associate’s Degree and 2 years pathology coding experience (non-Mayo) or 2 years non-surgical Mayo Clinic coding experience required; Bachelor’s Degree preferred.

Additional Qualifications:

1. Knowledge of professional/physician coding rules for anatomical pathology. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.

2. In-depth knowledge of lab medicine, medical terminology, disease processes, patient health record content and the medical record coding process. 3. Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections. 4. Knowledge of coding and billing requirements for services furnished in a teaching settings. 5. Knowledge of coding and billing requirements for provider based billing facilities. 6. Ability to work independently in a teleworking environment, to organize/prioritize work, exercise excellent communication skills, is attentive to detail, demonstrate follow through skills and maintain a positive attitude.

Licensure or Certification:

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist Physician (CCS-P) or a coding credential of a Certified Professional Coder (CPC) required.

Exemption Status

Nonexempt

Compensation Detail

$22.55 – $31.98 / hour. Education, experience and tenure may be considered along with internal equity when job offers are extended.

Benefits Eligible

Yes

Schedule

Full Time

Hours/Pay Period

80

Schedule Details

Monday Friday, business hours of 8:00 am 5:00 pm

Weekend Schedule

N/A

International Assignment

No

Site Description

Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.

Affirmative Action and Equal Opportunity Employer

As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the ersity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.

Title: Coding Administrative Assistant

Location: US National

Function

Revenue Cycle Management

Location

US-Remote

Employment Status

Full Time

Overview

Medical Coders are responsible for properly coding provider encounters. The coding specialist, level I is an entry level coder certified by a recognized professional organization, or a coder with appropriate experience who is working toward gaining a recognized certification. The coder performs all coding functions assigned to an entry level coder based on their knowledge.

Job Highlights

Essential Duties and Responsibilities:

• Accurately code from available documents using current CPT, ICD-10, ASA and HCPCS codes as appropriate
  • Capture all billable charges
• Review billing records for supporting documentation as needed for accurate coding and to maximize revenue
  • Identify and split bill cosmetic or case rate cases as needed
• Review or facilitate review of facility medical records for supporting documentation as needed and as available for accurate coding and to maximize revenue.
• Understand the importance and the process of holding a claim as needed until sufficient information can be obtained for proper billing and to maximize reimbursement.
• Review charges that are sent back from the billing department for additional information and make necessary corrections.
• Maintain certification CEU requirements.

• Maintains strictest confidentiality.
• Adhere to all company policies and procedures.

Qualifications

The requirements listed below are representative of the knowledge, skill, and ability required.

Qualifications include:

• 0 2 years coding experience.
• High School graduate or equivalent.
• Associate degree preferred.
• Current CPC or CCS-P required or working toward certification as a condition of employment.
• Knowledge of CPT, ICD-10, ASA and HCPCS coding.
• Knowledge of all payer rules and regulations.
• Knowledge of medical terminology and anatomy.
• Ability to multi-task and prioritize needs in order to meet timelines.
• Knowledge of organization policies, procedures and systems.
• Skill in computer applications including MS Word, MS Excel.
• Skill in verbal and written communication.
• Skill in gathering and reporting information.
• Ability to work effectively with staff, physicians and external customers.
• Must have a pleasant disposition and be a team player.
• Ability to work independently with limited supervision.
• Must report to work consistently, on time, and for expected duration.
• Ability to read, write, and speak English.

Working conditions and physical requirements

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

• Requires prolonged sitting, some bending, stooping and stretching.
• Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment.
• Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations.
• Requires lifting papers and boxes weighing up to 35 pounds occasionally.
• Requires dexterity to type at least 35 wpm.
• Work performed in office environment.
• Involves frequent contact with professional staff and managed care organizations.
• Work may be stressful at times.
• Interaction with others is frequent and often disruptive.

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Title: Nurse Practitioner

Location: Remote US

LetsGetChecked is a leading at-home health testing company, with a platform that allows consumers to discover and access personalized health information conveniently, confidentially and accurately. We empower people to take an active role in their health to live longer, happier lives. LetsGetChecked was founded in 2015 and has corporate offices located in New York City and Dublin.

Nurse Practitioner

Due to continued success and growth, we have the need to expand our team of clinicians. You will be joining Mammoth Health, LetsGetChecked’s exclusive partner in providing first class clinical care to our patients in the US.

You will be acting as a Nurse Practitioner interacting directly with patients and helping construct and drive evolving clinical care initiatives and pathways. MD supervision will be provided by Mammoth Health’s lead physician.

Responsibilities

• The role’s primary responsibility is to daily conduct virtual/remote visits with patients through telemedicine modalities to include asynchronous chat and video technologies
• Ask intuitive questions to patient’s to discover the root cause of illness
• Reach an informed diagnosis based on scientific knowledge and the patient’s medical history
• When appropriate, E-prescribe medications and provide comprehensive insight into medication
• management
• Maintain a comprehensive medical record of the patient’s complete health history using
• LetsGetChecked’s proprietary HALO electronic medical record platform.
• Cultivate an environment of trust and compassion between patients and clinician
• Contribute clinical content that will support business initiatives (website, ePrescriptions, client
• communications, care pathways)
• Ensure patient and nursing content is medically accurate, safe and accessible to the audience
• and will improve the overall quality and value of patient interactions.
• Protocol Development-Develop and maintain protocols and standard operating procedures for
• all new tests and programs offered by LGC.
• Improve the Quality and Value of Patient Interactions
• Be a Clinical resource and provide insight and support for other LetsGetChecked teams including
• but not limited to Nursing/Customer Support/Legal/ Compliance/Quality
• Liaise with Quality and Compliance to ensure issues are appropriately addressed and resolved
• and create policies with the view of mitigating against future errors. Work with Product to
• reduce technical related risk of error which impacts upon the patient experience and safety.

What we are looking for ..

• A Board Certified Nurse Practitioner, licensed in 50 states
• Minimum of 2 years of primary care experience
• Telehealth experience strongly preferred
• Bilingual (Spanish/English language) a plus
• Strong understanding of examination methodologies and diagnostics
• Proficiency in common medication indications, side effects, and contraindications
• A caring, compassionate inidual who enjoys helping others and providing a positive care experience in a telemedicine platform
• Care providers who are flexible and interested in working in a telemedicine environment with frequent change / product improvements, and who are extremely comfortable using new technology and software
• Advanced computer skills including typing speed, email, internet research, downloading and uploading files, and working in multiple browser windows
• Excellent oral and written communication skills
• Respect for patient confidentiality
• Compassionate and approachable
• Responsible and trustworthy
• Willingness to be flexible about working hours and days as there may sometimes be a need to
• help out the clinical team on off hours and/or weekends.

Benefits:

Alongside base salary of $110,000-$130,000 per year, we offer a range of benefits including:

• Health, dental & vision insurance
• 401k Matching contribution
• Employee Assistance Programme
• Annual Compensation Reviews
• 15 days paid time off and 3 paid volunteer days per year
• Free monthly LetsGetChecked tests as we are not only focused on the well being of our patients but also the well being of our teams
• A referral bonus programme to reward you for helping us hire the best talent
• Internal Opportunities and Careers Clinics to help you progress your career
• Maternity, Paternity, Parental and Wedding leave

Why LetsGetChecked?

Together we have a common goal to help people live longer, happier lives.

We want our employees to be healthy, travel often, and have the financial resources and support they need to live a fulfilling life, both inside and outside of work. We encourage our employees to build their careers at LetsGetChecked. We run regular career training clinics, interview assistance, and encourage employees to apply for internal opportunities. We support Learning & Development through our partner Udemy.

Diversity, Equity & Inclusion:

As we continue to grow, LetsGetChecked is fully committed to creating an inclusive environment where erse backgrounds, perspectives and experiences are valued, where each and every one of our people feels that they belong and are empowered to do the best work of their career.

To learn more about LetsGetChecked and our mission to help people live longer, healthier lives please visit https://www.letsgetchecked.com/careers/

Triage Registered Nurse (Part-Time Nights)

REMOTE

CLINICAL STRATEGY AND SERVICES – CLINICAL TEAM

PART-TIME

The Remote Triage Registered Nurse / RN supports patients and their families by providing clear, safe and effective telephone triage using evidence-based processes and tools. The Registered Nurse on this team will blend critical thinking skills with a decision support tool enabling safe, standardized care to our patient population.

Two (2) Part-Time Night / Evening positions available!

Shift/Schedule:

PTE 1:

Week 1: Mon 7p-4a (8h), Thurs 7p-11p (4h), Fri 7p-4a (8h) PST

Week 2: Mon 7p-11p (4h), Sat and Sun 7p-4a PST

PTE 2:

Week 1: Mon 7p-11p (4h), Sat and Sun 7p-4a PST

Week 2: Mon 7p-4a (8h), Thurs 7p-11p (4h), Fri 7p-4a (8h) PST

Essential Job Duties:

• • Respond promptly to each incoming call and assist patients by providing standardized care and benefits navigation, while quickly developing a friendly, yet professional rapport over the phone
  • Conduct a thorough clinical assessment of symptoms and confidently determine the appropriate level of care required to safely meet the patient’s medical need, and refer them using established guidelines
  • Follow standard procedures and protocols related to the triage service
  • Educate and communicate recommendations to patients thoroughly in patient-friendly language
  • Successfully route members to additional internal/external benefits and community resources, when needed
  • Provides care based upon the Included Health Core Values
  • Provides triage and support for urgent member prescription needs
  • Serves as a central point of contact for all Included Health member emergency escalations
  • Participate in team meetings and continuous quality improvement

Requirements:

• • Bachelor of Science in Nursing required
  • Registered Nurse, currently residing and licensed in a compact state with eligibility to obtain RN licensure in all 50 states
  • 2+ years experience in a triage setting, preferably some of that experience being focused on phone triage, or 2+ years experience in an emergency room, or 4+ years experience in an ambulatory primary care role that included triage
  • Ability to work in PST Timezone
  • Rotating holiday and weekend rotation (every 3rd weekend for Full Time and every other weekend for Part Time)
  • Expertise in advanced clinical decision making
  • Comfortable working with a wide variety of medical conditions for both pediatric and adult populations
  • Experience in engagement in complex decision making, including situations of uncertainty
  • Excellent written and verbal communication skills. The ability to gather a clinical history, answer questions at a patient level, and succinctly summarize findings is critical.
  • Strong competence and ability to use multiple computer/medical record systems, as well as Google suite
  • Must be able to work efficiently. We are a fast growing company and we are busy. Our team is expected to meet role specific metrics without sacrificing quality. Good judgment for balancing priorities is a must.
  • Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.

