Manager of clinical services work from home jobs

Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Reports Jointly To: Chief Executive Officer and Chief Medical Officer Clinical Specialty: MD, Board Certified in Sports Medicine (primary board specialty flexible) ViewFi is a nationwide virtual musculoskeletal (MSK) practice bringing high-quality orthopedic, sports-medicine, and physical-therapy care directly to patients in both traditional and non-traditional markets. We serve a diverse set of partners including personal injury/med-legal groups, self-insured employers, risk-based payers, and digital health collaborators in the sports and fitness markets through technology enabled, evidence-based clinical care. We are redefining what excellent MSK care looks like in a virtual environment. Position Summary The Medical Director will serve as the clinical leader of ViewFi's physician team and a core partner to our physical therapy, product, operations, and business teams. This role requires a practicing, board-certified Sports Medicine physician who can balance patient care with 30-40% administrative/leadership responsibilities. The Medical Director will ensure clinical excellence, maintain high-quality and consistent clinical pathways, represent ViewFi as the medical voice of the organization, and advance the science and evidence behind virtual MSK care. Key Responsibilities Clinical Leadership & Oversight Lead, oversee, and support the national team of physicians delivering virtual MSK care. Maintain and update clinical pathways, treatment standards, and practice guidelines across all ViewFi service lines. Partner closely with the Physical Therapy leadership team to ensure integrated, cohesive care between MDs and PTs. Ensure consistent, high-quality clinical documentation, coding accuracy, and compliance across markets. Oversee peer review, quality assurance activities, and clinical performance metrics. Participate in recruitment, onboarding, and ongoing development of new clinicians. Patient Care (70-80%) Actively see patients in a virtual setting, providing MSK consults and follow-ups. Model best-in-class virtual care workflows and contribute to continuous improvement of the patient experience. Support escalated or complex cases requiring senior clinical judgment. Strategic & Administrative Leadership (20-30%) Serve as the medical voice of ViewFi at conferences, webinars, panels, and partner meetings. Collaborate with executive leadership on product development, new service lines, geographic expansion and clinical innovation initiatives. Guide medical input for payers, partners, self-insured employers, and med-legal groups. Participate in strategic planning related to national expansion, licensure strategy, and resource allocation. Work cross-functionally with operations and technology teams to enhance clinical workflows. Provide medical insight and feedback on ViewFi's technology roadmap, including clinical decision support, AI integration, and general telehealth tools. Research, Publishing & Thought Leadership Lead or collaborate on clinical research demonstrating the efficacy of virtual MSK care, including both MSK MD consults and virtual PT. Publish and present outcomes, case series, and efficacy studies at relevant medical and industry conferences. Help build ViewFi's reputation as the leader in evidence-based virtual MSK care. Quality, Compliance & Risk Management Ensure the practice meets state and federal clinical guidelines, telehealth regulations, and licensure requirements. Maintain oversight of clinical incident review processes, risk-mitigation protocols, and outcome tracking. Drive continuous improvement in clinical quality, patient safety, and service reliability. Qualifications MD with Board Certification in Sports Medicine (primary board: FM, IM, EM, PM&R, etc. is flexible). Multi-state licensure required; willingness to pursue additional licensure required. Minimum 10 years of clinical experience; virtual care experience strongly preferred. Demonstrated leadership experience in a clinical or medical director role. Strong collaboration skills with PTs, operational teams, and cross-functional partners. Excellent communication and presentation skills; comfortable representing ViewFi publicly. Passion for virtual care, musculoskeletal medicine, and innovative delivery models. What We Offer Opportunity to lead a national MSK practice at the forefront of technology enabled virtual healthcare Collaborative environment with clinical and operational teams aligned around quality care and aggressive growth Competitive compensation with protected administrative time Support for conference travel, research, publishing, and clinical innovation Commitment to clinical excellence, patient outcomes, and provider support

Medical Director (Utilization Management) The Medical Director plays a key role in ensuring coverage and payment determinations are clinically appropriate, compliant, and aligned with plan benefits and contractual agreements with participating provider networks. This position requires sound clinical judgment, collaborative leadership, and a strong understanding of healthcare delivery, population health, and payer operations. Key Responsibilities Provide physician leadership and clinical guidance to Utilization Management and Care Management functions Render coverage and payment determinations in accordance with health plan benefits, medical policies, and provider contracts Apply evidence-based clinical guidelines and best practices to support consistent, high-quality decision-making Exercise informed medical judgment grounded in clinical medicine, patient safety, quality management, and population health principles Collaborate effectively with clinical teams, operational leaders, senior management, and external partners Promote efficient, cost-effective care delivery across all lines of business Support organizational initiatives related to quality improvement, compliance, and healthcare outcomes Required Qualifications & Experience Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited medical or osteopathic medical school recognized by AAMC, AOA, or WHO Unrestricted and active Pennsylvania medical or osteopathic license Current board certification through ABMS or AOBMS (Family Medicine or Internal Medicine preferred) Ability to successfully complete organizational credentialing requirements Strong knowledge of Utilization Management, healthcare delivery systems, and payer-based medical decision-making Work Location Fully Remote: This position is designated as fully remote Work must be performed within the Tri-State Area (Pennsylvania, New Jersey, or Delaware)

Spectrum Healthcare Resources is excited to offer a potential career opportunity for a Behavioral Health Medical Director supporting the TriCare/Department of Defense and Community Care Network/Department of Veterans Affairs. This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership. Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support! Requirements: Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school. Active, unrestricted license to practice medicine in the United States. Board certification or board eligibility through a recognized specialty board. U.S. Citizenship. Favorable background investigation through the Department of Defense (DoD). Minimum of 5 years of medical practice experience. 3+ years of experience in managed care environments. Preferred: Experience working with TRICARE, Veterans Affairs, or other federal health plans. Advanced degree in management (MPA, MBA, MHA, MPH). Corporate-level leadership experience. Experience using InterQual and/or similar evidence-based criterial to assess medical interventions, procedures and treatments. Job Responsibilities: Provide program-wide clinical guidance across multiple medical management domains including Utilization Management, Case Management, Quality, and Public Health. Lead and participate in quality committees and collaborative safety initiatives. Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems. Conduct peer-to-peer discussions with network providers and internal stakeholders. Develop and implement corrective action plans related to clinical quality or provider performance. Collaborate closely with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel. Support the Emergency Operations Center (EOC) in person or virtually during contingency operations, which may include 24/7 coverage. Provide clinical expertise on new technologies, treatment protocols, and population health initiatives. Interact with veterans and beneficiaries to support satisfaction and outcomes. Stay current with required licensure, board certification, and federal medical standards. Working Conditions: Remote position with standard weekday hours and occasional after-hours availability. Limited to moderate travel by air or ground as needed. May require short-notice deployment (24?48 hours) to austere environments in emergency events. Extensive computer-based work; prolonged periods of sitting may be necessary. Must obtain a Common Access Card (CAC); security clearance may be required. Company Overview: Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally.

