Clinical Documentation Improvement Specialist remote jobs - 502 jobs

Support CenterIf you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist HealthCare seeks to hire an experienced Clinical Documentation Improvement Specialist who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Clinical Documentation Improvement Specialist, you will: • Examine medical records to ensure documentation is accurate, complete, and reflective of the patient's clinical status. • Detect inconsistencies, ambiguities, or missing information in the medical record that may impact coding, compliance, or patient care and request provider clarifications as necessary. • Verify that clinical documentation supports correct ICD-10-CM/PCS and CPT coding for proper reimbursement and collaborates with the coding/revenue cycle team. • Ensure that documentation and provider queries align with regulatory standards, including CMS guidelines and organizational policies. • Communicates and establishes relationships with physicians and clinical staff to share insights, trends and education to improve documentation practices. • Contributes to organizational quality improvement initiates by ensuring robust and accurate documentation related to MHACs, PPCs, PSIs, SOI/ROM and mortality. • Track and report on metrics related to documentation quality, such as query response rates or documentation accuracy. • Provide guidance and education on documentation best practices and standards to physician and clinical staff to support ongoing improvement. • Assist in internal and external audits by ensuring proper documentation and addressing identified issues. • Maintains and enhances current medical, coding and CDI knowledge via participating in continuing education offerings. Qualifications include: • BSN or Equivalent RN (Registered Nurse) • Minimum of 5 years inpatient clinical experience with 2-5 years clinical documentation improvement experience • Experience with Solventum/3M 360 preferred • Current Maryland license • Relevant certification required, e.g. CDIP or CCDS • Maintains current working knowledge of Coding Clinic Guidelines and federal updates to DRG system (MS, APR, AP etc) • Knowledge of medical terminology, anatomy, physiology, microbiology, and disease processes. Work Schedule: Day Shift Hybrid Position Pay Range: $71,932.12 - $107,889.60 If the salary range is listed as $0 or if the position is Per Diem (with a fixed rate), salary discussions will take place during the screening process. Under the Fair Labor Standards Act (FLSA), this position is classified as: United States of America (Exempt) At Adventist HealthCare our job is to care for you. We do this by offering: Work life balance through nonrotating shifts Recognition and rewards for professional expertise Free Employee parking Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available) Paid Time Off Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance Subsidized childcare at participating childcare centers Tuition Reimbursement Employee Assistance Program (EAP) support As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County. If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference. Join the Adventist HealthCare team today, apply now to be considered! COVID-19 Vaccination Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination. Tobacco and Drug Statement Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use. While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act. As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result. Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing. ("Nicotine products" include, but are not limited to: cigarettes, cigars, pipes, chewing tobacco, e-cigarettes, vaping products, hookah, and nicotine replacement products (e.g., nicotine gum, nicotine patches, nicotine lozenges, etc.). Equal Employment Opportunity Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture. Our goal is to have a welcoming, equitable, and safe place to work and grow for all employees, no matter their background. AHC does not discriminate in employment opportunities or practices on the basis of race, ethnicity, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, pregnancy and related medical conditions, protected veteran status, or any other characteristic protected by law. Adventist HealthCare will make reasonable accommodations for applicants with disabilities, in accordance with applicable law. Adventist HealthCare is a religious organization as defined under applicable law; however, it will endeavor to provide reasonable accommodations for applicants' religious beliefs. Applicants who wish to request accommodations for disabilities or religious belief should contact the Support Center HR Office.

The Quality Improvement Specialist plans and executes organization-wide improvement projects in order to improve organizational performance and promote efficient use of resources through effective design, measurement and analysis of key clinical and operational processes. Applies statistical techniques, root cause analysis, Lean, Six Sigma, and other process improvement tools and techniques with subject matter experts to drive effective interventions and track the implementation of those interventions. The Quality Improvement Specialist will manage several projects simultaneously. This position is full-time remote. Selected candidate must reside in North Carolina. Occasional travel for onsite meetings at the Home office (Morrisville, NC) may be required. Responsibilities and Duties Manage interdepartmental projects to achieve quality targets- Form a team of experts required for effective completion of the project, documenting the projected resources, dates, and goals Develop and adhere to a timeline and list of tasks and resources should be generated that will describe the project in detail and plot important dates, meetings, and prospective finish Prepare and present project reports on a regular basis to the Project Team, Executives, and the Board of Directors Conduct regular meetings with team members to discuss the status of the project and also to make necessary changes and improvements to achieve the desired results Motivate and influence staff assigned to the project in order to accomplish task(s) successfully Statistics, Sociology, Economics, Public Health, Business Administration, Organizational Development, Psychology or related social science Identify and promptly address any problems that may pose a risk to achieving the desired outcome of the project within the time and budget constraints Create and deliver presentations and trainings to variety of internal and external stakeholders as needed Identify the root causes of quality issues to ensure the problem is well defined and can be addressed Leverage lean concepts to identify nonvalue-added elements and activities, and are able to use quality tools to identify failure points in processes Conduct process mapping exercises, design effective data collection plans, understand sources of performance variation, and communicate these principles effectively to a broad audience Define success targets based on internal and external requirements as well a well thought out business case Effectively measure the key output variables to ensure all performance changes are accurately assessed Conduct statistical analysis of initial and repeat measures to evaluate efficacy of interventions and to improve approach to successfully resolving root cause as needed Design appropriate sampling plans and measurement systems to assess process capability and overall system performance Evaluate validity and accuracy of data sources to draw appropriate conclusions Analyze changes in performance to determine the impacts of interventions Perform any required data analysis to evaluate performance gaps Prepare comprehensive reports to ensuring adequate documentation and methodology to support findings and recommendations Design and lead the implementation of effective interventions to drive improvement Generate and evaluate solution ideas using Lean methodologies to reduce and prevent waste Develop plans for implementing proposed improvements, including conducting pilot tests or simulations, and evaluate results to select the optimum solution Develop a sustainable monitoring process and procedure that will ensure long-term success Verify reduction in failures due to the targeted root cause Ensure that all staff involved in the improvement efforts are trained to sustain the improvements and have a robust monitoring plan to detect future performance issues Knowledge, Skills, & Abilities Advanced Project Management skills Advanced Quality Improvement Methodologies (Lean, Six Sigma, Kaizen, etc.) Advanced Data Collection & Analysis skills Advanced Microsoft Applications (Excel, Word, PowerPoint etc.) skills Advanced Communication Skills Advanced Collaboration Skills (problem-solving, mediation, conflict resolution and teamwork) Knowledge and experience with NCQA and HEDIS measurements Medicaid Experience Financial management skills Minimum Education & Experience Bachelor's degree and five (5) years of experience leading project teams focused on large-scale quality improvement efforts and/or experience gathering, editing, and analyzing data for social and economic research; or Master's degree and three (3) years of experience leading project teams focused on large-scale quality improvement efforts and/or experience gathering, editing, and analyzing data for social and economic research. Special Requirement Certification as a Lean practitioner and/or Six Sigma Black Belt is required within eighteen (18) months of employment Salary Range $68,227 -$86,990/ Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity. An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center,Henderson Hospital , Valley Health Specialty Hospital and West Henderson Hospital. Benefit Highlights: * Comprehensive education and training center * Competitive Compensation & Generous Paid Time Off * Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and discounted stock plan * Career opportunities within VHS and UHS Subsidies * Challenging and rewarding work environment Job Description: Provides clinically based concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. The goal of concurrent review includes facilitation of appropriate physician documentation of care delivered to accurately reflect patient severity of illness and risk of mortality. Specific reviews are both determined internally and by requirements/requests of external payers or regulatory agencies and play a significant role in reporting quality of care outcomes and in obtaining accurate and compliant reimbursement for acute care services. Qualifications Education: Associates or Bachelors Degree in Nursing or International Medical Graduate Experience: Minimum of five (5) years of clinical experience in an acute care setting; critical care, medical/surgical or Emergency Department nursing preferred. Technical Skills: Computer proficiency to include word processing, databases, and spreadsheets. Familiarity with the operation of basic office equipment. License/Certification: Current RN license in the state in which they reside/practice if Registered Nurse. Other Knowledge of age-specific needs and elements of disease processes and related procedures required. Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes. Working knowledge of inpatient admission criteria, Medicare reimbursement system and coding systems preferred, but not required. Must possess excellent written and verbal communication skills and critical thinking skills. Ability to work independently in a time oriented environment is essential. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: ************************* or **************.

Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes The Clinical Documentation Improvement Program is designed to improve the physician's documentation in the patient's medical record supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. Assists the providers with accurately identifying and documenting the healthcare services provided to the patient. Analyzes the clinical information, using the documentation as the primary driver. Acts as documentation liaison to physician staff as a means of finalizing information in the medical record. Job Duties: This role is 40 hours weekly, Monday through Friday; 6:00 a.m.- 2:30 p.m. A Bachelor's Degree in a Medical/Healthcare Field is required.Three years CDI or related experience is required.Candidates MUST currently hold one of the following four certifications: Certified Clinical Documentation Specialist (Strongly Preferred Certification) Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC) Registered Health Information Technician (RHIT) - American Health Information Management Association Certified Professional Coder - American Academy of Professional Coders (AAPC) Job Duties: Reviews inpatient medical records within 24 to 48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, relevant secondary diagnoses, and procedures for accurate assignment, risk of mortality, severity of illness; and initiate documentation of the review. Pursues a subsequent review of records every three days to support and assign a working DRG assignment upon discharge. Formulates queries when it is determined there is missing documentation, conflicting documentation or unclear documentation. Provides on-going education to physicians and essential healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the patient's record. Collaborates with nursing staff, nutrition, pharmacist, along with the physicians on documentation and to resolve queries prior to the patient's discharge. Consistently meets established productivity targets for record review. Identifies strategies for sustained work process changes that facilitate complete, accurate clinical documentation. Participates in the analysis and trending of statistical data for specified patient population; identifies opportunity for improvement. Promotes a partnership with the inpatient coding professionals to ensure the accuracy of principal diagnosis, procedures and completeness of supporting documentation to determine the working and final DRG, severity of illness and risk of mortality. Acts as a resource person for the interdisciplinary team in order to promote collaboration and coordination of patient care considering age specific, developmental, cultural, and spiritual needs of the patient. Assists with the establishment of training tools for all staff and other employees in regard to quality documentation and coding improvement and further communicates the ongoing improvements relative to process automation, streamline and employee development. Participates in the training of all new staff, including on-going mentorship. Position Details: Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Education: Bachelor's Degree-Healthcare Related Degree (Required) Experience: Minimum of 3 years-Related work experience (Required) Certification(s) and License(s): Certified Professional Coder - American Academy of Professional Coders (AAPC), Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association Skills: Analytical Thinking, Computer Literacy, Interpersonal Communication, Organizing, Problem Management OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

Job Description Bluestone Physician Services delivers great outcomes by bringing exceptional care to patients living with complex, chronic conditions and disabilities. Our unique, robust model of care goes beyond primary care services - our multidisciplinary care teams collaborate with patients, their families and other healthcare providers to deliver care that is preventative, proactive and tailored to their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients' chronic conditions, address social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone patients experienced 21% fewer ER visits, 36% fewer hospitalizations and 41% fewer hospital readmissions compared to patients with similar conditions and complexities over the same time period. Our care teams travel directly to patients who reside in Assisted Living, Memory Care and Group Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our corporate offices in Stillwater, Minnesota, and Tampa, Florida. Our success is only possible through the hard work of our employees who bring our core values of Dedication, Excellence, Collaboration and Caring to life every day. Bluestone has been named to the Star Tribune's Top Workplace list for the 13th year in a row! Bluestone also achieved Top Workplace USA 2021-2025! In 2022, Bluestone Accountable Care Organization (ACO) was the best performing ACO in the country as measured by the overall savings per Medicare beneficiary. Position Overview: We are seeking a highly motivated and detail-oriented individual to join our team as a Part-Time Clinical Documentation Improvement (CDI) Specialist. The primary responsibility of this role is to conduct thorough patient chart reviews to identify opportunities for providers to capture risk adjustment diagnostic codes accurately. The successful candidate will play a crucial role in ensuring proper documentation to support appropriate and accurate disease capture and documentation by Bluestone providers. This part-time position offers remote flexibility and the opportunity to make a meaningful impact on documentation accuracy and comprehensive disease capture for Bluestone providers. If you are passionate about improving coding practices and ensuring quality patient care, we encourage you to apply! Schedule: Part-time (32 hours per week), weekdays during regular business hours, no evenings, weekends or holidays. Location: This remote role MUST be located in one of the Bluestone Markets (Minnesota, Wisconsin or Florida). Salary: $29.00 - $37.00 per hour. Salary will be commensurate with experience. Responsibilities: Perform comprehensive reviews of patient charts to identify gaps in documentation and opportunities for risk adjustment coding improvement. Collaborate with Bluestone providers and other clinical staff to educate them on the importance of accurate documentation for risk adjustment purposes. Provide ongoing training and support to Bluestone providers to enhance their understanding of risk adjustment coding guidelines and documentation requirements. Offer guidance and feedback to providers to facilitate improved documentation practices and ensure compliance with coding standards. Act as a resource for clinical staff regarding coding inquiries and documentation best practices. Maintain accurate records of chart reviews, coding opportunities identified, and outcomes of provider education efforts. Stay current with updates and changes in risk adjustment coding guidelines and regulations. Assist in the development and implementation of CDI initiatives to optimize coding accuracy and capture disease burden among Bluestone's patient population Qualifications:Education/Certification/Experience Bachelor's degree in Health Information Management, Nursing, or related field. Certified Risk Adjustment Coder (CRC) certification, Risk Adjustment Coding (RAC) or related risk certification required Minimum of 2 years of experience in healthcare coding, with a focus on Hierarchical Condition Category (HCC) coding and risk adjustment. Knowledge/Skills/Abilities Proficiency in reviewing and analyzing medical records for documentation deficiencies and coding opportunities. Strong understanding of ICD-10-CM coding guidelines, particularly as they relate to risk adjustment. Excellent communication skills with the ability to effectively interact with Bluestone providers and clinical staff. Demonstrated experience in providing education and training to Bluestone professionals. Detail-oriented with strong analytical and problem-solving skills. Ability to work independently and manage time effectively in a remote or part-time role. Knowledge of healthcare compliance regulations and privacy laws. Demonstrated compatibility with Bluestone's mission and operating philosophies Demonstrated ability to read, write, speak, and understand the English language Bluestone Benefits: Health Insurance Dental Insurance Vision Materials Insurance Company paid Life Insurance Company paid Short and Long-term Disability Health Savings Account (with employer contribution) Flexible Spending Account (FSA) Retirement plan with 4% matching contributions Paid holidays for office closures Twelve days (12 Days) Paid Time Off (PTO) Company sponsored laptop and computer accessories Powered by JazzHR gGAAhkIv0m