Other Skills/Abilities:

• • Self-disciplined, energetic, passionate, innovative and flexible
  • Must be able to work independently remotely and work well under stress
  • A team player that can follow a system and protocol to achieve a common goal
  • Demonstrates sound judgment, independent decision-making and problem-solving skills
  • Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.
  • Maintains professional demeanor and service-oriented patient focus to prioritize the patient experience
  • Possess the ability to multitask, and using best judgement when to seek additional input from leadership

#LI-Remote

About Included Health

Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.

Registered Dietician Part Time

REMOTE 

MEMBER EXPERIENCE – MEMBER SUPPORT

PART TIME

REMOTE

Sword Health is on a mission to free two billion people from pain as the world’s first and only endtoend platform to predict, prevent and treat pain.

Delivering a 62% reduction in pain and a 60% reduction in surgery intent, at Sword, we are using technology to save millions for our 2,500+ enterprise clients across three continents. Today, we hold the majority of industry patents, win 70% of competitive evaluations, and have raised more than $300 million from top venture firms like Founders Fund, General Catalyst, and Khosla Ventures.

Recognized as a Forbes Best Startup Employer in 2023, this award highlights our focus on being a destination for the best and brightest talent. Not only have we experienced unprecedented growth since our market debut in 2020, but we’ve also created a remarkable mission and valuedriven environment that is loved by our growing team. With a recent valuation of $2 billion, we are in a phase of hyper growth and expansion, and we’re looking for iniduals with passion, commitment, and energy to help us scale our impact.

Joining Sword Health means committing to a set of core values, chief amongst them to “do it for the patients” every day, and to always “deliver more than expected” on behalf of our members and clients.

This is an opportunity for you to make a significant difference on a massive scale as you work alongside 800+ (and growing!) talented colleagues, spanning two continents. Your charge? To help us build a painfree world, powered by technology, enhanced by people — accessible to all.

We are looking for a dedicated and qualified Dietitian to join our team. The ideal candidate will hold a Bachelor’s degree in nutrition and be a registered dietitian (RD). This role primarily involves providing member care treatment and contributing to the creation and curation of content related to nutrition, both written and in audio/video formats.As a Registered Dietitian, you will play a critical role in improving the health and wellbeing of our members through nutrition counseling and education. Your responsibilities will include creating nutritional plans, and providing nutrition guidance to patients. Additionally, you will contribute to the development and management of nutrition related content, including written, video, and audio materials.

What you’ll be doing:

Member Care Treatment:

• Collaborate with PTs to identify patients in need of nutrition counseling.
• Conduct inidual nutrition assessments and evaluations.
• Develop personalized dietary plans and recommendations for clients with various nutritional needs.
• Provide evidence based dietary counseling to address health issues, weight management and dietary restrictions.
• Offer ongoing support and education to clients.
• Refer patients to community resources as necessary to support their nutritional goals.

Content Creation and Curation:

• Collaborate with the content team to create written, audio, and video content related to nutrition.
• Develop engaging and informative content that aligns with the organization’s nutrition objectives.
• Ensure content is accurate, evidencebased, and accessible to a erse audience.
• Participate in content planning, brainstorming, and strategy meetings.
• Collaborate with the marketing and communications team to promote nutritionrelated content.
• Ensure compliance with all relevant nutrition and dietetics regulations and guidelines.

Collaboration:

• Collaborate with other healthcare professionals, including psychologists and physicians, to provide comprehensive care to members

What you need to have:

• Bachelor’s degree in nutrition, dietetics, or related field from an accredited institution.
• Registered Dietitian (RD/ RDN) credential.
• Minimum of 2 years experience providing nutritional and dietary counseling
• Strong understanding of nutrition science and its practical applications.
• Excellent communication skills, both written and verbal.
• Empathetic and clientcentered approach to care.
• Ability to work collaboratively in a teambased environment.
• Proficiency in creating written, audio, and video content is a plus.
• Eligibility for Essential benefits: Fulltime employees regularly working 25+ hours per week

US Sword Benefits:

• *Eligibility for Essential benefits: Fulltime employees regularly working 25+ hours per week
• Comprehensive health, dental and vision insurance
• Equity Shares
• 401(k)
• Discretionary PTO Plan
• Parental leave

US Sword Perks:

• Flexible working hours

Remotefirst Company

• Internet Stipend for remote working
• Paid Company Holidays
• Free Digital Therapist for you and your family

Portugal Sword Benefits:

• Health, dental and vision Insurance
• Meal Allowance
• Equity Shares

Portugal Sword Perks:

• Remote Work Allowance
• Flexible working hours
• Work from home
• Unlimited Vacation
• Snacks and Beverages
• English Class
• Unlimited access to Coursera Learning Platform

*US Applicants Only: Applicants must have a legal right to work in the United States, and immigration or work visa sponsorship will not be provided.*

SWORD Health, which includes SWORD Health, Inc. and Sword Health Professionals (consisting of Sword Health Care Providers, P.A., SWORD Health Care Providers of NJ, P.C., SWORD Health Care Physical Therapy Providers of CA, P.C.*) complies with applicable Federal and State civil rights laws and does not discriminate on the basis of Age, Ancestry, Color, Citizenship, Gender, Gender expression, Gender identity, Gender information, Marital status, Medical condition, National origin, Physical or mental disability, Pregnancy, Race, Religion, Caste, Sexual orientation, and Veteran status.

Title: Nurse Clinical Lead

Location: Remote

How will this role have an impact?

The Nurse Clinical Lead is a role within the Network Success team responsible for leadership and generalized oversight of Signify Health’s provider network conducting in-home and virtual health evaluations.

In this role, the Nurse Clinical Lead serves as a lead within Network Success and is responsible for the generalized oversight of ensuring the provider network is meeting quality standards. The Nurse Clinical Lead will serve as the clinical resource for the Diagnostic and Preventive Services department, pilot projects, and escalations related to the provider network. The Nurse Clinical Lead will be responsible for the Covid-19 provider escalations, recommendations and will be required to follow all Signify Health policy and protocols related to Covid-19 and escalate to other departments if additional leadership is needed.

Education/Licensing Requirements:

• RN state licensure (unencumbered) required with ability to apply for licensure in other states
• Bachelor’s degree in nursing, required
• Master’s degree in nursing, preferred

Essential Experience:

• Minimum 2 years RN management experience with remote staff
• Minimum 2 years experience working home health
• Minimum 2 years clinical experience pertinent to the member population(s) being served

Essential Skills Characteristics:

• Fluently speak, read, and write English
• Excellent clinical skills
• Excellent oral and written communication skills
• Ability to adapt to rapidly changing technology and apply to business needs
• Ability to identify, analyze, and resolve business issues through solution-oriented projects
• Demonstrated customer service/customer relationship management acumen
• Willingness to promote corporate goals and objectives to the provider network and staff throughout the Signify Health enterprise.
• Ability to perform in a high-pressure environment and/or crisis situation and render good decisions to resolve the problems
• Proven ability to prioritize and multi-task
• Demonstrated ability to achieve results through team-based efforts
• Willingness to challenge established practices and draw relevant conclusions
• Basic skills in MS Office; moderate skills in Google
• Ability to effectively direct and oversee the work of others remotely
• Ability to develop, read, analyze, and interpret complex documents
• Possess critical thinking skills
• Possess strong attention to detail and organization

Essential Job Responsibilities:

RN Clinical Lead:

• Generalized oversight of ensuring the provider network is meeting quality standards
• Serve as the clinical resource for the Diagnostic and Preventive Services department, pilot projects, and escalations related to the provider network
• Responsible for the Covid-19 provider escalations, recommendations and will be required to follow all Signify Health policy and protocols related to Covid-19 and escalate to other departments if additional leadership is needed
• Point of contact for clinical leadership to the provider network as needed
• Provide ancillary service training to clinicians as needed
• Provides general support to the Network Success team as needed

Additional Job Responsibilities:

• Participate in staff meetings, conference calls, and other meetings as needed
• Attend training sessions to acquire/enhance skills related to programs offered
• Complete reports/projects/tasks as requested by the Sr. Nurse Clinical Manager
• Daily troubleshooting of program/processes as indicated
• Ability to travel 20-30% of the time air/land travel, may include some overnights and weekends
• Perform other incidental and related duties as required

Essential Characteristics:

• Strategic thinker
• Results driven
• Detail-oriented
• Self-directed and organized
• Sound judgment in handling/escalating difficult situations
• Sense of urgency
• Good interpersonal and conflict resolution skills
• Discrete (i.e., ability to maintain confidentiality)
• Team player
• Ability to work under pressure
• Ability to take direction

Working Conditions:

• Fast-paced environment
• Requires working at a desk to use a phone and computer
• Use office equipment and machinery effectively
• Work effectively with frequent interruptions
• Ability to ambulate to various parts of the building
• Ability to bend, stoop
• Lifting requirements of 20 pounds occasionally unassisted
• May require additional hours to meet project deadlines

About Us:

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across iniduals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for iniduals who need help the most. This leads to better outcomes and a better experience for everyone involved. Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million iniduals each year while helping payers and providers more effectively implement value-based care programs. To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com.

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.

We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.