Who We Are Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we're shaping a healthier, more engaged future. Responsibilities TEXT BODY - ( Advertising Summary ) What You'll Actually Do ESSENTIAL DUTIES and RESPONSIBILITIES: Responsible for the overall clinical aspects of the Care Management Team. · Supervise Utilization Review (UR), Chronic Disease Management (DM) and/or Case Management (CM) team personnel including participating in interviewing, hiring, and training employees; plan, assign, and direct work; appraise performance; rewarding and disciplining employees; addressing complaints and resolving problems. · Keep team informed of clinical updates, compliance related issues and policies. · Work with the VP of Care management to establish work procedures and processes that support company and departmental standards, procedures, and strategic directives. · Use appropriate judgment in upward communication regarding department or employee concerns. · Maintain and improve UR, DM, and CM teams operations by monitoring system performance; identify and resolve problems; audit and analyze staff performance; prepare and complete action plans; assist in managing system and process improvement and quality assurance programs as it relates to clinical management and plan language interpretation. · Oversee the negotiation and implementation of cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews as it relates to clinical aspects. · Ability to meet productivity, quality, and turnaround times daily. · Ability to pass external audits to include URAC and NCQA. · Maintain HIPPA compliance per company's policy and procedures. · Maintain confidentiality and minimum requirement rules. · Complete all required yearly training per company's expected period. · Ability to communicate with external sponsors and vendors and to communicate clearly about the programs that are offered by the company internally and externally. · Ability to create, teach and present information to internal and external audiences with varying backgrounds and cultures KEY COMPETENCIES: To work in the health industries and to work remotely, it has been demonstrated that those with computer skills work better in these remote job descriptions. UPON HIRE, must have: · Basic computer literacy · The ability to work on multiple screens, and proficient typing skills. · Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, and Outlook Excellent verbal and written communication skills · Ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as the ability to understand and interpret complex information from others. · Ability to work independently and utilize written resources to solve problems. After training with our training department and 1.5 months ramp (3 months total), must have and be able to work in: o Teams on and off camera, SharePoint, Drives as needed, VPN, UM Web or Health Notes, El Dorado, Quick Links, GIAS, ADP, Confluence, Phone system with headset, Smartsheet-there may be additional programs as it relates to job duties · Knowledge of medical claims and ICD-10, CPT, HCPCS coding · Excellent verbal and written communication skills for upward and downward conversations · Microsoft Office and other computer skills and ability to learn and help guide software development · Flexible and able to prioritize day-to-day position requirements · Strategic thinking with proven ability to communicate a vision and drive results · Proficient in analysis and interpretation of clinical data · Comfortable with multiple accountabilities and matrix management · Proven record of strong relationships and working with diverse teams · Demonstrated ability to work independently with excellent judgment · Strong interpersonal skills necessary to effectively communicate with medical personnel and members · Analytical and problem-solving skills necessary to identify and review pertinent information · The ability to incorporate analytical data into new or existing clinical programs to enhance quality of care · Ability to maintain an extremely elevated level of confidentiality · Able to successfully handle competing priorities · Experience in the Utilization Review Process which includes Prior-Authorization/Pre-Certification, Retro Reviews, Concurrent Reviews and Post Service Claims Review · Experience in disease management and know and understand disease progression · Knowledgeable of the Federal, State and ERISA regulations Qualifications What You Bring to Our Mission · Associate Degree of Nursing plus 3 years mgt. experience and/or Bachelor Degree of Nursing RN · Licensure in California required. · Master's degree of Nursing preferred · Certification in Case Management or Utilization Review a plus. · Minimum 5 years of Utilization Review, Case Management, Chronic Disease Management, and/or Hospital experience required. · Minimum 3 years of compliance related experience preferred. · Experience working in sales, with groups, Medicaid, Medicare, fully insured, HMO and Self Insured preferred · Managed Care management experience preferred in UR, CM, DM Physical and Mental Requirements: · Ability to perform the essential job functions safely and successfully with or without reasonable accommodation, including meeting qualitative and/or quantitative productivity standards. · Ability to maintain regular, punctual attendance. · Ability to sit for 6-8 hours. · Ability to travel throughout the United States and external countries. · Constant use of computer keyboard and mouse; repetitive use of both hands. · Occasional to frequent twisting of neck; occasional bending of neck and at waist. Why You'll Love It Here We believe in total rewards that actually matter-not just competitive packages, but benefits that support how you want to live and work. Your wellbeing comes first: Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!) Mental health support and wellness programs designed by experts who get it Flexible work arrangements that fit your life, not the other way around Financial security that makes sense: Retirement planning support to help you build real wealth for the future Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage Growth without limits: Professional development opportunities and clear career progression paths Mentorship from industry leaders who want to see you succeed Learning budget to invest in skills that matter to your future A culture that energizes: People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable The practical stuff: Competitive base salary that rewards your success Unlimited PTO policy because rest and recharge time is non-negotiable Benefits effective day one-because you shouldn't have to wait to be taken care of Ready to create a healthier world? We're ready for you. No candidate will meet every single desired qualification. If your experience looks a little different from what we've identified and you think you can bring value to the role, we'd love to learn more about you! Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $118,560-$137,280. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits. We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing. #WeAreHiring #PersonifyHealth #TPA #HPA #Selffunded Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to **************************. All of our legitimate openings can be found on the Personify Health Career Site. Application Deadline: Open until position is filled.

Alma is on a mission to simplify access to high-quality, affordable mental health care. We do this by making it easy and financially rewarding for therapists to accept insurance and offer in-network care. When a provider joins Alma, they gain access to a suite of tools that not only help them better run their business, but also grow it sustainably and develop as a provider. Alma is available in all 50 states, with over 20,000 therapists in our growing network. Anyone looking for a therapist can browse Alma's free directory. Alma has raised $220.5M in funding from Insight Partners, Optum Ventures, Tusk Venture Partners, Primary Venture Partners, First Round Capital, Sound Ventures, BoxGroup, Cigna Ventures, and Rainfall Ventures. Alma was also named one of Inc's Best Workplaces in 2022 and 2023. Website Job Board Values Candidate Interview Guide --- Director of Clinical Operations The Director of Clinical Operations is a strategic and operational leader responsible for ensuring scalable and compliant clinical operations. Working closely with the Chief Operations Officer, you will align operational strategy with organizational goals to maintain excellence in workflow efficiency, compliance, and provider support. This role oversees the day-to-day operations of the Clinical Operations team and serves as an operational subject matter expert in the design and implementation of systems and technologies that enhance efficiency, compliance, and provider performance across the Alma network. Key Responsibilities Operational Compliance & Oversight Lead the design and execution of internal auditing systems that support continuous improvement in operational quality and compliance. Develop and track operational compliance KPIs, using data to drive strategy and operational enhancements. Ensure operational frameworks align with federal and state regulations, industry best practices, and Alma's standards. Monitor audits, risk protocols, and compliance efforts to proactively identify risks and uphold the highest operational standards. Operational Execution & Program Management Serve as the operational lead for Alma's documentation review program, translating strategic vision into phased, actionable workflows. Develop and optimize scalable processes that ensure compliant operational workflows and documentation standards. Collaborate with the COO to integrate operational quality efforts into company-wide operational systems and performance metrics. Partner with cross-functional leaders to align operational strategy with product, technology, and operations initiatives. Use performance data and audit trends to inform quality initiatives and provide strategic updates to executive stakeholders. Leadership of the Alma Integrity Standards Program Direct the Integrity Standards team in monitoring provider adherence to administrative and membership standards, including conduct and fraud monitoring. Guide the development and execution of protocols to detect and address deviations from Alma's operational expectations. Review findings and recommendations from the team and ensure appropriate follow-up actions are taken. Work cross-functionally to implement corrective actions and long-term improvements. Provide coaching and professional development for team leaders, ensuring high team performance and engagement. Oversee resource planning and ensure effective internal and cross-functional communication. Strategic Alignment & Cross-Functional Collaboration Collaborate with senior leadership to ensure operational initiatives support broader strategic priorities, including growth, technology adoption, and provider engagement. Partner with Product and Marketing teams to align rollout milestones with provider experience and operational capacity. Provide operational expertise to initiatives focused on workflow innovation, efficiency, and request fulfillment (e.g., medical record requests). Qualifications 10+ years of progressive experience in operations management and leadership in a tech-forward environment, with significant operational and quality improvement responsibilities. Demonstrated success in leading data-driven operational quality and compliance programs at scale. Strong track record of integrating technology into operational workflows and documentation practices. Knowledge of healthcare regulations, compliance standards, and risk mitigation strategies. Exceptional leadership, communication, and change management skills. Ability to use operational metrics to inform strategy and drive accountability across multidisciplinary teams. Benefits: We're a remote-first company Health insurance plans through Aetna (medical and dental) and MetLife (vision), including FSA and HSA plans 401K plan (ADP) Monthly therapy and wellness stipends Monthly co-working space membership stipend Monthly work-from-home stipend Financial wellness benefits through Northstar Pet discount program through United Pet Care Financial perks and rewards through BenefitHub EAP access through Aetna One-time home office stipend to set up your home office Comprehensive parental leave plans 12 paid holidays and 1 Alma Give Back Day Flexible PTO Salary Band: $170,000-$180,000 All Alma jobs are listed on our careers page. We do not use outside applications or automated text messaging in our recruiting process. We will not ask for any sensitive financial or identification information throughout the recruiting process. Any communication during the recruitment process, including interview requests or job offers, will come directly from a recruiting team member with a helloalma.com email address. Learn more about how Alma handles applicant data by reading Alma's Applicant Privacy Notice.