Certification Details Certified Documentation Improvement Practitioner (CDIP) Certified Clinical Documentation Specialist (CCDS) Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Registered Nurse (RN) Registered Respiratory Therapist (RRT) Certified Coding Specialist (CCS) Certified Coding Specialist-Physician-based (CCS-P) Medical Degree (MD) Job Details The Inpatient Clinical Documentation Integrity (ICDI) Specialist is accountable for reviewing patient medical records in the inpatient and/or outpatient setting to capture accurate representation of the severity of illness and facilitate proper coding. Validates coding reflects medical necessity of services and facilitates appropriate coding which provides an accurate reflection and reporting of the severity of the patient's illness along with expected risk of mortality and complexity of care. Documentation of discharge diagnoses and co-morbidities are a complete reflection of the patient's clinical status and care. Utilizes advanced knowledge of disease processes (pathophysiology), medications, and have critical thinking skills to analyze current documentation to identify gaps. Identifies opportunities in concurrent and retrospective inpatient clinical medical documentation to support quality and effective coding. Understands and applies regulatory compliance related to documentation, coding and billing for all health insurance plans. Facilitates appropriate modifications to documentation through extensive interactions and collaboration with physicians, coding, case management, nursing and other care givers. Serves as an effective change agent as an educator and resource for physicians and allied health staff to improve the quality and completeness of the clinical documentation. Performs all duties and responsibilities in accordance with ethical and legal business procedures, compliant with federal and state statutes and regulations, official coding rules, guidelines and accepted standards of coding practice including appropriate clinical documentation policies. This Position is 100% Remote can work from anywhere within the U.S. Job Requirements CDIP or CCDS certification required. RHIT, RHIA, RN, RRT, CCS, CCS-P, or MD required. Candidates MUST HAVE current productivity experience (not in a current leadership role). Two years of experience in an Inpatient Clinical Documentation Integrity Specialist (ICDIS) role, concurrent review of medical records in the field of ICDI and experience in a production role within the last 12 months. Demonstrated skills in analytical thinking, problem solving. Effective verbal and written communication including ability to present ideas and concepts effectively to physicians, management and other members of our healthcare team. Self-motivated and able to work independently without close supervision. Demonstrated ability to work well with others in a creative and challenging work environment. Must be able to work flexible hours which may include evenings and weekends as required to meet business needs. High School diploma or GED required. Schedule Information Monday to Friday, 8 AM to 5 PM with mandatory overtime as needed. Additional Details Must be able to work flexible hours which may include evenings and weekends as required to meet business needs.

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Quality Improvement Outreach Specialist supports quality improvement initiatives through member-focused outreach and engagement focused on closing quality gaps in care and improving health outcomes. This role conducts proactive outreach to members for all lines of business to encourage completion of recommended preventive screenings and chronic care services. As a key member of the Quality team, this position plays a vital role in improving HEDIS, Stars and other quality measure performance and advancing overall member health through culturally competent education, coordination, and engagement. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key Functions/Responsibilities: · Perform outreach calls to members with quality gaps in care · Provide education, motivational support, and scheduling assistance to help close identified care gaps and improve quality outcomes · Follow up with members requiring support in taking steps to close care gaps · Document outreach activities, tracks progress and results and supports reporting for quality campaign and initiatives · Evaluate Health Related Social Needs that may impact the member's ability to access needed services · Collaborate with internal teams to ensure coordinated member support · Meet quality and timeliness standards to achieve individual and departmental performance goals · Maintain current knowledge of quality measures and best practices · Ensure compliance with all state and federal regulations for activities performed · Participate in quality improvement activities and cross-department meetings, supporting discussions and reporting as needed · Develop and maintain policies & standard operating procedures of processes to maintain compliance · Support programs and clinical best practices with the objective of improving health outcomes, preventing hospital readmissions, and promoting health and wellness activities · Other duties as assigned Qualifications: Education Required: · Associate degree in nursing or post high school nursing diploma Education Preferred: · Bachelor's or Master's Degree in healthcare or related field Experience Required: · 2 years of experience as a practicing nurse in a hospital/healthcare setting or performing direct member outreach Experience Preferred/Desirable: · 2+ years of experience in health insurance field · 2+ years of experience in quality improvement Required Licensure, Certification or Conditions of Employment: · Successful completion of pre-employment background check Competencies, Skills, and Attributes: Required : · Strong proficiency in use of office equipment including copier, fax machine, scanner, and telephones · Strong PC proficiency in word processing, spreadsheet, and database software Preferred: · Advanced PC proficiency Professional Competencies: Required: · Effective collaborative and proven process improvement skills · Strong oral and written communication skills; ability to interact within all levels of the organization · Demonstrated commitment to excellent customer service · Knowledge and understanding of current trends in healthcare · Aptitude for aligning process, projects, and people to meet business goals in cross-functional team settings · Health care payer business knowledge including processes and operational data and functions that support the business · Maintain confidentiality and privacy · Capable of investigative and analytical research to make decisions and recommendations based on available information · Independent and sound judgment with good critical thinking skills · Knowledge of managed care, utilization management, and quality management · Establish and maintain working relationships with health care providers, members, and coworkers · Practice interpersonal and active listening skills to achieve customer satisfaction and departmental communication standards · Ability to Interpret policies, programs, and guidelines · Establish and maintain working relationships in a collaborative team environment · Organizational skills with the ability to prioritize tasks and work with multiple priorities · Maintains current knowledge of State, Federal and other applicable regulatory/accrediting agency requirements as they apply to department functions Compensation Range $74,000 - $107,000 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Note: This range is based on Boston-area data, and is subject to modification based on geographic location. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Are you passionate about improving the quality of healthcare? Are you ready to leverage your talents to make healthcare better for everyone? Do you want the opportunity to give back to your community? Do you want to have fun at work ? Then join the growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States! SummaryUnder the supervision of the Director, the Quality Improvement Specialist (QIS) supports the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) Program with a primary focus on infection prevention, patient safety, and Healthcare-Associated infection (HAI) reduction in hospital and other healthcare settings. The QIS provides hands-on technical assistance and quality improvement (QI) support to healthcare providers-primarily hospitals-by advancing evidence-based infection prevention practices aligned with CMS priorities. The QIS collaborates with clinical and quality leaders to assess infection prevention performance, conduct root cause analyses related to HAIs and safety events, and co-develop Quality Action Plans (QAPs) targeting infection prevention, antimicrobial stewardship, and regulatory compliance. This role is instrumental in supporting hospitals through surveillance improvement, implementation of CDC-recommended practices, and sustainable infection prevention strategies via onsite visits, virtual coaching, and educational outreach.Core Competencies and Responsibilities / Provider Engagement and Relationship Management Serve as the primary point of contact for assigned hospitals and healthcare providers to promote participation in infection prevention-focused quality improvement initiatives and secure Provider Service Agreements. Build and maintain collaborative relationships with infection preventionists, quality leaders, nursing leadership, and frontline staff to support sustained engagement in HAI reduction efforts. Communicate complex infection prevention, patient safety, and regulatory concepts clearly through meetings, presentations, teleconferences, and written materials. Refer specialized infection prevention inquiries appropriately and collaborate with supervisors and internal subject-matter experts as needed. QI and Technical Assistance Apply evidence-based QI methodologies to assess infection prevention programs, conduct root cause analyses of HAIs and safety events, and deliver technical assistance aligned with CMS infection prevention goals and metrics. Support hospitals in implementing and strengthening CDC-recommended infection prevention practices, including standard and transmission-based precautions, device-associated infection prevention, and environmental infection control. Develop customized Quality Action Plans (QAPs) focused on reducing HAIs (e.g., CLABSI, CAUTI, SSI, C. difficile), improving surveillance accuracy, and enhancing compliance with regulatory requirements. Collaborate with internal teams and external stakeholders to implement sustainable infection prevention and patient safety interventions. Deliver education, training, and resources related to infection prevention, HAI surveillance, outbreak response, and quality improvement strategies. Data and Reporting Analyze infection-related clinical and operational data to identify performance gaps, interpret trends, and guide hospitals in implementing targeted infection prevention and safety strategies. Provide tailored technical assistance related to HAI surveillance, data validation, and performance improvement using CMS- and CDC-aligned measures. Support accurate and timely documentation of infection prevention activities, site visits, provider communications, and outcomes using HSAG and CMS-approved systems. Professional Development and Compliance Maintain current knowledge of infection prevention science, QI methodologies, and patient safety best practices through ongoing professional development. Stay up to date on infection prevention guidelines, surveillance requirements, and regulatory updates from CMS, CDC (including NHSN guidance), The Joint Commission, and other relevant agencies. Project Execution and Team Collaboration Manage multiple infection prevention-related initiatives, deadlines, and deliverables with strong organization and accountability. Contribute to the development of infection prevention tools, educational materials, reports, and technical guidance in collaboration with multidisciplinary teams. Adapt strategies and technical assistance approaches in response to evolving CMS priorities, regulatory updates, and emerging infection prevention challenges (e.g., outbreaks, novel pathogens). Occasionally work extended hours to meet project or regulatory deadlines. Other Qualifications Working knowledge of Microsoft Office, SharePoint, or similar productivity and customer relationship management (CRM) systems is preferred. Strong written and verbal communication skills, including experience delivering infection prevention education, conducting training, and engaging with providers via phone and email. Demonstrated commitment to infection prevention, patient safety, improving healthcare quality, safety, and outcomes for Medicare beneficiaries. Detail-oriented with strong initiative, sound judgment, and the ability to manage multiple priorities independently. Education and Experience Requirements Bachelor's degree required; Master's degree preferred (e.g., Public Health, Nursing, Healthcare Quality, or related field). Minimum of five (5) years of experience in a healthcare setting. Infection prevention experience or certification (e.g., CIC) strongly preferred. Work EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. DisclaimerThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments). HSAG is an EEO Employer of Veterans protected under Section 4212.If you have special needs and require assistance completing our employment application process, please feel free to contact us. EOE M/F/Veteran/Disability