#LI-RH1

Coding and QA Specialist (13222)

Functional Area

Teammate – Revenue Cycle

City

Remote

Work Location Type

Remote

Employment Type

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

PRACTICE OVERVIEW

Radiology Partners is the largest and fastest growing on-site radiology practice in the US. We are an innovative practice focused on transforming how radiologists provide consistently exceptional services to hospitals, imaging centers, referring physicians and patients. With our state-of-the art clinical technology, specialized expertise, access to capital, and retention of top physician talent, Radiology Partners reliably exceeds the expectations of our clients, patients, and partners. We serve our clients with an operational focus, and, above all, a devotion to quality patient care. Our mission is To Transform Radiology.

POSITION SUMMARY

Radiology Partners is seeking a Coding and QA Specialist to represent Radiology Partners by coding and correcting reports. Accurate coding of reports will provide customer satisfaction throughout the claim process and assure full collections for account resolution, providing the company with a firm foundation for growth potential and ensuring sustainability.

POSITION DUTIES AND RESPONSIBILITIES

Assign ICD and CPT codes to properly identify the procedures performed, while following Correct Coding Initiative and Medicare Local Coverage of Determination & NCD edits and Managed Care payer edits as needed, to ensure accurate coding for services. Review charges coded by vendor or autocoder, identifying coding or logic errors and sharing with Supervisor. Work with Supervisor, the Coding Team and outsource vendor to resolve coding issues. Review and correct coding denials, identifying trends in payer requirements and communicate findings back to Supervisor for coder education. Work with AR team to ensure denials are processed correctly. Process claim rejections from clearinghouse related to coding. Maintain regulatory compliance by staying abreast of current trends and regulations in the financial and healthcare industries. Promote a culture that reflects the organization’s values, encourages good performance, and enhances productivity. Contribute to team effort by accomplishing related results as needed. Perform other duties as assigned.

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE

High School diploma or General Education Degree (GED) highly preferred or two years related experience and/or training Certification through the American Health Information Management Technician (AHIMA) as one of the following: Registered Health Information Management Technician (RHIT), Registered Health Information Management Technician (RHIA), Certified Coding Specialist (CCS), or Certified Coding Specialist-Physician Based (CCS-P), or certified through the American Association of Procedural Coders (AAPC) as a Certified Professional Coder (CPC) Intermediate computer proficiency is required in this role At least one year of Radiology coding and Interventional Radiology coding experience is necessary for this position Oncology Coding experience a plus Excellent communication skills and attention to detail Ability to deal with problems involving a few concrete variables in standardized situations Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources Must have knowledge of ICD-10 and CPT

Radiology Partners is an equal opportunity employer. We believe in creating and celebrating a culture of belonging and are committed to creating an inclusive environment for all teammates.

CCPA Notice: 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.

Radiology Partners participates in E-verify.

Member Advocate

Remote

About us:

Parsley Health is a digital health company with a mission to transform the health of everyone, everywhere with the world’s best possible medicine. Today, Parsley Health is the nation’s largest health care company helping people suffering from chronic conditions find relief with root cause resolution medicine. Our work is inspired by our members’ journeys and our actions are focused on impact and results.

The opportunity:

As a Member Advocate, you will provide a high level of customer service to Parsley Health Members by corresponding to inquiries both via email, SMS, and over the phone, performing onboarding calls, managing cancellation requests, answering questions about the Program, and resolving member complaints in a professional and timely manner. This role works closely with our clinical and sales departments to ensure member satisfaction and loyalty. PST hours are preferred.

What you’ll do:

• Provide exceptional member service through prompt, accurate, and knowledgeable responses to member inquiries and complaints
• Maintain ownership of member issues from receipt of the initial request to resolution
• Follow up with members to ensure their issues have been resolved to their satisfaction
• Maintain a comprehensive understanding of the company’s products and services
• Utilize member feedback to identify opportunities for improvement and report trends
• Assist in developing initiatives to enhance member experience and satisfaction
• Manage inbound and outbound member inquiries via phone, SMS, and our online messaging platform.
• Escalate unresolved member questions to the appropriate department to ensure a quick turnaround for all member inquiries
• Ability to think on your feet and de-escalate member situations
• Assist members with renewal questions and encourage continued care
• Collect feedback from members and process cancellations
• Support members’ scheduling and member portal navigation needs and– troubleshooting as needed
• This is an evolving and growing department, and role requirements may change and expand as Parsley Health grows.
• Other duties as assigned

What you’ll need:

• At least one year of relevant work experience in a one-to-one client/patient-facing
• Healthcare tech/start-up experience preferred
• An empathetic customer-service approach that ensures your members feel heard and cared for
• Call management system experience preferred (i.e., Regal.io)
• A passion for helping others
• Excellent oral and written communication skills
• Can comfortably resolve issues over the telephone
• A detail-oriented mindset with a knack for organization and clarity – nothing slips through the cracks
• Proactivity, autonomy, and commitment to excellence in your work
• Flexibility as roles and responsibilities are subject to change and new ones may be assigned
• Ability to work from home in a quiet space to conduct phone calls.

Benefits and Compensation:

• Equity Stake
• 401(k) + Employer Matching program
• Remote-first with the option to work from one of our centers in NYC or LA
• Complimentary Parsley Health Complete Care membership
• Subsidized Medical, Dental, and Vision insurance plan options
• Generous 4+ weeks of paid time off
• Annual professional development stipend

Parsley Health is committed to providing an equitable, fair and transparent compensation program for all employees.

The starting salary for this role is $24.25/hour, depending on skills and experience. We take a geo-neutral approach to compensation within the US, meaning that we pay based on job function and level, not location.

Inidual compensation decisions are based on a number of factors, including experience level, skillset, and balancing internal equity relative to peers at the company. We expect the majority of the candidates who are offered roles at our company to fall healthily throughout the range based on these factors. We recognize that the person we hire may be less experienced (or more senior) than this job description as posted. If that ends up being the case, the updated salary range will be communicated with candidates during the process.

At Parsley Health we believe in celebrating everything that makes us human and are proud to be an equal opportunity workplace. We embrace ersity and are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We believe that the more inclusive we are, the better we can serve our members.

Important note:

In light of recent increase in hiring scams, if you’re selected to move onto the next phase of our hiring process, a member of our Talent Acquisition team will reach out to you directly from an @parsleyhealth.com email address to guide you through our interview process.

Please note:

• We will never communicate with you via Microsoft Teams
• We will never ask for your bank account information at any point during the recruitment process, nor will we send you a check (electronic or physical) to purchase home office equipment

We look forward to connecting!

#LI-Remote

Remote Coder

locations

Remote – USA

time type Full time

posted on Posted Today

job requisition id R002756

Company:

AHI agilon health, inc.

Job Posting Location:

Remote – USA

Job Title:

Remote Coder

Job Description:

Essential Job Functions:

• Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered.
• Review medical record information to identify all appropriate coding based on CMS HCC model.
• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
• Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
• Support and participate in process and quality improvement initiatives.
• Maintain a comprehensive tracking and management tool to track all HCC activities and ensure that all tasks are completed in a timely manner.
• Performs AHIMA compliant queries to providers when necessary
• Participate in ongoing training and education within assigned timeframe
• May participate in special project auditing as required
• All other duties as assigned

Other Job Functions:

• Understand, adhere to, and implement the Company’s policies and procedures.
• Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.
• Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
• Engage in excellent communication which includes listening attentively and speaking professionally.
• Set and complete challenging goals.
• Demonstrate attention to detail and accuracy in work product by meeting productivity standards and maintaining a company standard of accuracy

Location:

Remote – TX

Pay Range:

$24.00 – $28.70

Salary range shown is a guideline. Inidual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.

Title: Triage Registered Nurse

Location: US National

CLINICAL STRATEGY AND SERVICES CLINICAL TEAM

PART-TIME/ REMOTE

The Remote Triage Registered Nurse / RN supports patients and their families by providing clear, safe and effective telephone triage using evidence-based processes and tools. The Registered Nurse on this team will blend critical thinking skills with a decision support tool enabling safe, standardized care to our patient population.

Two (2) Part-Time positions available!

Shift/Schedule:

Week 1: Mon, Tues, Thurs, and Fri 3p-7p PST

Week 2: Mon and Fri 3p-7p; Sat and Sun 11a-8p PST

Essential Job Duties:

• • Respond promptly to each incoming call and assist patients by providing standardized care and benefits navigation, while quickly developing a friendly, yet professional rapport over the phone
  • Conduct a thorough clinical assessment of symptoms and confidently determine the appropriate level of care required to safely meet the patient’s medical need, and refer them using established guidelines
  • Follow standard procedures and protocols related to the triage service
  • Educate and communicate recommendations to patients thoroughly in patient-friendly language
  • Successfully route members to additional internal/external benefits and community resources, when needed
  • Provides care based upon the Included Health Core Values
  • Provides triage and support for urgent member prescription needs
  • Serves as a central point of contact for all Included Health member emergency escalations
  • Participate in team meetings and continuous quality improvement

Requirements:

• • Bachelor of Science in Nursing required
  • Registered Nurse, currently residing and licensed in a compact state with eligibility to obtain RN licensure in all 50 states
  • 2+ years experience in a triage setting, preferably some of that experience being focused on phone triage, or 2+ years experience in an emergency room, or 4+ years experience in an ambulatory primary care role that included triage
  • Ability to work in PST Timezone
  • Rotating holiday and weekend rotation (every 3rd weekend for Full Time and every other weekend for Part Time)
  • Expertise in advanced clinical decision making
  • Comfortable working with a wide variety of medical conditions for both pediatric and adult populations
  • Experience in engagement in complex decision making, including situations of uncertainty
  • Excellent written and verbal communication skills. The ability to gather a clinical history, answer questions at a patient level, and succinctly summarize findings is critical.
  • Strong competence and ability to use multiple computer/medical record systems, as well as Google suite
  • Must be able to work efficiently. We are a fast growing company and we are busy. Our team is expected to meet role specific metrics without sacrificing quality. Good judgment for balancing priorities is a must.
  • Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.