Role Type and Location Work from home role - this role requires you to be based full time in the East Coast, USA. Eligibility to work Unfortunately, we cannot offer USA based Visa sponsorship for this full time USA BASED role. Role Summary We are seeking a proactive and detail-oriented Project Manager to support the delivery of pathology-focused clinical trial projects at Diagnexia Analytix. Sitting under the Clinical Trial Manager, this role will act as the operational driver of projects - ensuring that timelines, deliverables, and quality standards are met across complex, multi-stakeholder clinical studies. The Project Manager will not design the science, but will make sure the science happens: coordinating vendors, labs, pathologists, and internal teams, while keeping communication clear and projects audit-ready. Key Responsibilities Project Delivery & Coordination Translate Statements of Work (SoWs) into actionable project plans, timelines, and trackers. Manage day-to-day execution, logistics, and operational workflows. Oversee sample flow, staining, scanning, and digital pathology processes. Pathologist Management, training and communication Stakeholder Communication Serve as a central point of contact between sponsor, CRO, central labs, and internal teams. Organize and document sponsor calls, training sessions, consensus/adjudication meetings. Maintain action logs, decision records, and issue escalation pathways. Quality & Compliance Ensure all activities follow GCP/GCLP, ICH E6, and regulatory standards. Support preparation of validation reports, pathology manuals, final study reports, and archival outputs. Track QC metrics, deviations, CAPA actions, and maintain audit readiness. Risk & Change Management Maintain a risk register for timelines, logistics, and deliverables. Coordinate structured change control processes when scope or timelines shift. Required Skills & Experience (Must-Have) Degree in life sciences, biomedical sciences, or a related discipline. 3-5 years' experience in clinical trial project management, CRO operations, or translational/biomarker projects. Strong knowledge of GCP/GCLP and ICH E6 standards. Proven ability to deliver multi-stakeholder projects on time and within scope. Excellent organizational skills; able to manage multiple vendors, labs, and deliverables. Strong communication skills, with experience preparing reports, dashboards, and running status calls. Ability to anticipate issues, escalate appropriately, and drive solutions. Proficiency with project management tools (e.g., Smartsheet, MS Project, Asana) and shared document platforms. Preferred Skills & Experience (Nice-to-Have) Exposure to pathology, histology, or biomarker assay workflows. Experience coordinating pathologists and pathology vendors. Familiarity with digital pathology platforms (WSI, image hosting, secure data transfer). Therapeutic area experience in oncology, immunology, or liver disease trials. Formal PM certification (PMP, PRINCE2) or Lean/Agile training. Strong interpersonal skills: able to “manage up” to senior stakeholders while motivating delivery teams. Experience in a scale-up/fast-growing environment. Ideal Candidate Profile A “doer” who thrives on making things happen in complex clinical projects. Comfortable working alongside scientific leaders while taking responsibility for operations, timelines, and compliance. Highly organized, proactive, and able to bring structure and accountability to dynamic, multi-stakeholder studies. What are the benefits of working with Deciphex 💰 Competitive salary with annual performance-based increases. Rewarding your impact and growth 🩺 Healthcare benefits, giving you peace of mind to focus on what you do best 🌴 Annual leave with service increments - Means more time to recharge and enjoy life outside work 💡 Pension contributions, helping you build a secure future 🚀 Work with a world-class, high-performing team in a hyper-growth startup. You'll earn fast, make an impact, and shape the future 📈 Regular feedback and clear career growth opportunities. You keep developing and moving forward 🌍 A collaborative, supportive, multicultural team. Here you'll feel valued and inspired every day About the Company Through the work that we do, the team at Deciphex helps pharma to accelerate the process of essential drug development and helps patients to get timely and accurate diagnosis. Founded in Dublin in 2017, Deciphex has scaled rapidly to a team of over 180 people and counting who are providing software solutions to address the pathology gap in research pathology and clinical areas. We have offices in Dublin, Exeter, Oxford, Toronto and Chicago and are expanding our team throughout the world. We are software developers, clinical specialists, AI engineers, operations professionals and so much more, all working as one team to support our customers and patients. Our team culture is built on trust. We give our team the space they need to deliver results and the environment to ensure they can enjoy doing it. We are looking for highly motivated individuals who are excited to take on challenges and value making a difference in their day-to-day work. This is a unique opportunity to make a difference in the emerging Digital Pathology field. Read more about Deciphex here and more about our incredible team on our Careers Page here

Who we are: Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ, enables life-saving patient care through telemedicine and empowers healthcare organizations to build telemedicine programs in any clinical specialty. We provide healthcare teams with industry-leading solutions that drive improved clinical care, patient outcomes, and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commission's Gold Seal of Approval and has maintained that accreditation every year since inception. We love what we do and if you want to know more about our vision, mission and values go to accesstelecare.com to check us out. What you'll be responsible for: The Clinical Service Excellence Manager will be responsible for overseeing all clinical processes and serving as the client champion for Access TeleCare's Neurology programs. In this role, you will have the opportunity to build effective relationships with client stakeholders, develop clinician workflows, support new program implementation, create action plans to support service performance, and interface with clinicians to facilitate clinical excellence. In addition, this you will serve as the clinical point of contact for practice issues for partner sites. What you'll work on: Participate in program launches and support with the development of clinical workflows Maintain working rapport with individual providers covering the service as needed to address clinical workflow or practice issues, and communicating recommended changes to medical director and hospital(s) affected Build and maintain positive working relationships with partner facility clinical staff; train partner staff on tasks that promote clinical workflow efficiency such as cart coordination, and address concerns in a timely manner Analyze and present reports on healthcare processes and patient outcomes to identify and prioritize areas for improvement Coordinate performance improvement activities focused on specific patient services or organizational quality initiatives through the use of specific benchmarks and evidence-based practices Participate in efforts to establish and maintain organizational readiness to meet regulatory requirements based on service line specialty Collaborate closely with Neurology Practice Administrator and Service Line Chief to work on team initiatives, develop and report KPIs, identify opportunities within programs to improve communication, efficiencies, and processes What you'll bring to Access TeleCare: Bachelor of Science in Nursing from an accredited school of nursing At least three years of experience in neurology service line, inpatient services preferred (required) Prior experience as a charge nurse or nurse supervisor (preferred) Ability to navigate multiple EMR systems required Excellent computer skills and familiarity with Microsoft Office programs including Excel for data manipulation Excellent interpersonal communication skills and the ability to exercise empathy when working with patients and their families Excellent organizational and time management skills Demonstrate an understanding of standard clinical procedures, laws, and regulations Thorough knowledge of medical terminology Ability to work independently, but function as part of a team Work Environment and Schedule: High growth fast paced organization Primarily remote based environment Not more than 20 days travel to select sites annually Travel quarterly to corporate office in Dallas, TX Must be able to remain in a stationary position 50% of the time. Company perks: Health Insurance (Medical, Dental, Vision) Health Savings Account Flexible Spending (Medical and Dependent Care) Employer Paid Life and AD&D (Supplemental available) Flexible Vacation, Wellness Days, and Paid Holidays About our recruitment process: We don't expect a perfect fit for every requirement we've outlined. If you can see yourself contributing to the team, we would like to speak with you. You can expect up to 4 interviews via Zoom. Access TeleCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, age, religion, color, marital status, national origin, gender, gender identity or expression, sexual orientation, disability, or veteran status.