Remote - Clinic/Outpatient Coder III Outpatient Coding PRN Status Variable Shift Pay: $24.74 - $37.11 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. Expected to be proficient in assigning ICD-10-CM and/or CPT codes for following types of services: Outpatient: Complex Surgeries, Observations (non-obstetric), Interventional radiology, radiation oncology and/or non-complex inpatient coding encounters. Clinic coder: Either proficient in coding for all non-surgery specialty areas, primary care, or complex surgeries. This position works under the guidance and supervision of the HIM Outpatient APC and Clinic Coding Manager and is employed by Mosaic Health System. Codes procedures and diagnoses using the ICD-10-CM, CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Communicates with providers, querying providers to ensure the highest level of specificity is provided in documentation. May assist in training of newly hired coders. Caregiver may work in conjunction with Patient Financial Services to verify and modify charges and coding to ensure accuracy of supporting documentation, payer rules and correct coding. Working reports for clean-up, auditing services, edits, and denials. Ensures data accuracy of State HIDI data by responding to edits received. Performs other duties as assigned. Must have coding education, HS Diploma and Medical Terminology and Anatomy and Physiology Required to obtain CCS - Certified Coding Specialist or RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CPC and/or CCSP - Certified Professional Coder within 180 days of employment. Must also obtain COC - Certified Outpatient Coding within 180 days of employment. Five years experience in a Health Information Services department performing a job that requires detail, and familiarity with patient medical record preferred.

PSI is a leading Contract Research Organization with more than 30 years in the industry, offering a perfect balance between stability and innovation to both clients and employees. We focus on delivering quality and on-time services across a variety of therapeutic indications. Job Description We are looking for an Operating Room (OR) Nurse to join PSI as a Clinical Trial Liaison! In this role, a Clinical Trial Liaison: Acts as a specialized liaison to assist sites with a protocol-tailored approach to increase efficiency of the patient identification and recruitment process Assists sites in developing and implementing patient enrollment techniques Coordinates site specific patient recruitment and retention plans observing the planned metrics Provides information specific to the area of expertise to site team members involved in patient recruitment Identifies, tracks, and reports patient enrollment progress throughout the study Analyses the protocol in order to provide the site with the support needed to improve the patient pathway Provides support to the project teams to ensure proper documentation of study-specific assessments related to patient enrollment Assists and advises the site monitor in the area of patient enrollment This role requires travel. Qualifications Registered Nurse (RN) Degree A minimum of 5 years of experience as an OR Nurse Experience in operation and QC procedures related to the equipment used in the specialized area Additional Information All your information will be kept confidential according to EEO guidelines.