Other Skills/Abilities:

• • Self-disciplined, energetic, passionate, innovative and flexible
  • Must be able to work independently remotely and work well under stress
  • A team player that can follow a system and protocol to achieve a common goal
  • Demonstrates sound judgment, independent decision-making and problem-solving skills
  • Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.
  • Maintains professional demeanor and service-oriented patient focus to prioritize the patient experience
  • Possess the ability to multitask, and using best judgement when to seek additional input from leadership

Title: Registered Nurse Care Manager – Remote, nationwide

Location: United States

Full time

Description

The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member’s physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.

Responsibilities

The first 4 weeks of training will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training. Following training, the start time is 10:00AM EST.

Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence, while using a multidisciplinary team.

This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are work at home associates, working from a dedicated home office space. Work at home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all time with demonstrated advanced communication and interpersonal skills.

This is a very compliance driven and highly visible program at Humana. The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. Environment is fast paced and requires ability to engage quickly with member while concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility in care manager’s schedule.

Duties:

• Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members’ progress toward goals
• Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)
• Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc.
• Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
• Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention

#LI-Remote

This is a remote position

Required Qualifications

• Active Registered Nurse (R.N.) license with no disciplinary action.
• Hold an active Compact nursing license and reside in the state that holds your compact license.
  • The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. License must be current with no disciplinary action.
• Minimum education of an Associates degree in Nursing.
• Minimum of 3 years of clinical nursing experience as a RN.
• Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of inidualized care planning.
• Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors.
• Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.
• Experience with Microsoft and Excel
• Ability to quickly learn and navigate software programs and applications.
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Effective communication and interpersonal skills.
• Effective problem solving and appropriate application of clinical knowledge
• Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.
• Must possess advanced telephonic and virtual communication skills.

Preferred Qualifications

• BSN or MSN degree in nursing or equivalent
• CCM
• Bi-lingual in Spanish and English
• Previous adult chronic conditions care management
• Previous experience in care management including knowledge of complex care management and care management principles
• Experience with motivational interviewing
• Experience with MCG or CMS guidelines, assessment and documentation practice
• Inidual licenses in non-compact states

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates‘ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
• Associates 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 or Hybrid Home/Office associates 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

Additional Information – How we Value You

Benefits starting day 1 of employment Competitive 401k match Generous Paid Time Off accrual Tuition Reimbursement Parent Leave Go365 perks for well-being

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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$69,800 – $96,200 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.

CLINICAL AUDITOR, COMPLIANCE (RN) – REMOTE

Molina Healthcare

United States

Job ID 2022676

JOB SUMMARY

Molina Healthcare’s Compliance team supports compliance operations for all Molina product lines enterprise-wide. It is a centralized corporate function supporting compliance activities at inidual state health plans.

Reporting to the Compliance Manager, the Compliance Nurse Auditor is responsible for designing and conducting Compliance Clinical Audits that effectively prevents and/or detects violations of applicable federal, state and local laws, regulations and contracts. Ensures compliance with established internal control procedures by examining records, reports, operating practices, and documentation.

JOB DUTIES

• Performs on-going internal compliance clinical audits, regulatory validation audits and ad hoc audits, by developing audit tools and in some instances, building regulatory matrices.
• Works with key stakeholders (business areas, compliance officers et. al.) to identify and define audit scopes and criteria and Develop audit objectives, plans, and scope by reviewing available information and conducting research.
• Completes audit workpapers by documenting audit tests and findings.
• Appraises adequacy of internal department processes by reviewing cases, documentation, processes and/or other applicable documentation that supports the business.
• Appraises adequacy of internal control systems by reviewing monitoring and audit tools, key performance indicators, training documents and/or other applicable documentation.
• Maintains internal control systems by updating audit tools and questionnaires, and recommending new policies and procedures, key performance indicators and corrective actions when appropriate.
• Communicates audit findings by preparing a final report and discussing findings with the business areas, Compliance Officers and others as appropriate.

REQUIRED EDUCATION:

Registered Nurse

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

1-3 years

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Registered Nurse

PREFERRED EDUCATION:

Bachelor‘s degree in health care related area.

PREFERRED EXPERIENCE:

3-5 years experience.

Medicaid & Medicare experience.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

LVN, LPN or Registered Nurse, R

Pay Range: $49,930 – $99,980 a year*

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

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.

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

Specialist-HIMS – Remote

Job ID 316290

Rochester, MN

Full Time

Health Information Management Services

Why Mayo Clinic

Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting ersity, equity and inclusion, and provides the resources you need to succeed.

Responsibilities

Analyzes patient information to ensure compliance with standards established by Federal/State & Joint Commission & CMS regulations. Coordinates with clinicians to ensure documentation contains all required elements and is completed in a timely manner. Adheres to institutional policies regarding health care documentation. Utilizes independent analytical and critical thinking skills. Works independently and collaboratively across the enterprise with minimal supervision.

Adheres to guidelines with regard to accessing minimum necessary information to complete job function. Adheres to state and federal rules regarding privacy and confidentiality of protected health information. Leverages technology to serve the patients and practice. Professionally communicates through all electronic, written, and verbal methods. Ensures great customer service while assisting patients, care providers, allied health staff, attorneys, insurance companies, government audits, and others in a courteous, professional and confidential manner. Identified Candidate will train for 10-12 weeks on day shift before moving to permanent shift utilizing CORE/Variable hours. If you have any questions, please contact HR.

** Visa sponsorship is not available for this position; Also, Mayo Clinic DOES NOT participate in the F-1 STEM OPT extension program**

This Position is 100% Remote can work from anywhere within the United States

Qualifications

Associate of Science degree in a healthcare related discipline required (i.e., applied health sciences A.S. degree). Associate of Science degree in Health Information Technology preferred. Health Information Technology (HIT) program students actively completing the last semester of their associate degree program will be considered; successful completion of HIT Associate degree is required within 6 months of hire date for continued employment.Must possess knowledge of medical records format and content and be able to perform work in a fast paced, constant change, production environment with a focus on quality.

Must possess excellent customer service skills and be able to clearly, concisely and professionally communicate verbally and in written forms. Demonstrated ability to maneuver in multi technology environment and demonstrates proficiency in Microsoft Office (Excel, Word, and Outlook) applications. Keyboarding skills necessary, with intermediate typing/keyboard/computer skills. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred. Flexible, hard working, self-motivated

Exemption Status Nonexempt

Compensation Detail $18.59 – $25.50/hourly; Education, experience and tenure may be considered along with internal equity when job offers are extended.

Benefits Eligible Yes

Schedule Full Time

Hours/Pay Period 80

Schedule Details M-F, Rotating Weekends, CORE and Variable Hours; 3:00pm-3:00am / CORE hours 3:00pm-7:00pm

Weekend Schedule M-F, Rotating Weekends, CORE and Variable Hours; 3:00pm-3:00am / CORE hours 3:00pm-7:00pm

International Assignment No

Site Description

Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.

Affirmative Action and Equal Opportunity Employer

As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the ersity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.

Virtual Nurse Practitioner or Physician Assistant (DC License Required)

• Req Number: 5316126

About Us

One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn’t your average doctor’s office. We’re on a mission to transform healthcare, which means improving the experience for everyone involved – from patients and providers to employers and health networks. Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years.

In February 2023 we marked a milestone when One Medical joined Amazon. Together, we look to deliver exceptional health care to more consumers, employers, care team members, and health networks to achieve better health outcomes. As we continue to grow and seek to impact more lives, we’re building a erse, driven and empathetic team, while working hard to cultivate an environment where everyone can thrive.

The Opportunity:

The One Medical Virtual Medical Team (VMT) is a leading provider of virtual clinical care, providing world-class, convenient, evidence-based virtual medical care to One Medical patients in concert with their primary care providers. Through advanced technology and a team-based approach, we care for patients 24 hours a day, 365 days a year. Our team is united by intellectual curiosity, inclusiveness, and a powerful mission: transforming healthcare and bringing world-class primary care to everyone.

Employment type:

• Full time (32 hours minimum including evenings and weekends)

What you’ll be working on:

• Treating patients via tele-health visits, including telephonic triage calls, video visit appointments, and email follow-ups
• Continuous learning during weekly Clinical Rounds and through other modalities
• Ongoing collaboration with both virtual teammates via daily huddles
• Utilization ofyour specific clinical training and opportunities to give exceptional care to patients virtually

Education, licenses, and experiences required for this role:

• Completed an accredited FNP or PA program with a national certification
• Currently licensed in Washington DC with ability to obtain additional state licenses as needed
• In the past 5 years, practiced as an Advanced Practitioner for at least:

• 2 years in an outpatient primary care setting seeing patients of all ages (0+), OR 2 years in an urgent care or emergency medicine setting seeing patients of all ages (0+) Ability to work weekday and weekend shifts (every other Saturday and Sunday required)

• Ability to work afternoons and evenings
• Excellent clinical and communication skills

An example schedule for this role:

Week A:

Monday: 1pm-10pm ET

Tuesday: 1pm-10pm ET

Thursday: 1pm-10pm ET

Saturday: 1pm-10pm ET

Sunday: 1pm-10pm ET

Week B:

Monday: 1pm-10pm ET

Tuesday: 1pm-10pm ET

Thursday: 1pm-10pm ET

One Medical providers also demonstrate:

Benefits designed to aid your health and wellness:

Taking care of you today

Protecting your future for you and your family

Supporting your medical career

This is a full-time virtual role.

One Medical

is committed to fair and equitable compensation practices.

The base hourly range for this role is $53.50 per hour to $59.00 per hour based on a full-time schedule. Final determination of starting pay may vary based on factors such as practice experience and patient care schedule. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. The total compensation package for this position may also include RSUs, benefits and/or other applicable incentive compensation plans. For more information, visit https://www.onemedical.com/careers/

One Medical is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.