At Author Health, we're revolutionizing how mental health care is delivered, and we want you to be part of it! Our mission is to bring compassionate, high-quality care to people with serious mental illness, substance use disorders, and dementia, including older adults. We don't just treat symptoms. We treat people - fully, holistically, and with heart! Through our virtual-first, innovative care model, we deliver community-based wrap-around outpatient mental health care inclusive of psychiatric, psychotherapeutic and care management services. We partner with primary care providers, hospitals, families, and caregivers to keep patients out of the hospital and empower them to live healthier, more connected lives. At Author, inclusivity isn't a checkbox. It's how we build trust and drive better outcomes! We honor the unique cultures, identities, and stories that shape every patient's experience, and we're creating a workplace where team members can show up as their full selves, too. If you're driven by purpose, ready to shake up the status quo, and eager to make a real impact in people's lives, we'd love to meet you. Let's build the future of mental health care together! We are seeking a dynamic and experienced Clinical Manager of Care Management Services to oversee,coordinate, and deliver comprehensive care management services across both behavioral health and medical care settings. This clinical leadership role is critical in ensuring the seamless delivery of integrated care, optimizing patient outcomes, and promoting the efficient and effective utilization of resources within our organization. This Clinical Manager is expected to split his or her time between administrative / managerial responsibilities (typically ~60% of the time) and time serving patients directly (typically ~40% of the time). WHAT IS YOUR SUPERPOWER? Administrative & Managerial Responsibilities * Develop, implement, and oversee care management policies, procedures, and protocols for behavioral health and medical care. * Lead and supervise a multidisciplinary Care Management team organized in a "pod" model where: * Care Managers (Registered Nurses and Behavioral Health Care Managers) are responsible for comprehensive care planning and clinical coordination, * Licensed Practical Nurses (LPNs) focus on post-discharge outreach, coordination, and Transitional Care Management (TCM), while * Patient Resource Specialists (PRSs) support our patients by addressing health-related social needs and social determinants of health. * Manage care coordination processes across multiple payor environments, ensuring consistent standards of care, regulatory alignment, and effective operational workflows. * Ensure compliance with regulatory requirements related to care management and patient care. * Support the design and implementation of strategic initiatives that enable Author Health to innovate by piloting modifications or new builds in our care delivery model. * Participate in interdisciplinary meetings and committees to enhance coordination and communication across departments. * Coach members of the Care Management team to enhance performance on both clinical quality and overall efficiency - do so while using a data-driven approach, and by regularly shadowing and auditing individual team members (e.g., auditing calls and documentation). * Monitor and analyze data related to care management outcomes, utilization, and quality improvement initiatives. * Promote a culture of excellence, professionalism, and continuous improvement within the Care Management team. * Perform other duties as assigned to support departmental and organizational needs. Patient Care Delivery Responsibilities * Conduct regular assessments of patient needs, develop individualized care plans, and monitor progress towards goals. * Coordinate transitions of care and ensure continuity across different levels of care and health care settings. * Collaborate closely with interdisciplinary teams of health care providers both within and outside of Author Health, including physicians, nurses, therapists, and social workers, to ensure integrated care planning and delivery. * Serve as a resource for staff, patients, and families regarding care management services, resources, and community referrals. WHAT WE ARE SEEKING: * Bachelor's degree in Nursing; Master's degree preferred. * Experience building and leading teams * Minimum of 5 years of Nursing experience in care management, preferably in behavioral health or medical care settings. * Proven leadership and supervisory experience with strong team-building skills. * Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders. * Solid understanding of health care regulations, policies, and reimbursement practices. * Strong analytical skills and the ability to use data for decision-making and quality improvement. * Certification in Case Management (CCM, ACM, or similar) preferred WHAT WE OFFER: * Retirement savings plan (401k) Plan up to 3.5% company match * Low cost benefits package for employee and dependents ( medical/ dental/ vision/ STD/ Life Insurance) * Paid vacation * Paid sick leave * 9 paid holidays throughout the year with (2) additional flex holidays .. 11 in total! * Performance-based bonuses * and more! NEXT STEPS: * Submit an application * Upload an updated resume * Share LinkedIn profile and/or cover letter Author Health is committed to a diverse and inclusive workplace. It is the company's policy to comply with all applicable equal employment opportunity laws by making all employment decisions without unlawful regard or consideration of any individual's race, religion, ethnicity, color, sex, sexual orientation, gender identity or expressions, transgender status, sexual and other reproductive health decisions, marital status, age, national origin, genetic information, ancestry, citizenship, physical or mental disability, veteran or family status or any other basis protected by applicable national, federal, state, provincial or local law. The company's policy prohibits unlawful discrimination based on any of these impermissible bases, as well as any bases or grounds protected by applicable law in each jurisdiction. We are committed to providing an inclusive and accessible experience for all applicants. If you require any accommodations at any stage of the process, please let us know. The company is pleased to provide such assistance and no applicant will be penalized as a result of such a request. In accordance with applicable legal requirements such as the San Francisco Fair Chance Ordinance Author Health will consider for employment qualified applicants with arrest and conviction records. Monday through Friday, 8am-5pm EST