Clinical Liaison Facility: St Joesph ARU, Lewiston Job Type: Full-Time Your experience matters At Copper Springs, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but as a person. As an Activities Therapist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve. Connect with our Recruiter Not ready to complete an application, or have questions? Please contact Lindsay Simboli by email ************************************, text ************ or via phone ************ How you'll contribute Position Summary: The Clinical Liaison is responsible for educating the community on acute rehabilitation services, building relationships with referral sources, and developing business in alignment with the rehabilitation program's strategic goals. Essential Functions: Educate the community on acute rehabilitation to develop a census through face-to-face contacts. Develop business based on the strategic goals of the rehabilitation program. Build relationships with referral sources within the assigned territory through in-person outreach. Identify and address barriers to the admission process in collaboration with the program director. Maintain face-to-face contact with patients, families, and referral sources in the market territory. Conduct in-person in-services and presentations to educate stakeholders on available programs and services. Perform other duties as assigned. What we offer Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers: Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts Competitive paid time off and extended illness bank package for full-time employees Income-protection programs, such as life, accident, critical-injury insurance, short- and long-term disability, and identity theft coverage Tuition reimbursement, loan assistance, and 401(k) matching Employee assistance program including mental, physical, and financial wellness Professional development and growth opportunities Qualifications and requirements Education: Minimum 2-year degree required. Bachelor's degree in a health-related, business, or marketing field preferred. Experience: Previous experience in clinical liaison, marketing, or healthcare sales preferred. License: Current license to practice as required by applicable state licensure regulations. About us Lifepoint Rehabilitation is a leading provider of acute inpatient rehabilitation services with more than 300 hospital-based rehabilitation units, medical/surgical and outpatient therapy settings and more than 30 joint venture inpatient rehabilitation hospitals across the country. We provide high quality, patient-centered care to those who have experienced a loss of function from an injury or illness. Our team conducts comprehensive evaluations to determine each patient's unique needs and then creates a multifaceted program using the latest rehabilitation therapies and advanced technologies to support them on their road to recovery. Our goal is to help our patients recover as fully as possible and regain the level of independence they hope to achieve. If you are an enthusiastic individual seeking an environment dedicated to superior patient care and an organization with a strong mission to serve our community, we invite you to apply! Through a history of successful joint-venture partnerships and management agreements, Lifepoint Rehabilitation works with hospitals to more effectively meet the needs of their patients, maintain employee satisfaction and generate long-term quality outcomes for their entire organization. We are fully dedicated to our partners and deliver on the promise made to patients. EEOC Statement Lifepoint Rehabilitation is an Equal Opportunity Employer. Lifepoint Rehabilitation is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging from actuarial science to information technology to clinical practice. Together, we develop and deploy category-defining, data-driven, software-as-a-service (SaaS) products for a broad spectrum of insurance clients. We're a business unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick of jobs are drawn to IntelliScript's entrepreneurial and collaborative culture of innovation, excellence, exceptional customer service, balance, and transparency. Every single person has a voice in our company and we challenge each other to push the outer limits of our full, diverse potential. We've shown sustained growth that ensures you'll have room to grow your skillset, responsibilities, and career. Our team is smart, down-to-earth, and ready to listen to your best ideas. We reward excellence and offer competitive compensation and benefits. Visit our LinkedIn page for a closer look at our company and learn more about our cultural values here. Milliman invests in skills training and career development and gives all employees access to a variety of learning and mentoring opportunities. Our growing number of Milliman Employee Resource Groups (ERGs) are employee-led communities that influence policy decisions, develop future leaders, and amplify the voices of their constituents. We encourage our employees to give back to their varied professions, including leadership in professional organizations. Please visit our website to learn more about Milliman's commitments to our people, diversity and inclusion, social impact, and sustainability. What this position entails IntelliScript offers an innovative suite of products that interpret and deliver electronic medical data (such as prescription histories, diagnoses, and treatment data) to help our clients make effective underwriting and risk assessments. The Clinical Informatics Consultant is a vital part of IntelliScript's Clinical Services Team - a team that delivers the clinical intelligence and expertise needed for industry-leading clinical interpretation solutions. Working with various members of teams across the company, you will be instrumental as we continue to innovate, design, and maintain the clinical intelligence behind our decision support software and fulfill the specific needs of each client. Our proven interpretation engines (Irix and Curv ) are being adapted to incorporate and interpret electronic health record data in addition to our existing pharmacy and medical claims data. In this role, the Clinical Informatics Consultant will bring professional experience and training from a variety of settings and perspectives, a passion for leveraging health-related data and performing complex analysis to solve business questions, as well as an entrepreneurial spirit. What you will be doing Clinical condition interpretation: Translate complex clinical data elements into meaningful medical condition identification and severity insights to support our clients' decision-making processes. Clinical value set creation: Develop and maintain groupings of clinical codes. These building blocks create the foundation of our clinical interpretation insights. You will leverage terminologies such as GPI, RxNorm, ICD-10, CPT, HCPCS, REV, SNOMED, and LOINC codes to facilitate our client's risk assessments. Clinical terminology management: Oversee the organization, standardization, and maintenance of clinical terminologies to ensure up-to-date, consistent, and accurate results from our interpretation solutions. UAT and impact testing: Conduct user acceptance testing and impact analysis to validate the functionality and effectiveness of new features and enhancements in our clinical products. Research and development: Engage in research activities to identify emerging trends in clinical practice and our products, contributing to the development of interpretation solutions. Model consultation: Consult with data science team to align predictive model features with clinical data concepts and medical knowledge. Innovation collaboration: Participate in brainstorming and whiteboarding sessions to drive the creation of enhancements for our clinical interpretation solutions and innovative new products. Clinical data solutions consulting: Provide expert consulting services on clinical data solutions, guiding internal and external clients through the effective design and use of our systems. What we need Current licensure in good standing as a healthcare professional Minimum three years of experience in clinical informatics Experience analyzing electronic health record, medical claims, and pharmacy claims data Experience enhancing EHR systems and/or clinical decision support software What you bring to the table Focused on results and able to explain clinical concepts in a way that answers business questions Adept at ascertaining client needs, conducting an analysis, and presenting solutions Ability to shift communication styles for clinical, technical, or business audiences Strong eye toward quality and an acumen for peer review as part of the development process Capacity to work with and analyze medical data for extended periods of time Demonstrated “let's find a way to do it” attitude-conviction that no task is too big or too small, quick to approach an issue and find the optimal solution, ready to adapt in any situation Detail oriented with excellent verbal and written communication skills Professional when interacting with clients and colleagues Able to work independently and thrive on a small team Adaptable and willing to pitch in wherever needed Skilled in understanding complex systems and thinking abstractly to identify patterns, connections, and opportunities Proficient in identifying and gathering the information needed to diagnose and solve problems Capable of generating, developing, and evaluating a wide range of creative ideas, concepts, and solutions Effective in maintaining performance when faced with uncertain, unclear, or incomplete information Wish list Continued education and/or advanced degree(s) Advanced degree or certification in clinical informatics Experience in software-as-a-service industry Experience in clinical practice in addition to clinical informatics Published thought leadership articles, past speaking engagements, etc. Experience presenting to management-level decision-makers Location The expected application deadline for this job is March 31, 2026. This position is open to remote work. Applicants must be willing to travel to the Milliman office in Brookfield, WI as needed and travel nationwide for meetings, conferences, and team events (up to 10%). Compensation The overall salary range for this role is $93,700 - $199,065 For candidates residing in: Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia: $107,755 - $177,675 if overall experience is less than 5 years; and $120,635 - $199,065 for experience greater than 5 years. All other states: $93,700 - $154,500 if overall experience is less than 5 years; and $104,900 - $173,100 for experience greater than 5 years. A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. Milliman Benefits We offer a comprehensive benefits package designed to support employees' health, financial security, and well-being. Benefits include: Medical, Dental and Vision - Coverage for employees, dependents, and domestic partners. Employee Assistance Program (EAP) - Confidential support for personal and work-related challenges. 401(k) Plan - Includes a company matching program and profit-sharing contributions. Discretionary Bonus Program - Recognizing employee contributions. Flexible Spending Accounts (FSA) - Pre-tax savings for dependent care, transportation, and eligible medical expenses. Paid Time Off (PTO) - Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis. Holidays - A minimum of 10 paid holidays per year. Family Building Benefits - Includes adoption and fertility assistance. Paid Parental Leave - Up to 12 weeks of paid leave for employees who meet eligibility criteria. Life Insurance & AD&D - 100% of premiums covered by Milliman. Short-Term and Long-Term Disability - Fully paid by Milliman. Equal Opportunity All qualified applicants will receive consideration for employment, without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran.