One Medical participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Please refer to the E-Verification Poster (English/Spanish) and Right to Work Poster (English/Spanish) for additional information.

• A passion for human-centered primary care
• The ability to successfully communicate with and provide care to iniduals of all backgrounds
• The ability to effectively use technology to deliver high quality care
• Clinical proficiency in evidence-based primary care
• The desire to be an integral part of a team dedicated to changing healthcare delivery
• An openness to feedback and reflection to gain productive insight into strengths and weaknesses
• The ability to confidently navigate uncertain situations with both patients and colleagues
• Readiness to adapt personal and interpersonal behavior to meet the needs of our patients
• Paid sabbatical after 5 and 10 years
• Employee Assistance Program – Free confidential advice for team members who need help with stress, anxiety, financial planning, and legal issues
• Competitive Medical, Dental and Vision plans
• Free One Medical memberships for yourself, your friends and family
• Pre-Tax commuter benefits
• PTO cash outs – Option to cash out up to 40 accrued hours per year
• 401K match
• Credit towards emergency childcare
• Company paid maternity and paternity leave
• Paid Life Insurance – One Medical pays 100% of the cost of Basic Life Insurance
• Disability insurance – One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance
• Malpractice Insurance – Malpractice fees to insure your practice at One Medical is covered 100%.
• UpToDate Subscription – An evidence-based clinical research tool
• Continuing Medical Education (CME) – Receive an annual stipend for continuing medical education
• Rounds – Providers end patient care one hour early each week to participate in this shared learning experience

Title: Pro Fee Coder- General Surgery

Location: United States

US – Remote (Any location)

Full time

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

The General Surgery Coder must be proficient in surgical coding for all Trauma Surgery type cases. E/M experience is also required for associated providers. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines. This position is full time and 100% remote.

Demonstrates the ability to perform quality surgical coding on General and Trauma surgery chart types as assigned.

Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing. Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards. Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility. Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary. Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines. Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility. Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request. Coders must maintain their current professional credentials while working for Guidehouse. Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility. Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy) It is the responsibility of each coder to review and adhere to the coding ision policy and procedure manual content. Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.

What You Will Need:

Minimum 3-5 years General Surgery Coding experience, both IP and OP coding for physician claims.

2-3 years coding Trauma or other complex procedures.

CPC certification from AAPC EMR experience Must maintain credential throughout employment Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients Excellent verbal, written and interpersonal communication skills Advanced knowledge of Excel, Word and PowerPoint High level of accuracy Strong Working Knowledge & experience with Federal & State Coding regulations and Guidelines

What Would Be Nice To Have:

COSC credential from AAPC

Multiple EMR and/or practice management systems experience E/M experience along with surgical coding experience (Office, OP and OR procedures

#LI- Remote

The annual salary range for this position is $40,200.00-$72,300.00. 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.

Billing and Coding Specialist

Location: Virtual – Work From Home

Job Id: 1437

# of Openings: 1

About Revecore

Revecore is an innovative, technology-driven company that is committed to helping our clients, our employees, our company, and our communities thrive. An award-winning services firm, partnering with hospitals and health systems, providing the momentum they need to maintain a strong revenue cycle amid today’s evolving healthcare environment.

With a 20+ year history, Revecore is the leading provider of revenue integrity and complex claims solutions for hospitals.

We offer a dynamic and flexible work environment, full of opportunity for motivated, hands-on team players. We strive each day to solve complex business problems and find new ways to enhance the efficiency, effectiveness, and quality of our services. If those attributes resonate with you, regardless of where you are locatedwe want you on our team!

Position Summary

Performs retrospective outpatient coding and both inpatient and outpatient billing reviews in coordination with internal staff in our mission to capture full, fair, and accurate reimbursement for our hospital clients

Duties and Responsibilities

• Support internal and external customers by providing accurate and timely responses to coding and billing questions
• Perform retrospective coding and billing reviews on inpatient and outpatient hospital claims
• Provide correction recommendations to internal associates or clients, and support recommendations with rationale that may include coding guidelines, industry standard billing guidelines, or payer specific guidelines
• Research and stay current on industry changes with regards to coding guidelines and payer specific billing guidelines for commercial and government payers
• Ability to comprehend payment methodologies and how they apply to billing and coding scenarios
• Build strong, lasting relationships with Revecore personnel
• Attend department and company meetings as required
• Comply with federal and state laws, company and department policies and procedures
• Assist with other related responsibilities to meet the needs of the business

Skills and Experience

• Coding certification required, with 1+ years hospital coding/ auditing experience i.e. CPC, COC, CIC, CCS-P, CCS
• Entry level understanding of Managed Care, Medicare and Medicaid billing and reimbursement guidelines
• Entry level understanding of inpatient and outpatient hospital reimbursement methodologies a plus
• Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
• Mathematical skills sufficient to apply the concepts of claim payment methodologies
• Ability to read and interpret an extensive variety of documents such as claims, instructions, policies and procedures in written (in English) and diagram form
• Ability to present ideas on complex, detailed issues with ease
• Ability to define problems, collect data, establish facts and draw valid conclusions
• Strong team player, with willingness to adapt to changing priorities

Physical Demands and Work Environment

The physical demands and work environment characteristics described here are representative of those that must 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.

• Physical Demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to handle or feel objects, tools or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
• Work Environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time. The noise level in the work environment is usually moderate.

Title: Full Time Bilingual Pennsylvania (PA) Licensed Nurse Practitioner (NP) – (English/Spanish) (Remote)

Location: Remote

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a Series B startup with a simple mission: Delivering extraordinary outcomes by unlocking the power of caregivers. We enable people with personal assistance to thrive at home, in their community by assuring their caregivers have the resources, data, and support they need. We achieve this through a combination of analytics, technology, services, and deep healthcare expertise.

Our program monitors in real-time, identifying issues before they become health events, and helping connect those in need with those who can help via technologies such as video, chat, and telephone. Our technology platform includes home-based mobile applications, a clinical dashboard, and data analytics on data not previously available to health professionals. We are disrupting a $109 billion industry and have recently closed our latest funding round with a blue-chip list of investors.

We’re looking to add to our team of experts who care deeply about our mission.

Our team is passionate, driven, collaborative, intellectually curious, and excited about the opportunity to transform our healthcare system. We’re inspired by caregivers and seek to create a platform that recognizes, utilizes and supports the vital role they play. We strive to continuously learn, explore, experiment and achieve results. We are 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 person who’s passionate about working closely with a clinical team to ensure the best clinical outcomes for those we serve. A person who enjoys a fast paced clinical environment, performing telephonic and virtual visits related to proactive chronic care management, remote patient monitoring, and/or resolving more urgent clinical issues quickly. Lastly, someone who aspires to work with a company who is on the leading edge of community health working with partners to allow our elderly to remain at home and free of avoidable hospitalizations.

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 in the state of Pennsylvania (required)
• Master’s or doctoral degree from an accredited institution for nurse practitioners (required)
• Bilingual in English and Spanish (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)
• Experience working in home care and/or family medicine, geriatrics (preferred)
• Experience working within a clinical team environment
• The ability to work remotely and has a private area with a computer in their home/workspace (required)
• 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

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.

MEI Support Specialist

US-Remote

2023-32908

# of Openings: 2

Administrative

Employee Full-Time

Overview

Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer

At Ciox Health we offer all employees a place to grow and expand their current skills to create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

What we need

The MEI Support Specialist position serves as a key role within the Service Operation Division within Ciox. This position will support the Manager of Embedded Support (MEI) Team with performing daily administrative and clerical tasks that will enable the MEI and Service Operations teams to meet customer SLAs and to focus on critical client tasks. The position has specific responsibility for maintaining communication with MEI Leadership at a specific project level, to ensure the strategic plan is executed, as well as incorporating escalation as needed to facilitate completion of retrieval method identified.

Responsibilities

What You Will Do…

• Work closely with MEIs to understand project needs and assist with successful completion of same.
• Ensure timely delivery of reports to MEIs on a daily, weekly and/or monthly basis.
• Perform basic online research, move providers, create new Outreaches, Resolve SH Codes, Set Retrieval Methods, etc. within Ciox Chartfinder platform.
• Perform basic research in Ciox Healthsource platform.
• Log all transactions into the designated Ciox platform.
• Maintain accurate record keeping and data management
• Maintain an excel spreadsheet of daily work as directed.
• Other duties as assigned

Qualifications

What You Need…

• 6-12 months experience in a role similar to ROI medical record retrieval preferred
• Basic computer skills including Windows based applications (Excel and Outlook) and the ability to perform other basic computer functions.

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

Title: Triage Registered Nurse (Nights)

Location: Remote

Type: Full-time

Workplace: remote JobDescription:

The Remote Triage Registered Nurse / RN supports patients and their families by providing clear, safe and effective telephone triage using evidence-based processes and tools. The Registered Nurse on this team will blend critical thinking skills with a decision support tool enabling safe, standardized care to our patient population.

Shift/Schedule:

Sunday-Thursday 7p-4a PST (Pacific Standard Timezone)

Essential Job Duties:

• Respond promptly to each incoming call and assist patients by providing standardized care and benefits navigation, while quickly developing a friendly, yet professional rapport over the phone
• Conduct a thorough clinical assessment of symptoms and confidently determine the appropriate level of care required to safely meet the patient s medical need, and refer them using established guidelines
• Follow standard procedures and protocols related to the triage service
• Educate and communicate recommendations to patients thoroughly in patient-friendly language
• Successfully route members to additional internal/external benefits and community resources, when needed
• Provides care based upon the Included Health Core Values
• Provides triage and support for urgent member prescription needs
• Serves as a central point of contact for all Included Health member emergency escalations
• Participate in team meetings and continuous quality improvement

Requirements:

• Bachelor of Science in Nursing required
• Registered Nurse, currently residing and licensed in a compact state with eligibility to obtain RN licensure in all 50 states
• 2+ years experience in a triage setting, preferably some of that experience being focused on phone triage, or 2+ years experience in an emergency room, or 4+ years experience in an ambulatory primary care role that included triage
• Ability to work in PST Timezone
• Rotating holiday and weekend rotation (every 3rd weekend for Full Time and every other weekend for Part Time)
• Expertise in advanced clinical decision making
• Comfortable working with a wide variety of medical conditions for both pediatric and adult populations
• Experience in engagement in complex decision making, including situations of uncertainty
• Excellent written and verbal communication skills. The ability to gather a clinical history, answer questions at a patient level, and succinctly summarize findings is critical.
• Strong competence and ability to use multiple computer/medical record systems, as well as Google suite
• Must be able to work efficiently. We are a fast growing company and we are busy. Our team is expected to meet role specific metrics without sacrificing quality. Good judgment for balancing priorities is a must.
• Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.