About Apogee Therapeutics Founded in 2022, Apogee Therapeutics, Inc. (Ticker: APGE) is a well-funded, Nasdaq listed company that offers the opportunity to work in a fast-paced, highly dynamic environment. At Apogee, you can actively contribute to shaping the company culture, take on various roles and responsibilities, and grow professionally. Apogee Therapeutics, Inc. is a biotechnology company seeking to develop differentiated biologics for the treatment of atopic dermatitis, chronic obstructive pulmonary disease and other inflammatory and immunology indications with high unmet need. Our antibody programs are designed to potentially overcome limitations of existing therapies by targeting well-established mechanisms of action and incorporating advanced antibody engineering to optimize half-life and other properties. We seek to reshape the current standard of care for inflammatory and immune diseases because we believe people living with these diseases deserve the best possible treatment, and we refuse to stop at “good enough.” We are a fast-paced company committed to building an exceptional company culture, founded on our C.O.R.E. values: Caring, Original, Resilient and Egoless. If this sounds like you, keep reading! Role Summary We are seeking a Clinical Monitoring Manager to oversee in-house Oversight CRAs that will oversee CRO CRA's management of clinical study site activities for Apogee sponsored clinical trials. This role will also support the study team in various trial related activities. In this role, you will serve as Apogee's primary liaison with the in-house CRAs and CRO clinical monitoring team and liaise with clinical study sites and contribute to building a culture of team, site and patient centricity. Helping Apogee become “Sponsor of Choice” with both our CRO partners and sites will be critical. This role is accountable for oversight of clinical monitoring activities from site identification through close out of the study site. The Clinical Monitoring Manager has ‘in-house' responsibilities (e.g., oversight CRAs), and as required by project scope, sponsor monitoring or co-monitoring visits at the clinical study sites. The Clinical Monitoring Manager collaborates closely with the Apogee Executive Director, Clinical Operations and the Clinical Study Lead, assists in the planning/management/execution of Apogee sponsored clinical trials, and contributes to the overall success of the clinical study according to company and department objectives. Key Responsibilities In-house responsibilities The Clinical Monitoring Manager is responsible for the study deliverables of in-house CRAs on a given study(s), ensuring study deliverables are met with efficiency and quality and in accordance with applicable standard operating procedures (SOPs), regulations, good clinical practices (GCP), Key Performance Indicators (KPs), and study-specific requirements May be responsible for the hiring of in-house CRAs Input into and assist with the development of study documents (e.g., protocols, case report forms, informed consent forms) Oversee development and implementation of project specific processes, tools, and documents (e.g., monitoring oversight plans, site visit report templates, monitoring tools) Support the training and development of in-house CRAs and ensuring study training compliance is maintained Works with the study team on developing and updating best practices and processes, with input on discussions around quality by design and operational delivery Oversight of review of monitoring visit reports and metrics, including protocol deviations and follow-up items, to evaluate for compliance and trends, summarizing for the study team, escalating issues, and involved in the development of corrective and preventative actions, as needed Responsible for oversight of CRA review of clinical data (e.g., electronic case report forms, eCOA data, central laboratory data, risk-based monitoring outputs, etc.) to ensure the CRAs are informed and managing their site's data with quality and integrity Responsible for ensuring CRAs maintain their sites as inspection ready, including the Trial Master File (TMF), for health authority inspections at all times Responsible for compiling and providing clinical monitoring metrics per KPIs to ensure adequate oversight of clinical monitoring activities Lead, conduct, and document regular meetings with their in-house and CRO CRA team and with individual CRAs to disseminate timely and relevant updates and best practices for consistency and efficiency Oversee the study specific performance of the CRA team(s) and implement plans of action as needed; escalate performance issues to the Executive Director, Clinical Operations Support and liaise with clinical site personnel, as needed Review and approve time sheets and expense reports Assist with review and revision of departmental SOPs and policies Assist with creation and delivery of new department initiatives, improvement plans or training May assist with the identification and selection of appropriate clinical trial sites and investigators Field monitoring responsibilities Conduct CRO co-monitoring visits or other monitoring visits (site qualification visit, site initiation visit, interim monitoring visit, or close-out visit) as required by study needs Oversee CRO site visits to qualify, initiate, and close-out study sites, and perform site monitoring to ensure study sites' compliance with study timelines, protocol requirements, and applicable regulatory guidelines Review and ensure data integrity, accuracy, and completeness at the clinical study sites Escalate site related issues to the study team Oversee the coordination for study site audit and ensure assigned study sites are inspection-ready, as needed Ideal Candidate Bachelor's degree in a scientific or healthcare-related field Minimum of 8 years of experience as a CRA or related role within the pharmaceutical, biotechnology, or medical device industry Minimum 2 years of experience leading a team of CRAs Recent experience working on respiratory, dermatology and / or gastrointestinal clinical trials a plus Certification as a Clinical Research Associate (CCRA) or equivalent preferred Recent experience working on trials utilizing risk-based monitoring models Strong knowledge of International Council for Harmonization (ICH) guidelines, Good Clinical Practice (GCP), and FDA regulations Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and Smartsheet Experience with EDC systems, electronic trial master files (eTMFs) and other clinical trial databases and systems Strong understanding of clinical trial processes and study conduct Excellent organizational and time management skills Effective communication and interpersonal skills, with the ability to work collaboratively in a team environment, but can also work independently without significant oversight Experience working in a fast-paced and dynamic environment Successfully exhibit Apogee's C.O.R.E. values: Caring, Original, Resilient and Egoless Position requires up to 35% travel, including mandatory in-person attendance at Apogee All Hands meetings typically held twice per year. Travel is also required to attend key Phase 3 meetings, typically held at the Apogee San Francisco office. This position may also require US and international travel to clinical sites and/or medical conferences. Position requires up to 35% travel, including mandatory in-person attendance at Apogee All Hands meetings typically held twice per year, and a clinical operations meeting held once per year. Travel is also required to attend key Phase 3 meetings, typically held at the Apogee San Francisco office. This position may also require US and international travel to clinical sites and/or medical conferences. The anticipated salary range for candidates for this role will be $150,000 - $170,000. per year. The final salary offered will depend on several factors, which may include, but is not limited to relevant years of experience, educational background, and geography. What We Offer A great culture, grounded in our C.O.R.E. values: Caring, Original, Resilient and Egoless Opportunity to work in a fast-paced, highly dynamic environment where you help shape the culture and company, wear multiple hats, and learn quickly Market competitive compensation and benefits package, including base salary, performance bonus, equity grant opportunities, health, welfare & retirement benefits We provide competitive time off, including three weeks PTO, two one-week company-wide shutdowns a year and dedicated paid sick leave Commitment to growing you professionally and providing access to resources to further your development Apogee offers regular all team, in-person meetings to build relationships and problem solve E-Verify Participation: As part of the I9 verification of authorization to work in the US, Apogee participates in E-Verify. To learn more about E-Verify please review this poster. A pogee Therapeutics is proud to be an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. To review our privacy policy, click here It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

About us Pomelo Care is a multi-disciplinary team of clinicians, engineers and problem solvers who are passionate about improving care for moms and babies. We are transforming outcomes for pregnant people and babies with evidence-based pregnancy and newborn care at scale. Our technology-driven care platform enables us to engage patients early, conduct individualized risk assessments for poor pregnancy outcomes, and deliver coordinated, personalized virtual care throughout pregnancy, NICU stays, and the first postpartum year. We measure ourselves by reductions in preterm births, NICU admissions, c-sections and maternal mortality; we improve outcomes and reduce healthcare spend. Role Description Your North Star: Deliver an exceptional experience to clinicians providing care to our Pomelo Care customers. Exceptional experience will be measured by: Clinician Net Promoter Score (NPS) Clinician quality metrics Clinician retention rates What You'll Do In this role, you will have the following responsibilities: Act as the primary internal point of contact for clinicians delivering care across our pilot programs; answer questions, provide feedback, and monitor utilization. Design the onboarding and training program for new clinicians, in partnership with the Training team, and ensure that all providers complete onboarding and training in a timely manner. Own communication and change management to clinicians regarding important updates, using scalable and effective methods. Maintain an up-to-date clinician handbook with accurate details on our offering, such as services included, documentation expectations, and required scripting. Ensure that clinicians meet the expectations of our client sponsors, including documentation requirements, quality standards, and preferred partners. Use data to identify areas for improvement at the individual and team level; escalate programmatic areas of opportunity and provide coaching to specific clinicians, as needed. Build relationships with relevant community clinician groups to support recruitment, build trust within the community, and stay informed of market trends. Who You Are Prior experience working within a healthcare environment, either as a clinician or as a team leader of clinicians. Strong interpersonal skills and demonstrated ability to engage with a diverse population. Demonstrated ability to build trusting relationships in a virtual environment. Excellent written and verbal communication skills. Demonstrated ability to drive change management with large frontline teams at scale. Comfort leading difficult conversations 1:1. Strong sense of ownership, with demonstrated experience partnering cross-functionally to find answers and to find solutions quickly and independently. Able to own processes end-to-end and ensure that all steps are completed accurately. Strong project management skills and attention to detail, ensuring that every step is understood accurately, completed in full, and communicated effectively. Comfort using data to inform prioritization and decision-making. Ability to adapt to changing priorities and work effectively in a fast-paced environment. Willingness to learn new processes and systems, and to teach them to others. Why you should join our team By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. And you'll learn, grow, be challenged, and have fun with your team while doing it. We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first. We also offer: Competitive healthcare benefits Generous equity compensation Unlimited vacation Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship) At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status. Our salary ranges are based on paying competitively for our company's size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $95,000-$110,000. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash. Potential Fraud Warning Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information. Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending ******************. If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at ********************** to confirm its legitimacy. For your safety, we also recommend applying only through our official Careers page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.