AirStrip is adding a Clinical Consultant to our team. In this role, you serve as one of AirStrip's clinical workflow and informatics SME's during technology implementations with clients. You engage directly with clients' clinical champions, end users, including both nurses and physicians, clinical IT staff and partner vendors to optimize the value of AirStrip's tech solutions. Drawing upon your previous clinical experience and expertise, you'll assist as an internal resource for pre-sales activities, implementation, training support and strategic product discussions. Please note, this position requires 75-80% travel. You are regularly traveling Monday-Friday to client locations across the United States, multiple weeks in a row. Day-to-day activities include, but are not limited to: Employ clinical knowledge and understanding of clinical workflow design / redesign to propose AirStrip solutions that improve and optimize client's workflow and processes Conduct clinical workflow design sessions at project sites, gathering data and working with the client's clinical staff in developing new processes and workflow improvements Develop drafts of clinical documentation and assist with clinical marketing and support of new products and services Conduct hospital level training or facilitate client team meetings prior to or during initial deployment of solutions to ensure that physicians and nurses drive key use cases within their workflows to generate value and data required for clinical effectiveness. Participate with AirStrip innovation, engineering, and operations teams to ensure an efficient and comprehensive interaction with clients at the assessment, testing, validation, initial deployment, and steady state phases of the client relationship Interact with client physicians and nursing champions through planning, go-live, and post-deployment to enable adoption of AirStrip solutions and communicate feedback Deliver AirStrip solutions focused presentations to groups and demo how AirStrip solutions will meet prospect and customer needs Lead and coach customers to success through ADPIE methodology including workflow “day in the life” positioning , go live support and ongoing education Manage multiple, simultaneous projects from assessment through clinical implementation Assist Sales team with sales calls and clinical discovery sessions to accelerate new account development and expansions Develop leading clinical practices and tools for project execution, management, training and support Design and present user stories, use cases, site assessments, clinical requirements, and workflow diagrams Education & Experience Requirements: Bachelor's of Science in Nursing (or other health care related BS AND MSN), along with an active RN license Recent clinical experience (within last 5 years) in adult critical care, Telemetry, or Emergency Department 5+ years or more overall clinical experience in one or more of the above-mentioned areas. 2+ years of experience supporting clinical workflow initiatives in a hospital system involving clinical informatics, deployment of new technologies with successful adoption among physician and nurse users, including EMR, Monitoring alarms and mHealth technologies (strongly preferred) Required Knowledge, Skills, and Abilities: Demonstrable advanced clinical skills and knowledge in cardiac and critical care nursing and standards of care for critical care patients. Solid clinical workflow knowledge, including how departments relate to one another and process flows in between them Excellent verbal and written communication skills, including demonstrated ability to develop and deliver presentations, workflow designs, and training materials Strong ability to explain data and insights concepts to non-technical audiences and to communicate clinical informatics concepts and tasks to cross-functional teams Ability to instill confidence and persuade customers and coworkers Deep knowledge and experience with electronic medical records and workflow of medical and nursing staff around use of EMRs and other automated systems. Demonstrated project management, organizational and interpersonal skills Self-assured and results oriented, able to work independently as well as collaboratively. Strong analytical skills - understands how to collect, analyze, and leverage data to achieve clinical/business objectives Experienced knowledge of computer operations and ability to competently use MS Office - i.e. Word, Excel, Outlook, Visio, and other applications. The salary range for applicable US-based applicants to this position is below. The specific rate will depend on the successful candidate's qualifications, prior experience as well as geographic location. $90,000 - $115,000 base salary.

A government contract requires that this position be restricted to U.S. citizens or legal permanent residents. You must provide documentation that you are a U.S. citizen or legal permanent resident to qualify. The Psychiatrist provides comprehensive psychiatric care as a Practitioner and Consultant, with emphasis on low- to moderate-acuity patients, primarily using virtual platforms. Responsibilities include evaluating, diagnosing, and treating patients with a variety of mental health conditions, including chronic disorders, psychosis, substance abuse, and other complications. The incumbent develops and implements treatment plans, makes recommendations for major diagnostics, and provides follow-up care. Collaboration with other medical and mental health professionals, military leadership, and case management teams is required to ensure coordinated, high-quality care. Compensation & Benefits: Estimated Starting Salary Range for Psychiatrist: Commensurate with experience. Pay commensurate with experience. Full time benefits include Medical, Dental, Vision, 401K, and other possible benefits as provided. Benefits are subject to change with or without notice. Psychiatrist Responsibilities Include: Conduct psychiatric evaluations, interpret laboratory and clinical findings, and prescribe treatment or refer to specialty services as needed. Provide virtual outpatient care for low- and moderate-acuity patients, maintaining high standards of clinical judgment and patient safety. Participate in Quality Assurance activities, making decisions impacting patient care, including hospitalization recommendations, Medical Evaluation Board (MEB) evaluations, and fitness-for-duty assessments. Prepare and maintain patient records, case summaries, and reports according to regulations and SOPs; update patient charts within 72 business hours or by COB for high-visibility cases. Collaborate with multidisciplinary teams, including physicians, psychologists, nurses, social workers, and military command, to ensure comprehensive care. Attend staff meetings, continuing education sessions, and quality improvement initiatives. Communicate TRICARE and DoD healthcare requirements to patients and ensure safe, effective therapeutic outcomes. Performs other job-related duties as assigned Psychiatrist Experience, Education, Skills, Abilities requested: Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.). Completion of accredited Psychiatry internship, residency, and/or fellowship. Minimum of 2 years providing psychiatric care via virtual platforms; experience within the Military Health System preferred. Current certification from the American Board of Psychiatry and Neurology or the American Osteopathic Board of Psychiatry and Neurology. Current, full, active, unrestricted license to practice Psychiatry. Basic Life Support (BLS) required. Advanced certifications do not replace BLS. Must obtain and maintain appropriate clinical privileges and fulfill credentialing requirements. Must pass pre-employment qualifications of Cherokee Federal Company Information: Cherokee Nation Integrated Health (CNIH) is a part of Cherokee Federal - the division of tribally owned federal contracting companies owned by Cherokee Nation Businesses. As a trusted partner for more than 60 federal clients, Cherokee Federal LLCs are focused on building a brighter future, solving complex challenges, and serving the government's mission with compassion and heart. To learn more about CNIH, visit cherokee-federal.com. #CherokeeFederal #LI #LI-REMOTE Cherokee Federal is a military friendly employer. Veterans and active military transitioning to civilian status are encouraged to apply. Similar searchable job titles: Staff Psychiatrist Clinical Psychiatrist Telepsychiatrist Military Psychiatrist Outpatient Psychiatrist Keywords: Mental health treatment Patient evaluation Virtual care Diagnostic assessment Care coordination Legal Disclaimer: All qualified applicants will receive consideration for employment without regard to protected veteran status, disability or any other status protected under applicable federal, state or local law. Many of our job openings require access to government buildings or military installations. Please Note: This position is pending a contract award. If you are interested in a future with Cherokee Federal, APPLY TODAY! Although this is not an approved position, we are accepting applications for this future and anticipated need.