Other Skills/Abilities:

• Self-disciplined, energetic, passionate, innovative and flexible
• Must be able to work independently remotely and work well under stress
• A team player that can follow a system and protocol to achieve a common goal
• Demonstrates sound judgment, independent decision-making and problem-solving skills
• Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.
• Maintains professional demeanor and service-oriented patient focus to prioritize the patient experience
• Possess the ability to multitask, and using best judgement when to seek additional input from leadership

#LI-Remote

About Included Health

Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It s all included. Learn more at includedhealth.com.

Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants in accordance with the San Francisco Fair Chance Ordinance.

Manager, Coding

Location: Remote, United States

Surgical Notes is hiring for a Manager, Coding who is responsible for client management and managing the coding team. 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.

Reports to: Director, Coding

Responsibilities:

• Client management, including emails, phone calls, and video meetings with client staff as well as physicians
• Aid clients in denial management and coding reviews
• Manage a coding team consisting of Team Leads and production coders
• Approve employee time and contractor payroll entries
• Provide training and ongoing education to coders
• Participate in meetings, trainings, and conferences as needed
• Other responsibilities as assigned

Role Information:

• Full-Time
• Salaried
• Exempt
• Eligible for Benefits
• 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:

• Coding certification through AAPC or AHIMA (CPC, COC, RHIT, CCS, etc., no apprentice designation)
• High school diploma or equivalent
• 5+ years of surgical coding experience (ASC or Same-Day Surgery)
• 3+ years management experience
• Extensive knowledge of medical terminology, anatomy, and physiology
• Ability to stay on task, working independently
• Must have a dedicated home office space with reliable high-speed internet (desktop computer will be provided)
• Experience managing a remote team
• ASC revenue cycle knowledge
• Presentation experience
• Ability to work independently and as part of a team
• 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:

• Bachelor’s Degree in healthcare related field
• 4-6 years management experience

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:

• Leadership
• Job Knowledge/Technical Knowledge
• Communication
• Initiative/Execution
• Quality Control

Compensation Information

$57,600 – $72,000 based on skills and qualifications.

US Pay Ranges

$59,287.50—$71,493.75 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.

Privacy Statement

We use the personal information collected for the purpose of processing job applications, evaluating candidates for employment, and/or carrying out and supporting HR functions and activities We may share your personal information in connection with, or during negotiations of, any merger, sales of Company assets, or acquisition of a portion or of all of our business to another company. If you have any questions regarding this California Job Applicant Privacy Notice or our privacy practices, please contact us at [email protected].

Title: Nurse Care Manager

Location: Remote

Company Description

This is an exciting opportunity in a fast-paced, growing digital health startup. The Clinic by Cleveland Clinic, a joint venture between Cleveland Clinic and Amwell, was launched in 2019 to unlock access to the world’s best healthcare expertise so no one is left behind. This startup company’s initial focus is transforming the $5 billion global second opinion market, with additional digital health solutions in development. The Clinic offers virtual care from Cleveland Clinic’s highly-specialized experts through Amwell’s leading-edge digital health technology platform. Learn more at www.theclinic.io.

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey.

Amwell is a leading telehealth platform in the U.S. and globally, connecting and enabling providers, insurers, patients, and innovators to deliver greater access to more affordable, higher quality care. Amwell solutions are used by 240 health systems and 55 health plan partners, covering over 150 million lives.

The position is remote. The role reports to the Director, Clinical Operations.

Brief Overview:

We are looking for an experienced and dynamic nurse committed to delivering empathetic, concierge services to our consumers of the Virtual Second Opinion Services. You will be responsible for establishing a relationship with patients via online/telephone intake through active listening and questioning process, documenting these encounters and providing instruction and creating an opinion timeline based on established protocol.

A strong background in an ambulatory, hospital or telehealth with the ability to function independently in an organized fashion managing a portfolio of patients through the virtual second opinion process is essential to success in this position.

Core Responsibilities:

• Responsible for establishing a relationship with patients and effectively triaging and providing care guidance and resolution to all contacts and patients.
• Assesses patient needs, determines and initiates appropriate action or response to meet identified needs.
• Assesses patient and physician needs, provides requested information and/or guidance or service as appropriate or forwards to the appropriate person on the clinical management team.
• Initiates and independently implements appropriate clinical activities, including communication with patient/caregiver, physician (as applicable) and complete documentation of events.
• Maintains consistent communication with patients.
• Assists, reviews, researches, and resolves active patient and referral concerns and complaints and records outcomes accordingly to meet regulatory compliance standards.
• Other duties as assigned.

Qualifications:

• Graduate of an accredited school of professional nursing. BSN preferred or other allied health professional degree.
• Current Ohio RN and/or multistate compact license
• Other Allied Health license
• Good clinical judgment, careful listening, critical thinking skills and assessment skills.
• Strong customer service skills, including both verbal and written communication skills.
• Strong computer skills
• Ability to be self-directed, excel in critical thinking and problem solving skills.
• Minimum of 2 years nursing or clinical experience (preferred in ambulatory, hospital, med/surg, long term care, home care, hospice or palliative care setting)
• Prior phone triage or telehealth services.
• Manual dexterity to operate office equipment. May require periods of sitting or standing for long periods of time.
• Requires good visual acuity through normal or corrected vision. Must be able to hear normal conversation. Must be able to lift at least 20 pounds.

Additional information

Working at The Clinic

This Clinic is a partnership between American Well and Cleveland Clinic, where the two parent organizations founded the company on the mission of To make it easier for patients to get the best care by aligning world-class clinical expertise with innovative digital technology.’ The vision for The Clinic is to unlock access to the world’s best healthcare expertise so no one is left behind. We are a group of visionaries defining and realizing the global possibilities of digital health. We believe in: patient centricity; being bold, daring, and decisive; having a passion to win; teamwork and collaboration; transparency and trust. The pace is fast, the work rewarding and the outcomes, deeply satisfying.

Benefits

• The Clinic offers a competitive benefits package that includes health, dental, and vision insurance, paid holidays, and paid vacation.

Compliance Team Assistant

remote type

Fully Remote

Allina Commons

Part time

Shift Length:

Hours Per Week:

32

Union Contract:

Non-Union

Weekend Rotation:

None

Job Summary:

Coordinates the day-to-day activities for office support and management, scheduling and staffing, and data management. Collaborates with leaders to address questions and resolve issues.

Key Position Details:

32 Hours a week-64 Hours in a pay period

4 Days/flexible day off

No Weekends

8:00AM-4:30PM

Remote Role

Job Description:

Principle Responsibilities

• Obtains information for insurance authorization
• Faxes information to companies as requested
• Follows up to obtain authorization responses
• Reports results to Care Manager and puts in computer
• Advises clinicians of need for Auth action/completion
• Ensures clinical is completed so data can be processed in a timely manner
• Tracks date status so Recert clinical are sent timely to MD as necessary.
• Runs and prepares quarterly insurance reports as directed.
• Maintains other reports as needed for the team
• Assists Supervisor in projects as needed

Job Requirements

• Must be 18 years of age with education and/or experience needed to meet required functional competencies as listed on the job description, and High school diploma or GED preferred
• Associate’s or Vocational degree preferred or
• Bachelor’s degree preferred
• 0 to 2 years healthcare/home care and/or hospice experience preferred and
• 0 to 2 years Strong customer service, office and computer skills preferred
• Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN) or Health Unit Coordinator (HUC) Certified Nursing Assistant (CNA, Licensed Practical Nurse (LPN) or Health Unit Coordinator (HUC) Upon Hire preferred

Functional Competencies

• Analytical Thinking: Practices investigative techniques to determine the best approach.
• Business Impact: Role has impact on the department.
• Collaboration: Develops partnerships with internal team members.
• Communication Skills: Able to communicate well in straight-forward situations.
• Problem Solving: Uses common sense to solve routine issues.