HistoSonics is a medical device company, founded in 2009, that has developed a non-invasive, sonic beam therapy platform that uses histotripsy, which is capable of destroying targeted liver tumors. Our mission and passion are to advance the novel science of histotripsy and its powerful benefits, bringing meaningful and transformational change to physicians and their patients. Location: Remote position, ideally candidates will live in a major metro area with an international airport. Travel Expectation: Travel (by automobile or air, day trips and overnight stays) up to 25% of the time. Position Summary: The Senior Clinical Program Manager (Sr. Clinical PM) develops, manages and executes global clinical studies in collaboration with the Clinical Affairs team in accordance with applicable regulatory requirements and company's strategic imperatives. The Clinical PM manages all activities of study design and development, vendor management, site management including qualification, training, activation and monitoring. The Sr. Clinical PM will ensure study performance and compliance. Key Responsibilities: * Responsible for the management of Clinical Trials from inception through Clinical Study Report (CSR) completion. * Ensure clinical trial activities are completed on time, within budget and in a highly dynamic and complex environment in accordance with appropriate quality standards including ICH/GCP requirements. * Create and implement study-specific clinical monitoring tools and documents. * Lead the identification, evaluation, selection, and oversight of clinical trial sites. * Author and implement operational plans to ensure efficient study enrollment and monitoring activities at clinical sites. * Review/approve vendor and site invoices and track study budget to forecast, working closely with finance and clinical business operations. * Responsible for implementation and oversight of Trial Master File for inspection readiness. * Drive overall process and provide support to cross-functional teams in the development of study documents including study protocols, consent forms and budget templates. * Serve as lead in the creation of project plans, logs, templates, newsletters, and other documents. * Review and approve site specific documents (such as informed consent forms, site budgets, monitoring reports). * Provide study updates and reports, inclusive of study risks and issues. * Lead internal and external meetings, including Investigator Meetings, conferences, events and study management meetings. * Responsible for ongoing study data reviews and data cleaning activities. * Provide oversight of study activities such as site initiation, data quality, interim monitoring and close out activities. * Support the development of study training to investigators, site staff and internal staff. * Participate in the preparation and follow up of internal process audits, vendor, and study site quality audits as well as regulatory inspections. * Other duties as assigned. Qualifications and Skills: * Bachelor's degree in relevant area of study. * Minimum of 3-5 years clinical trial management experience; IDE trial experience REQUIRED. * Minimum of 8 years experience in the medical device industry REQUIRED. * Knowledge of, and experience with, the FDA and the EU regulatory environments. * Excellent written and verbal communication skills. HistoSonics will not offer sponsorship or take over sponsorship of an employment visa for this position at this time. Benefits: We offer a comprehensive benefits package for full-time employees. This includes health, dental, and vision insurance, life, short-term and long-term disability insurance, 401(k), paid time off, and more. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. #LI-Remote

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Location: Remote (For Non-Local) or Hybrid (Local to NYC area) Position Responsibilities: Oversee a dynamic team of pharmacy technicians engaged in the prior authorization process. Analyze available data to provide prior authorization staffing, workflow, and system enhancement recommendations to maximize team agility and performance. Actively participate in the prior authorization technician metric and quality goal setting process. Generate and deliver comprehensive reports on prior authorization technician metrics to both internal and external stakeholders. Assist the talent acquisition team in the hiring, evaluation, training, and onboarding of new employees. Investigate/resolve escalated issues or problems from team members, clients, and other internal teams. Key stakeholder in ensuring the prior authorization review platform is optimized for technician functions. Maintain relationships with external Independent Review Organizations and clinical resource vendors. Support the training and growth of both new and existing staff members in adherence to proper procedures. Collaborate with prior authorization leadership to develop process improvements and support long-term business needs, recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and help establish best practices for conflict resolution while actively participating in problem identification and coordinate resolutions between appropriate parties. Assists with in other responsibilities, projects, implementations, and initiatives as needed in accordance with the policies and procedures established within the department. Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines. Maintain compliance with local, state, and federal laws, in addition to established organizational standards. Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review. Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions. Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies Required Qualifications: Active, unrestricted, National Certified Pharmacy Technician (CPhT) license required Bachelor's or Associate's degree is preferred 4+ years of PBM or Managed Care pharmacy experience required Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint Strong clinical background required Excellent communication, writing, and organizational skills Ability to multi-task and collaborate in a team with shifting priorities Preferred Qualifications: 2+ years of regulated market prior authorization operations experience or knowledge of how to operationalize regulated market requirements Previous prior authorization operations leadership experience Salary Range$80,000-$90,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Location: Remote (U.S.) Schedule: Monday-Friday, 8:00 AM-4:30 PM ET Employment Type: Full-Time Position Overview We are seeking an experienced Program Manager to oversee daily operations for the CMS Review and Validation Contractor (RVC) Program. This role serves as the primary point of contact to the CMS RVC COR and is responsible for ensuring all contract, operational, and medical review requirements are executed in accordance with CMS guidelines. The ideal candidate brings a strong clinical background (RN), extensive Medicare program knowledge, and proven leadership experience managing large, complex healthcare projects. Key Responsibilities Serve as the contractor's authorized representative on all daily operational matters. Maintain ongoing communication with the CMS RVC COR regarding contract performance, staffing, and deliverables. Oversee medical review activities and ensure compliance with CMS guidelines and FFS RAC Program requirements. Lead cross-functional teams and manage staff required to support RVC operations. Ensure accurate interpretation of Medicare coverage, documentation, and regulatory standards. Monitor project progress, performance measures, and quality assurance outputs. Prepare operational updates, reports, and data summaries for CMS and internal leadership. Ensure effective workflows, staffing coverage, and adherence to deadlines and contract terms. Provide clinical oversight and guidance across medical review tasks and methodologies. Required Qualifications 5+ years of Program Management experience overseeing large or complex healthcare projects. Experience in medical review, healthcare auditing, or clinical review operations. Extensive knowledge of the Medicare program, including CMS regulatory and operational requirements. Working knowledge of the CMS FFS RAC Program. Strong leadership abilities with experience managing multidisciplinary teams. Education & Licensure Master's degree in Business, Healthcare Administration, Nursing, Management, or a related healthcare field from an accredited institution. Current, active U.S. Nursing License (RN); must be maintained throughout employment. Preferred Skills Excellent written and verbal communication skills. Strong analytical, organizational, and problem-solving abilities. Experience working with government contracts or federal healthcare programs. Ability to manage multiple projects and deadlines in a fast-paced environment. Why Join Us Opportunity to lead mission-critical work that supports the integrity of the Medicare program. Collaborative team environment with impactful clinical and operational responsibilities. Competitive compensation and benefits package. How to Apply Submit your resume detailing your program management experience, clinical background, and Medicare/CMS expertise. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