The Senior Clinical Consultant, Cardiology shall be responsible for providing clinical consulting for the project, report configuration, workflow analysis, end-to-end testing, and go-live support to the implementation projects. In addition, provide clinical support for development, sales and company team members with respect to the use of the company's products and serving as a consultant on behalf of customers and company personnel in compliance with the company's quality procedures. Company Overview At FUJIFILM Healthcare Americas Corporation, we're on a mission to innovate for a healthier world, and we need passionate, driven people like you to help us get there. Our cutting-edge healthcare solutions span diagnostic imaging, enterprise imaging, endoscopic and surgical imaging, as well as in-vitro diagnostics. But we don't stop at healthcare; our Non-Destructive Testing (NDT) team harnesses advanced radiography solutions to keep transportation infrastructure, aerospace, and oil and gas assets safe and running smoothly. Ready to innovate, collaborate, and make a difference? Join us and bring your big ideas to life while working in a dynamic, flexible environment that fuels your creativity and drive. Our headquarters is in Lexington, Massachusetts, an inspiring healthcare research hub in a historic town. Fujifilm is globally headquartered in Tokyo with over 70,000 employees across four key business segments of healthcare, electronics, business innovation, and imaging. We are guided and united by our Group Purpose of “giving our world more smiles.” Visit: *************************************************** Job Description Duties and Responsibilities: Serve as consultant on behalf of customers and company personnel. Provide advanced clinical expertise, workflow analysis, report configuration, end to end testing for conversions, upgrades and new projects. Provide product feedback and feature requests to the development team to further enhance the product based due to clinical expertise. Participate in Clinical Validations Testing for each software release of the product to further enhance the overall accuracy of the release. Work closely with development of documentation for software releases and training to the teams. Drive process change to improve efficiency and customer satisfaction. Ensure compliance with all applicable requirements of the company's quality management system. All other functions and responsibilities that may be assigned by management. Comply with all applicable U.S. Food and Drug Administration (U.S. FDA) medical device regulatory requirements, applicable ISO 13485 standard requirements and all other applicable laws, regulations, and standards. Qualifications: Advanced Cardiac Sonographer. Technologist or Nurse 5+ years of progressive experience in medical technology, devices, or healthcare industry, experience in Cardiology discipline preferred. Bachelor's degree business related field and/or equivalent work experience Registered in one or more of the following: Registered Diagnostic Cardiac Sonographer RDCS experience in: Transthoracic Echo Transesophageal Echo Stress Echo Dobutamine Stress Echo Pediatric Echo Fetal Echo ECG Registered Vascular Technologist RVT experience in: Non-invasive Registered Nuclear Medicine Technologist experience in: MPI MUGA PET Registered Nurse Cardiac experience in: Cath, Peripheral Angiography, Electrophysiology Lab experience ECG Registered Radiology Technologist experienced in: Experience in the Cardiovascular PAC's environment Experience in digital imaging Professional presence Proven ability to prioritize and handle multiple functions. Successful experience in related field. Healthcare or software application or IT industry background a plus. Medical imaging background. Excellence in written and verbal communication skills. Demonstrated ability to work comfortably with end-users and clinical supervisors. Demonstrated end-user computer skills. Competence with Microsoft Office tools (Word, Excel, and PowerPoint). Excellent interpersonal skills. Strong technical support experience with excellent troubleshooting skills. Ability to address and/or translate workflow requirements to product features. Ability to work in a fast-paced environment. Extensive travel required. In addition to the above, all employees are expected to: Promote teamwork and cooperative effort. Help train and give guidance to other employees. Provide customers with the highest quality products and services. Understand and apply appropriate quality management system processes. Promote Company standards of business conduct. The above description is intended to include the general content of and requirements for the performance of this job. The position will perform other related duties and assignments as required. Physical Requirements: The position requires the ability to perform the following physical demands and/or have the listed capabilities: The ability to sit up 75-100% of applicable work time. The ability to use your hands and fingers to feel and manipulate items, including keyboards, up to 100% of applicable work time. The ability to stand, talk, and hear for 75% of applicable work time. The ability to lift and carry up to ten pounds up to 20% of applicable work time. Close Vision: The ability to see clearly at twenty inches or less. Travel Up to 75% travel required, based on business need. * #LI-REMOTE FUJIFILM is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration without regard to race, color, national origin, sex, gender identity, sexual orientation, religion, disability, protected veteran status or any other characteristic protected by applicable federal, state or local law. In the event that COVID-19 vaccine mandates issued by the federal government, or by state or local government become effective and enforceable, the Company will require that the successful candidate hired for positions covered under relevant government vaccine mandate(s) be fully vaccinated against COVID-19, absent being granted an accommodation due to medical or sincerely held religious belief or other legally required exemption. Applicants to positions where vendor credentialing or other similar requirements exist to enter facilities will be required to comply with the credentialing requirements of the facilities, including complying with vaccine requirements. For all positions, the Company encourages vaccination against COVID-19 and requires that the successful candidate hired be willing to test for the COVID-19 virus periodically and wear a face covering indoors as required, absent being granted an accommodation due to medical or sincerely held religious belief or other legally required exemption. EEO Information Fujifilm is committed to providing equal opportunities in hiring, promotion and advancement, compensation, benefits, and training regardless of nationality, age, gender, sexual orientation or gender identity, race, ethnicity, religion, political creed, ideology, national, or social origin, disability, veteran status, etc. ADA Information If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to our HR Department (****************************** or ***************.

The Clinical Consultant II is responsible for acting as the clinical expert while leading the implementation of WellSky solutions for clients. The scope of this job includes bridging the gap between clinical workflows and solution functionality to ensure successful deployment, customization, and adoption of the solution. This opening is with our Blood Management Professional Services team. If the details below sound like you, we invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities: Collaborate with project teams to complete implementation tasks, including gathering requirements, analyzing clinical workflows, and identification of workflow challenges. Engage with providers to review requests and offer recommendations based on proficient knowledge of clinical workflows that will ultimately enhance patient care, treatment plans, and health outcomes. Provide hands-on training to designated clients while guiding them through the solution's functionalities and features to increase proficiency in utilization. Use industry compliance knowledge and follow established practices and guidelines to ensure the implementation of clinical solutions complies with regulations and standards. Review a variety of factors for solution configurations, understand solution functionalities, and troubleshoot technical issues to offer consultation and support. Perform other job duties as assigned. Required Qualifications: Bachelor's Degree or equivalent work experience At least 2-4 years relevant work experience in a blood bank setting Preferred Qualifications: Proven experience implementing FDA 510(k)-cleared software solutions in clinical settings Demonstrated ability to design workflows, develop staff training programs, and author standard operating procedures (SOPs) In-depth knowledge of blood and cellular therapy regulations and compliance standards Job Expectations: Willing to travel up to 50% based on business needs Willing to work additional or irregular hours as needed Must work in accordance with applicable security policies and procedures to safeguard company and client information Must be able to sit and view a computer screen for extended periods of time WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year

Grow With Us! At Hilb Group, we recognize that our associates are our greatest asset. We promote a service-driven culture of high performance that encourages career and professional development. The Hilb Group is currently seeking a motivated and ambitious Benefits Clinical Nurse Advocate to join our team. This position will report to our agency located in Cranston, RI. The ideal candidate will be motivated to succeed, is well organized, able to prioritize, and able to work well with a team. This is a remote position. Responsibilities: Review of a variety of health plan data and the ability to develop clinical findings and projections of future spend. Use of clinical knowledge to work with health insurance carriers to ensure appropriate clinical care coordination. Work with employer to develop an appropriate a health risk management plan. Work closely with our Account Management Team to develop a cohesive plan to control costs within the health plan. Assist members in identifying participating providers that meet nd when appropriate, assist members in obtaining appointments with the provider. Assist members with access to medically necessary, quality healthcare in a cost-effective setting Assist member in answering their complex medical questions. Assist members in locating available community resources. Development of a variety of health care education topics for represented membership. Assist members with appealing health carrier's denial of medically appropriate care. Qualifications: Must be a Registered Nurse Certified Case Manager a plus At least 5 years of clinical experience preferably with an insurance company or Managed Care Company. Demonstrated proficiency using Microsoft Office applications Dynamic personality with excellent presentation skills. Comfortable working with various data analytics platforms to identify gaps in care and mitigatable risk. Excellent written and verbal communication skills Excellent time management and project management skills Ability to articulate thoughts and speak clearly and professionally Benefits: Company Paid Life Insurance, Long-Term and Short-Term Disability. Medical, Dental, Vision and FSA/HSA plans. 401(k) with company match. Additional voluntary benefits including Critical Illness, Accident Insurance, Hospital Indemnity and Supplemental Life Insurance, Legal and Identity Protection, and Pet benefits. Generous PTO. An awesome team of professionals! The Hilb Group is an equal opportunity employer, and we actively support and comply with all applicable federal, state, and local laws prohibiting all forms of discrimination in employment. Additionally, we have a zero-tolerance policy for all forms of harassment in violation of federal, state, and local laws.