Physical Demands

Sedentary: Lifting weight Up to 10 lbs. occasionally, negligible weight frequently

Physician Coding Liaison II – Urgent Care

Remote

Full time

10395 Revenue Cycle – Coding & HIM Clinician Support

Status:Full time

Benefits Eligible:Yes

Hours Per Week:40

Schedule Details/Additional Information:First Shift

This is a REMOTE Opportunity

Major Responsibilities:

• Provides service line/specialty specific coding/documentation education and feedback related to coding changes (CPT including E&M, modifiers, ICD-10-CM, and HCPCS), annual code updates, payer requirements, and payer rejection resolution to assigned Physicians/APCs. Partners with CMOs to standardize coding processes across a specific specialty. Shares and/or presents coding/documentation education presentations to Chief Medical Officers (CMOs), Physicians/APCs, Senior Director Administrators across the organization. Coordinates with PSA Liaisons to provide adequate Physician/APC and/or clinical team member support.
• Conducts orientations for all Physicians/APCs, residents/students and clinical team members on specialty specific coding and documentation related education. Performs new clinician documentation reviews for specialty specific coding, and documentation feedback, as requested.
• Coordinates responses to Physicians/APCs, Locum Tenens, residents/student’s questions and feedback from various sources and partners, including Senior director administrators, CMOs, Medical Group Compliance, Internal Audit, Physician Compensation, Clinical Informatics/Clinical Informatics Educators, Quality Improvement Coordinators, and/or other external partners.
• Queries Physician/APC, Locum Tenens, residents/students when prompted by Professional Coding Department production coders to assist in resolving coding and documentation questions. Relays any coding changes, feedback, and education to Physician/APC, Locum Tenens, residents/students and/or clinic leadership, as appropriate.
• Monitors and works to resolve charge sessions requiring additional information for assigned clinicians and/or service line/specialty in the Epic work queues and/or other transfer work queues to ensure Clinicians are completing work timely to ensure proper supporting documentation for billing and timely filing.
• Attends and provides service line/specialty specific coding and documentation information, as requested, to CMOs, Physicians/APCs and/or Clinic/Site Department meetings. These may be virtually and/or in-person. Virtually attends Physician/APC education that include coding and/or documentation topics, such as Documentation Specialist clinician low risk review meetings, Risk Adjustment/HCC meetings, and/or Medical Group Compliance reviews/meetings.
• Collaborates with PSA Liaison to review and provide coding/documentation guidance on Epic order entry, diagnosis, and charge capture preference lists as well as SmartSets and templates.
• Develops Physician/APC monthly service line/specialty newsletters to continually educate and communicate updates from various coding resources including specialty society organizations. Communicates new services performed by Physician/APCs to Professional Coding department leadership.
• Identifies service line/specialty specific trending data and opportunities to capture revenue through documentation improvement. Attends service line/specialty specific coding and/or society conferences, as requested, to gain further knowledge that is uniquely relevant to that specialty and how coding, documentation, and billing are affected. Maintains expert knowledge of Medicare, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies and standards.

Licensure, Registration, and/or Certification Required:

• Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or
• Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), or
• Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
• Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or
• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or
• Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC), and
• Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC) needs to be obtained within 1 year.

Education Required:

• Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist.

Experience Required

• Typically requires 5 years of experience in expert-level professional coding and least 3 years educating/training licensed clinicians.

Knowledge, Skills & Abilities Required:

• Specialty Medical Coding Certification must be held in the area(s) you will support.
• Excellent communication (oral and written), adult education, and interpersonal skills. Ability to develop rapport and maintain positive, professional partnerships primarily with employed Physicians, APCs, CMOs, Senior director administrators, Medical Group Operations, and physician coding team members.
• Advanced computer skills including the use of Microsoft office products, electronic mail, video/web conferencing, including exposure or experience with electronic coding and EHR systems or applications.
• Excellent/comprehensive skills in organization, prioritization, problem solving, facilitation skills as well as the ability to have meaningful, albeit, difficult conversations with CMOs/Physicians/APCs and/or Senior Director Administrators.
• Highly proficient in critical thinking and analytical skills with an extensive attention to detail.
• Ability to work independently and exercise independent judgment and decision making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to work in multiple work environments (ie virtual, office, clinic/hospital, other).

Physical Requirements and Working Conditions:

• Exposed to normal office environment.
• Position requires travel which will result in exposure to road and weather hazards.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Remote Pro Fee Coder (Denials Review)

Location: LOUISVILLE Kentucky; United States

Job Description & Requirements

Pay Rate: $26.00 – $34.00

TYPE OF JOB ORDER: Remote Pro Fee Coder (Denials Review)

REQUIRED SKILLS: 3- 5 Yrs.

Pro Fee Experience. Denials exp a plus

Academic Level -1 – IP and OP settings

#OF WEEKS: 20 + Weeks

SHIFT/HOURS: M-F Flexible hours

EXPECTED HOURS: 40

LICENSE/CRED. REQ: Prefer a CPC

SYSTEMS: 3M EPIC, Cerner

NOTES: Must be comfortable with Trauma 1 Academic Medical Centers, Remote Work Setting. Appeals and Denials Coding Specialist Profee (Physician-based). Within RCM Dept

Job Benefits

Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary but the perks don’t stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

CERTIFIED CODER

REMOTE

• Molina Healthcare
• United States
• Job ID 2020989

Job Summary

Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.

KNOWLEDGE/SKILLS/ABILITIES

• Performs on-going chart reviews and abstracts diagnosis codes
• Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
• Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
• Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
• Builds positive relationships between providers and Molina by providing coding assistance when necessary
• Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
• Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
• Contributes to team effort by accomplishing related results as needed
• Other duties as assigned
• 2 years previous coding experience
• Proficient in Microsoft Office Suite
• Ability to effectively interface with staff, clinicians, and management
• Excellent verbal and written communication skills
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
• Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance

JOB QUALIFICATIONS

Required Education

Associates degree or equivalent combination of education and experience

Required License, Certification, Association

• Certified Professional Coder (CPC)
• Certified Coding Specialist (CCS)

Preferred Education

Bachelor’s Degree in related field

Preferred Experience

• Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
• Background in supporting risk adjustment management activities and clinical informatics
• Experience with Risk Adjustment Data Validation

Preferred License, Certification, Association

• Certified Risk Adjustment Coder – (CRC)
• Certified Professional Payer – Payer (CPC-P)
• Certified Coding Specialist – Physician based (CCS-P)

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.

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

Coder II-Anesthesia

locations

Remote

time type

Full time

job requisition id

R82520

Department:

10271 Revenue Cycle – Professional Production Coding Specialty

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

First Shift

This is a REMOTE Opportun

Anesthesia experience preferred.

Major Responsibilities:

• Reviews medical documentation at a proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations an EMR and/or Computer Assisted Coding software.
• Adheres to the organization and departmental guidelines, policies and protocols.
• Reviews all clinician documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes.
• Conduct independent research to promote knowledge of coding guidelines, regulatory policies and trends.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
• Maintains the confidentiality of patient records. Reports any perceived non-compliant practices to the coding leader or compliance officer.
• Meets then exceeds departmental quality and productivity standards.
• Recommend modifications to current policies and procedures as needed to coincide with government regulations.
• Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable

Licensure, Registration, and/or Certification Required:

• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or
• Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or
• Coding Specialist -Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA)

Education Required:

• Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge)

Experience Required:

• Typically requires 3 years of experience in professional coding that includes experiences in either hospital or professional revenue cycle processes and health information workflows.

Knowledge, Skills & Abilities Required:

• Advanced knowledge of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology.
• Intermediate computer skills including the use of Microsoft officeproducts, electronic mail, including exposure or experience with electronic coding systems or applications.
• Advanced communication (oral and written) and interpersonal skills.
• Advanced organization, prioritization, and reading comprehension skills.
• Advanced analytical skills, with a high attention to detail.
• Ability to work independently and exercise independent judgment and decision making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to take initiative and work collaboratively with others.

Physical Requirements and Working Conditions:

• Exposed to a normal office environment.
• Must be able to sit for extended periods of time.
• Must be able tocontinuously concentrate.
• Position may be required to travel to other sites; therefore, may be exposed to road and weather hazards.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties. Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties.

MEDICAL CODING SPECIALIST

WORK AT HOME

MultiPlan United States of America (Remote) Full-Time

Job Details

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company that helps our customers thrive by interpreting our client’s needs and tailoring innovative cost management solutions.

We are MultiPlan and we are where bright people come to shine!

JOB SUMMARY: The Medical Coding Specialist is responsible for providing billing analysis of claims and applying coding standards and federal regulations to ensure correct billing practices. In this role, you will perform bill and chart reviews in identifying any variation from quality of billing as well as monitor patient bills for accuracy and compliance.

JOB ROLES AND RESPONSIBILITIES:

1. Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of treatment; analysis of charges of various revenue centers with consideration to patient diagnosis, procedures, age and facility type; and any additional information relevant to the negotiation process.
2. Apply recommendation of national coding and regulation standards to claims billed.
3. Prepare clear, concise and legible findings.
4. Research, review and provide internal response based on receipt of itemized bills, claims, operative notes and other documentation as needed.
5. Assist with, create or enhance internal claim and review recommendations.
6. Communicate with co-workers and management regarding clinical and reimbursement findings.
7. Assist with clinical education of staff as it relates to clinical aspects of claims, suggesting additional negotiation talking points or tools, and communicating overall industry or regulatory changes which affect the department.
8. Monitor, research, and summarize trends, coding practices, and regulatory changes.
9. Research and review inidual claims, claim trends or detailed itemized bills, operative notes and other documentation as needed.
10. Collaborate, coordinate, and communicate across disciplines and departments.
11. Ensure compliance with HIPAA regulations and requirements.
12. Demonstrate commitment to the Company’s core values.
13. Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

Job Scope: This position works independently with general supervision in order to complete the outlined responsibilities. The incumbent balances several projects at a time and work is varied and complex. Complex issues are referred up to higher levels. The incumbent will use established procedures and uses knowledge of the Company’s general business principles, industry dynamics, market trends, and specific operational details when performing all aspects of the job.