Description - Behavioral Health Services Manager Original Board Approval Date 08/26/2020 Reports to Director of Behavioral Health Division Behavioral Health/Administrative Exempt/Non-Exempt Status Exempt Security Roles Clinical Administration; Clinical Care Specialist JOB SUMMARY: The Behavioral Health Services Manager plays a key role in supporting HOPE's integrated care model by helping oversee the day-to-day operations of the Behavioral Health (BH) department. This position provides direct supervision to BH nurses, medical assistants, and other support roles within the department, ensuring high-quality, patient-centered care. The Manager also serves as a vital administrative partner to the Director of Behavioral Health, offering clerical, programmatic, and operational support to help drive departmental goals, improve workflows, and maintain compliance with FQHC standards. Primary Duties & Responsibilities: Clinical Support: Demonstrates proficiency in all aspects of patient triage within the Behavioral Health department and completes competency assessments for both new and existing employees. Serves as a backup for the Behavioral Health medical assistant or nurse during periods of absence to ensure continuity of patient care and clinic operations. Human Resources & Staffing Support: Assists with the orientation and onboarding of new Behavioral Health staff, including interview coordination and preparation of new hire materials. Manages the department's weekly staffing schedule, including time-off approvals, timesheet submissions, missed punch corrections, and payroll approvals using ADP. Organizes and facilitates regular departmental meetings, including preparing agendas and documenting meeting minutes. Quality Improvement & Data Management: Supports departmental quality improvement efforts through data collection, analysis, and reporting. Tracks and reports on key indicators such as patient satisfaction, departmental expenses, and service utilization. Provides feedback and suggestions for process improvement based on insights from staff, patients, and community partners. Collaborates with the Director of Behavioral Health to develop and maintain spreadsheets and databases (e.g., Excel) to support budgeting and quality initiatives. Assists with the maintenance and updates of departmental forms and documentation. Community & Program Development: Educates patients, families, and community partners on available behavioral health services. Assists the Director of Behavioral Health in community outreach efforts to increase awareness and utilization of services. Represents the Behavioral Health department on internal committees, such as the Compliance/Risk Committee, Safety Committee, and Quality Assurance/Quality Improvement (QA/QI) Committee. Administrative & Operational Support: Provides general administrative support to the Director of Behavioral Health, including assistance with travel arrangements, training logistics, and expense reimbursements. Demonstrates adaptability and serves as a change agent to support ongoing departmental and organizational improvements. Supports teamwork and proactive communication among the Behavioral Health team and across departments. Intermittent Duties: Performs other duties as assigned by the Director of Behavioral Health to support departmental operations and organizational needs. Off-Site Work: Occasional off-site work is required for this position. With prior Team Leader approval, various job tasks may be completed remotely. These may include, but are not limited to: program development, policy and procedure updates, conference calls, grant writing, and similar administrative tasks. Employees approved for off-site work must have a confidential, designated workspace to ensure privacy and productivity. Off-site work classification and arrangements will be reviewed by the Team Leader at hire, during annual performance evaluations, and as needed throughout the year. Skills/Qualifications: Education & Experience: Some college coursework with 2-4 years of experience in a social or human services-related field, preferably with direct behavioral health experience. Bachelor's degree in a related field preferred. Specialized training or certifications (e.g., Non-Violent Crisis Intervention, Suicide Prevention/Intervention) are preferred. Technical & Professional Skills: Proficient in Microsoft Office Suite (Word, Excel, PowerPoint); ability to learn additional software and systems as needed. Strong organizational and time management skills, with the ability to prioritize tasks, meet deadlines, and manage multiple responsibilities. High-level problem-solving skills and sound judgment, with the ability to make independent decisions and consult with leadership when appropriate. Communication & Interpersonal Skills: Excellent verbal and written communication skills. Demonstrated cultural competency and the ability to engage effectively with individuals from diverse backgrounds. Strong interpersonal skills and a professional, customer-service-oriented demeanor. Other Key Competencies: Ability to take initiative and follow through on assignments with minimal supervision. Flexible, adaptable, and able to function effectively in a fast-paced, team-oriented environment. Personal Attributes: The Behavioral Health Services Manager must maintain strict confidentiality and consistently uphold HOPE's core values while performing all duties. The ideal candidate will demonstrate the following personal qualities: Trustworthiness and integrity Respectfulness toward patients, colleagues, and the community Cultural awareness and sensitivity to diverse backgrounds Flexibility and adaptability in a dynamic work environment Strong work ethic and commitment to excellence Working Conditions & Physical Demands: This position primarily functions in a professional office environment with periodic travel between HOPE sites. Occasional extended hours may be required based on organizational priorities. As a healthcare setting, employees may be exposed to body fluids and other potential health hazards. Requires sufficient visual acuity to read, write, and operate equipment commonly used in this role. Must be able to communicate effectively in English, both verbally and in writing; proficiency in a second language is helpful but not required. Requires adequate hearing ability to communicate effectively in person and by telephone. Occasionally required to lift items weighing up to 25 pounds. Note: This is intended to convey information essential to understanding the scope of the Behavioral Health Services Manager. It is not intended to be an exhaustive list of qualifications, duties, or responsibilities, as other duties may be assigned as needed. This job description follows the Americans with Disabilities Act (ADA) and the Fair Labor Standards Act (FLSA) (May 1995) HOPE Family Health Services is an equal opportunity employer who complies with applicable State and Federal civil rights laws and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, veteran or disability status. Many positions at HOPE Family Health Services are funded in-part or in-whole by State or Federal Department of Health and Human Services funding and as such, our organization cannot employ individuals with certain criminal backgrounds or who are on State or Federal exclusion or debarment lists.