Pharmacy Clinical Consulting Advisor Internal Job Title - Clinical Account Manager (CAM) Area of Operation - Colorado, Utah, Pacific Northwest As part of Cigna Pharmacy Management, the Pharmacy Sales Advisor is a licensed clinician who serves as the primary pharmacy benefits subject matter expert supporting Cigna Integrated Pharmacy clients within an assigned geographical market(s) and client size band. The Pharmacy Sales Advisor position will be responsible for developing and maintaining relationships with internal stakeholders including the medical sales teams and pharmacy underwriting organization as well as external brokers and consultants. The primary objective of this position is supporting long-term client retention and growth, while achieving Cigna's corporate strategic goals. The Pharmacy Clinical Consulting Advisor also provides pharmacy product and clinical expertise in support of the Medical Sales teams as well as the Pharmacy Implementation organization. This position is responsible for working with the Cigna Medical teams to support the Pharmacy component of an integrated benefit, which typically includes Medical, Pharmacy, and Behavioral. This includes service support, reporting, pricing, and/or other performance guarantees - while working with multiple internal stakeholders at Cigna and Evernorth, as well as external influencers (e.g. consultants, producers and decision makers in the benefits organization or financial and/or C-Suite of our clients). The primary roles of the Pharmacy Clinical Consulting Advisor are: Retain the assigned book of business through proactive portfolio management, including an understanding of available performance guarantees and pricing strategies in order to renew clients and preserve earnings. Participate in client meetings and presentations to review client performance and sell in the suite of pharmacy management programs and solutions that align to Cigna's overall value proposition of lowering total healthcare costs. Act as Pharmacy Sales support for renewals involving consultants. Cultivate meaningful, productive, mutually beneficial relationships internally and externally by gaining the confidence and trust of key stakeholders through honesty, integrity and reliability. Educate and consistently advance the knowledge of pharmacy within the Cigna Medical sales organization. This includes deep dives on our products and services, as well as championing an understanding of the clinical integration points across benefits. Communicate effectively, delivering multi-modal messages that convey a clear understanding of the unique needs of the different audiences requiring interaction. Proactively anticipates communication needs in order to remove ambiguity. Actively participate in finalist meetings for existing business where necessary. Gather and share relevant competitive intelligence in support of retention and new sales efforts. Acts as the clinical subject matter expert supporting medical sales team or the pharmacy Implementation team with escalated pharmacy benefit issues, when necessary. Manages complexity, by analyzing and making sense of a considerable volume of sometimes contradictory information to effectively solve problems. Asks the right questions and attentively listens to others. Stays abreast of clinical pharmacy practice guidelines, including the new drug pipeline, biosimilars, gene therapies, upcoming patent expirations, etc. Additional Responsibilities: Facilitate meetings with clients and brokers to resolve service concerns; act as the escalated issue contact for pharmacy issues when contacted by the medical sales teams. Support detailed ad-hoc analysis of pharmacy claims utilization in order to provide clients with proactive consultation, as well as manage follow-up questions that may arise. Provide executive support for pricing, audit, and contract questions, as requested by internal partners managing these efforts. Translate pharmacy coverage rules and formulary decisions based on Cigna policies with support from Clinical program development partners. Any other tasks as defined by management and/or client needs not named above, as required to support our internal and external stakeholders, clients, and partners. Qualifications: Clinical pharmacy background required; R.Ph. or Pharm.D. 5 years or more of Pharmacy Benefit Management (PBM) experience supporting client expectations Mid to Large Employer account management experience preferred Experience with consultative client management methodologies Proven ability to manage thru a renewal independently with minimal supervision Ability to work through the organizational processes needed to support clients (especially those that are clinical in nature, considering exceptions, etc.) A self-motivated individual displaying ownership, accountability and responsibility Operational understanding and competence with PBM business model Understanding the financial and pricing strategy of PBM Technical skills using all Microsoft programs Ability to travel up to 50% of the time depending on candidate's location with little or no advance notice Competencies: Clinical understanding of PBM space Customer Focus Organizational Agility Network Building Verbal & Written Communication Skills Presentation Skills Financial Acumen Negotiation skills Executive presence If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 107,000 - 178,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Summary Description: Under general direction, this position will be responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Cardiology Coding Specialist works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition, this role monitors and analyzes coding performance at the section and business unit levels. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention. Essential Duties and Responsibilities: Review charts and capture all reportable services. Coordinate with other coding staff to ensure all reportable services are captured and assigned to appropriate physician or ARNP. Assign all appropriate ICD codes, CPT codes, and modifiers per ICD, CPT, and Medicare or commercial carrier published guidelines. Enter charges, review WQs to address edits/denials. Review work queues in EMR and resolve coding issues for professional services for both hospital and clinic places of service. Reconcile charges monthly to ensure capture of all reportable services. Work with business office to resolve hospital billing questions/coding denials or concerns. Assist employees and physicians in providing coding guidance. Ability to communicate effectively both orally and in writing. Pull audit reports and back up documentation for internal audits. Comply with all legal requirements regarding coding procedures and practices Conduct audits and coding reviews to ensure all documentation is precise and accurate Assign and/or review the sequence of all CPT and ICD 10 codes for services rendered Collaborate with AR teams to ensure all claims are completed and processed in a timely manner Support the team with applying expertise and knowledge as it relates to claim denials Aid in submitting appeals with various payers about coding errors and disputes Submit statistical data for analysis and research by other departments Ability to identify PSI triggers or have working knowledge of PSI triggers which includes identifying and assigning co-morbidities and complications. Ability to assign the appropriate DRG, discharge disposition code and principal DX codes Serves as the liaison between revenue cycle operations and clients as it relates to charge capture documentation and reconciliation Possesses a clear understanding of the physician revenue cycle Oversees understands and communicates coding and charging processes for each client account based on their existing EHR system as it relates to office and hospital-based services which includes charge captures charge linkages to the CDM and charging processes. Analyzes and communicates denial trends to Clients and operational leaders. CPC or CCS coding credentials required. Cardiology experience preferred. EMR, eCW, Centricity, Epic, Encoder Pro or 3M experience highly desired. Microsoft Office Skills: Excel - Must have the ability to create and manage simple spreadsheets. Word - Must be able to compose business correspondence. License: CPC, CCC or CCS (Required)