The salary range for this position is $60,000-$75,000. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

Job Requirements:

JOB REQUIREMENTS (Education, Experience, and Training):

• Minimum completion of educational curriculum required of medical license or coding certification held with Bachelor’s Degree preferred; or minimum Bachelor’s Degree in healthcare related field and at least 2 years of coding experience.
• Current nursing certification and/or current certified coder (CCS, CCS-P or CPC), Registered Health Information Technician (RHIA/RHIT).
• Minimum 2 years experience in direct patient care, medical procedure billing, medical insurance auditing, line item review, audits, coding, and/or reimbursement.
• Knowledge of inpatient/outpatient hospital billing requirement including UB-04s, revenue codes, itemization of charges, CPT codes, HCPCS codes, ICD-9/10 diagnoses and procedure codes, DRG, APCs.
• Knowledge of professional claim billing requirements including HCFA­1500s, CPT codes and ICD-9/ICD-10 diagnoses codes.
• Knowledge of payer reimbursement policies, state and federal regulations, medical necessity criteria and applicable industry standards.
• Knowledge of commonly used medical data resources such as MDR, Medical Fees in the US, etc.
• Auditing and health information management experience in a healthcare setting preferred.
• Excellent communication (verbal and written), teamwork, training, presentation, negotiation and organizational skills.
• Ability to use hardware, software and peripherals related to job responsibilities, including MS Office Suite and database software.
• Ability to handle multiple tasks in a fast paced environment.
• Ability to read and abstract medical records.
• Knowledge of medical terminology, anatomy, and physiology.
• Ability to interact and discuss audit results with providers.
• Required licensures, professional certifications, and/or Board certifications as applicable.
• Inidual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone

BENEFITS

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• 401(k) + match
• Generous Paid Time Off
• Paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Summer Hours

EEO STATEMENT

MultiPlan is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please

Job Snapshot

Employee Type

Full-Time

Location

United States of America (Remote)

Job Type

Health Care

Experience

Not Specified

Title: Inbound Engagement Specialist (Bilingual)

Location: Remote

Position Description:

This is a rare chance to have a significant personal impact in changing the lives of people and communities dealing with the effects of addiction. In this role, you are responsible for engaging with iniduals who may be struggling with substance use disorders and helping them understand the whole-person care and inidualized support that Eleanor Health provides. Through these interactions, you will lay the foundation of trust and understanding which lets them know that Eleanor Health is there for them when they need us. You will also help guide them to the appropriate Eleanor Health services if they choose to seek our help.

This role will report to Eleanor’s Access Team Supervisor

Candidate Responsibilities:

• Understand Eleanor Health’s care mode and be able to communicate it’s value in a clear, compassionate and non-judgmental way
• Understand how insurance works, including the plans our patients have, and be able to effectively verify insurance eligibility and communicate patient cost sharing responsibility
• Field inbound communications through various intake channels inquiring about the nature of Eleanor Health’s services, qualify patients for Eleanor Health’s care, and schedule them with the appropriate appointments in EMRs.
• Facilitate successful telehealth by performing virtual intakes, communicating with members to remind them about upcoming telehealth sessions and coaching them on accessing their sessions.
• Collaborate online with other care team members to facilitate the enrollment of new members to Eleanor Health, including making appointments, verifying insurances and collecting co-payments
• Outreach to iniduals identified as having Substance Use Disorders to establish a relationship and let them know about Eleanor Health’s services

You’ll be a good fit if you:

• Are Bilingual English/Spanish
• Have 3-4 years of customer facing experience, preferably in a healthcare setting, particularly behavioral health or substance use treatment
• Have experience working from home in a contact center environment, fielding a high number of calls each day
• Have experience and comfortable using technology such as computer telephony & EMR software to document patient interactions & schedule patients for appointments
• Have strong interpersonal communication skills, written communication skills, and active listening abilities
• Are highly empathetic, non-judgmental, open-minded and resilient
• Are able to build trust quickly and can translate complex concepts such as insurance and care into easily understood conversations that put potential patients at ease.
• Strong interpersonal and written communication skills, active listening abilities, and motivational interviewing skills
• Are highly motivated and self-directed with the ability to multitask between phone calls, documentation, and collaboration with other team members
• Enjoy working in a fast-paced, collaborate environment
• Our current hours are Monday – Friday from 8am-8pm EDT you must be available to work any shift during these hours

Benefits:

The total target compensation range for this position is $20-22 an hour. The actual compensation offered depends on a variety of factors, which may include, as applicable, the applicant’s qualifications for the position; years of relevant experience; specific and unique skills; level of education attained; certifications or other professional licenses held; other legitimate, non-discriminatory business factors specific to the position; and the geographic location in which the applicant lives and/or from which they will perform the job.

Eleanor Health offers a generous benefits package to full-time employees, which includes:

• Flexible time off that includes 80 annual hours of PTO accrued monthly + 10 wellness days granted on day 1 – unplug, relax, and recharge!
• 9 observed company holidays + 3 floating holidays- if you need a mental health day, celebrate a special holiday, or just want to take your birthday off and celebrate!
• Fully covered medical and dental insurance plan, with affordable vision coverage.– We are a health first company and we strive to make our plans affordable and accessible
• 401(k) plan with 3% match. We want our team members to be excited about their future and retirement
• Short-term disability- We understand that things happen, we want you to feel comfortable to take the time to recover. Fully paid by Eleanor!
• Long Term Disability – Picks up where Short Term Disability leaves off.
• Life Insurance – Both Eleanor and employee-paid options are available.
• Family Medical Leave- Eleanor Health’s Paid Family & Medical Leave ( PFML ) is designed to provide flexibility and financial peace of mind for approved family and medical reasons such as the birth, adoption, or fostering of a child, and for serious health conditions that they or a family member/significant other might be facing.
• Wellness Perks & Benefits- Mental Health is important to us and we want our employees to have the accessibility they deserve to talk things through, zen with a mindfulness app, or seek assistance from health advocates
  • Mindfulness App Reimbursement
  • 1 year subscription to TalkSpace
  • Paid Membership to Health Advocate, One Medical, and Teladoc

About Eleanor Health:

Eleanor Health is the first outpatient addiction and mental health provider delivering convenient and comprehensive care through a value-based payment structure. Committed to health and wellbeing without judgment, Eleanor Health is focused on delivering whole-person, comprehensive care to transform the quality, delivery, and accessibility of care for people affected by addiction.

To date, Eleanor Health operates multiple clinics and a fully virtual model statewide across Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Texas, Florida, and Washington, delivering care through population and value-based partnerships with Medicare, Medicaid, and employers.

If you are passionate about providing high quality, evidence based care for iniduals with substance use disorder through an innovative practice and about building a great business that makes a difference, Eleanor Health is an ideal opportunity for you. We seek highly skilled, motivated and compassionate iniduals who take responsibility and adapt quickly to change to join our deeply committed and collaborative team.

Job Types: Full-time

Title: Triage Unit Manager – Registered Nurse (RN) (NY/Compact License) (Remote)

Location: Remote US

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a startup with a simple mission: Delivering extraordinary outcomes by unlocking the power of caregivers. Caregivers are one of the largest, most untapped resources in the healthcare delivery system and are the unsung heroes of their care recipients. Yet despite their vital role, they are largely unsupported and invisible to the healthcare ecosystem.

At Vesta Healthcare, we enable people with personal assistance to thrive at home, in their community by assuring the people they rely on, their caregivers, have the resources, data, and support they need. We achieve this through a combination of analytics, technology, services, and deep healthcare expertise. Our analytics help identify and target the right people and populations. Our technology creates real-time connectivity and actionable data out of observations. Our services connect to real people who can help when needs arise, and our healthcare expertise helps us understand how we create value for both payers and providers.

Our program monitors in real-time, identifying issues before they become health events, and helping connect those in need with those who can help via technologies such as video, chat, and telephone. Our technology platform includes home-based mobile applications, a clinical dashboard, and data analytics on data not previously available to health professionals. We are disrupting a $109 billion industry and have recently closed our latest funding round with a blue-chip list of investors.

We’re looking to add to our team of experts who care deeply about our mission.

Our team is passionate, driven, collaborative, intellectually curious, and excited about the opportunity to transform our healthcare system. We’re inspired by caregivers and seek to create a platform that recognizes, utilizes and supports the vital role they play. We strive to continuously learn, explore, experiment and achieve results. We are 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 nursing leader who is passionate about caring for our members, teammates, and clients and can leverage technology to create new programs, systems, and processes to drive exceptional clinical team performance
• Someone who has a proven track record of using data to drive high quality and efficient clinical outcomes
• Someone who has experience with triage, telehealth, remote patient monitoring, and valuable based care of vulnerable populations
• Love learning and helping others learn: you’re excited to bring your wisdom and coach others, and you’re equally energized to learn from other’s experience (such as product managers, software engineers, and data scientists), and then continue improving how Vesta does care management as we learn more together
• Comfortable working in an ambiguous environment within an organization that is growing and changing quickly
• Enjoy moving back and forth between direct care management with members when needed to helping us build out a care management program
• Curious about changing regulations within the space and how they can be leveraged to create additional revenue streams

The ideal teammate would be able to:

• Provide leadership, coaching, and development to a team of nurses and eventually additional multidisciplinary iniduals performing triage
• Develop triage protocols following evidence based guidelines while helping patients stay healthy at home
• Develop and maintain strong relationships with our provider and vendor partners, identifying inefficiencies and creating and implementing process improvement to achieve member satisfaction and provider satisfaction
• Partner with Vesta’s data analytics team and clinical leadership to develop ongoing reporting and analysis to drive the efficiency, quality, and effectiveness of the clinical team and outcomes
• Participate in prioritization efforts and help shape the clinical roadmap
• Continue to push the boundaries of what technology can do to empower our caregivers and clinicians to improve health outcomesfor our patients
• Support the development of strategies to help scale the program. Assist in evaluating capacity planning, hiring, training, and measuring and managing productivity including creating operational metrics and benchmarks

Would you describe yourself as someone who has:

• Registered Nurse License with unrestricted license within NY and/or compact states with ability to obtain additional licenses within 1 month (required)
• 4+ years of nursing experience within acute care, triage, and/or RPM (required)
• 2+ years of experience leading/managing a clinical team overseeing several complex projects simultaneously (required)
• 3-4 years of experience working in an ER or Urgent Care (required)
• 2-3 years of experience managing a clinical team (required), ideally remotely (preferred)
• Bachelor’s degree from an accredited institution (preferred)
• Passionate about our mission to improve people’s lives
• Digital health or hybrid digital health experience (preferred)
• An ability and humility to roll up your sleeves
• Detail- and process-oriented, ability to context- and mode-switch easily, fast learner
• Excellent communication skills, combined with the ability to collaborate across functions and use available tools
• Self-driven, self-starter and excited to support new technology

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, home equipment, 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 + match

Pay range is $110K-$130K based on experience. (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).

We look forward to speaking with 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.