The Clinical Manager is responsible for developing and implementing clinical training curricula detailing the application and fitting of the designated Etac product area to achieve positive functional outcomes. This position trains providers, therapists, and sales associates in the form, fit, and function of Etac products and their clinical applications. This is a traveling position providing product presentations, clinical in-services, and product/client fittings with providers and/or clinicians and provides one-on-one training with sales associates with the goal of supporting efforts to increase sales of all designated Etac products. The role also supports and leads larger in-person clinical product education and training engagements with key customers. Product Areas: Seating & Positioning: all Etac North America Mobility custom and “packaged” seating products, including Axiom, Axiom Kids, Axiom Custom Back, Axiom Custom Seating, Star Cushions, secondary positioning supports, and other products and accessories as they may be designated in the future. Mobility: all Etac North America Mobility manual wheelchairs and related accessories or components, including power assist. This includes manual wheelchair in the folding, rigid, tilt-in-space, pediatric and adolescent categories, as well as, any products and accessories as they may be designated in the future. Pediatrics: all Etac North America Mobility products intended for use by the pediatric population. This includes all products, accessories, or components from R82, Convaid, Ki Mobility, including power assist. This will also include any products and accessories as they may be designated in the future. Essential FunctionsJob Responsibilities Assist in the development of clinical training curricula relating to relevant Etac products. Create and deploy training materials that will be used by sales associates, export partners, and other clinical education team members. Establish and maintain a travel schedule with Etac sales associates centered around in-field customer and clinician engagements. Attend trade shows, customer events, and sales meetings as necessary. Contribute to the development of the company's strategic plan to drive future growth and profitability for relevant Etac products. Present professional continuing education content (CEUs) as needed, either through coordination with sales associates and managers, or at key business partner education events. Manage sales expenses within the guidelines of the Company expense policy. Work closely with the sales team, specifically Territory Sales Managers, to align training initiatives with sales strategies and customer needs. Collaborate with cross-functional teams to align and deliver product education and training programs. Uphold Company values and ethical business conduct, as well as, maintain confidentiality of sensitive information. Utilize sales and order analysis tools, including Qlik, to strategically plan and prioritize travel to optimize effectiveness. Utilize sales and order analysis tools, including Qlik, post-travel to analyze effectiveness of travel and/or training curricula. Be a key contributor to product development requirements around competitive opportunity, clinical requirements and efficacy that deliver strong new product enhancements that meet market needs. Ensure and follow safety, quality, and other company requirements and standards. Keep the work area clean and orderly. Perform all duties in a manner that follows, demonstrates, and promotes Company's values. Report to work as scheduled, on time, and able to work entire work schedule. Perform additional duties as assigned. Knowledge, Skills, and Ability Excellent presentation skills and confidence in front of small and large groups. Strong organizational skills. Strong Microsoft PowerPoint skills. Knowledge and proficiency with Microsoft Office Suite products, including Excel and Outlook, and other enterprise software. In depth knowledge of clinical issues relating to disabled populations. Knowledge of manual mobility and seating products than span adult and pediatric solutions within the complex rehabilitation industry. Ability to establish and maintain professional communications both inside and outside the company. Funding knowledge within complex rehab technology. Ability to network with providers, ATP's, clinicians, and caregivers. A high level of interactive communication is required to service our customers and clinicians; must be able to respond quickly and effectively to satisfy customer and clinician inquiries. Possess a strong business acumen with an understanding of market potential and contract development. Analytical skills in order to solve complex problems and make informed decisions. Possess excellent written and oral communication and interpersonal skills to collaborate effectively with cross-functional teams. Proactive and self-motivated with the ability to work independently and in a team environment. Ability to lift and handle wheelchairs. Ability to observe and identify details. Ability to work extended hours as scheduled, including weekends. Physical Demands Frequent sitting, wrist manipulation, walking, and standing. Frequent bending, pushing, pulling, and twisting. Occasional to frequent driving in a vehicle. Frequent light/medium work with lifting up to 30 pounds. Occasional medium work with lifting up to 50 pounds. Must be able to lift, handle, load, and unload all products. Manual dexterity to type and operate office equipment frequently. Must be able to complete all physical requirements to perform essential functions. QualificationsEducation/Experience Degree in a clinical discipline (Occupational or Physical Therapy, Kinesiology) or a related field or 3-5 years of experience in the complex rehab industry. ATP certification is beneficial. Must possess and maintain a valid driver's license. Intermediate level experience with computer applications. Working Environment Remote position with an expectation of up to 75% travel focusing on specific key referral sources, their clinicians, providers, and ATP's. This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the associate for this position. Duties, activities, and responsibilities may change, or new ones may be assigned at any time with or without notice. Associate must be able to satisfactorily perform the essential functions of the position with or without reasonable accommodations. Ki Mobility is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.

Ready to Elevate Addiction Recovery? If you're looking to redefine the way care is delivered and be at the forefront of addiction recovery, we have the career for you! Your expertise and compassion can change lives-one virtual session at a time Gateway Rehab Center (GRC) is seeking a passionate and skilled Clinical Manager to revolutionize the way we deliver care. This management position allows you to bring compassion, innovation, and expertise to individuals on their journey to recovery-all from the comfort of your home with occasional travel to a GRC location. If you're driven by the mission of making high-quality, accessible care a reality for all, we want to hear from you! Please Note: This is a remote position with occasional travel to a GRC facility in Robinson, PA. Ideal candidate should live in the Pittsburgh area or surrounding counties. Why Choose Gateway Rehab? Make an impact through Gateway's mission “to help all affected by addictive disease to be healthy in body, mind, and spirit.” Be a part of an organization that has been leading the way in addiction treatment for over 50 years. Leverage cutting-edge telehealth technology to bridge gaps in care and transform lives. Enjoy the flexibility of a remote role while maintaining meaningful client Why This Role is the Future of Addiction Treatment? GRC's Telehealth Services team is changing lives, and as a Clinical Manager you'll be at the forefront of this movement. Your work will expand access to critical services, empower clients, and shape the future of addiction recovery. This is more than just a job-it's a mission-driven career where you can make a lasting impact every single day. Your Role in Transforming Recovery Conduct authorization audits to ensure timely completion, avoiding any disruption in payments. Develops a training curriculum for Aura/m.care, tailored for new hires in all Telehealth positions. Performs chart audits for compliance of all new admissions, ensuring deadlines are met and sending reminders to staff with outstanding documentation. Maintains staff training records and identify training opportunities based on areas of need, as recommended by the Director or Executive Director. Oversees patient program attendance, ensuring compliance with policies and licensure requirements, particularly for psych services and IOP. Conducts documentation audits across different levels of care to ensure timely completion of all required items. Attends mandatory GRC trainings and in-services. Requirements What We're Looking For Master's degree in field that meets Pennsylvania Department of Health staffing qualification regulations required. License or certification from the Pennsylvania Certification Board eligible. Two years' clinical experience in a health or human service agency, including one year working directly with chemically dependent persons. Supervisory experience preferred. Knowledge of Substance Use Disorders and Evidence-based treatment methods. Strong leadership skills. Ability to manage crisis, make decisions, and make sound clinical judgements. Excellent written and verbal communication skills. Additional Requirements Pass PA Criminal Background Check. Obtain PA Child Abuse and FBI Fingerprinting Clearances. Pass Drug Screen. TB Test. Work Conditions Remote with travel into a GRC facility. Favorable working conditions. Minimal physical demands. GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.

Join the BlueCare team at BCBST as a Clinical Review Manager! In this role, you will complete medical reviews for utilization management within the BlueCare member population. You'll have the opportunity to collaborate with the BlueCare Utilization Management team, Case Managers, and other departments. The ideal candidate for this role is a quick learner who thrives in a role that requires attention to detail and research skills. The role also requires the ability to navigate clinical information and disseminate it in a timely manner. Finally, we're looking for a candidate with strong communication skills to be able to work effectively across multiple teams. Key Schedule Details: Typical schedule is 8-5 pm EST or 9-6 pm EST. Fully remote, at home position. There is an option, upon management approval, for alternative workdays or a compressed work schedule. For example, the Clinical Review Manager may work five 8-hour shifts or four 10-hour shifts, which may include a combination of weekdays and weekends (e.g., Wednesday-Sunday or Thursday-Sunday)." Join our team and make a significant impact on the quality of care our members receive! Job Responsibilities Initiate referrals to ensure appropriate coordination of care. Seek the advice of the Medical Director when appropriate, according to policy. Assists non-clinical staff in performance of administrative reviews Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility. Occasional weekend work may be required. Must be able to pass Windows navigation test. Testing/Assessments will be required for Digital positions. Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. Job Qualifications License Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law. Experience 3 years - Clinical experience required Skills\Certifications Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint) Working knowledge of URAC, NCQA and CMS accreditations Must be able to work in an independent and creative manner. Excellent oral and written communication skills Strong interpersonal and organizational skills Ability to manage multiple projects and priorities Adaptive to high pace and changing environment Customer service oriented Superior interpersonal, client relations and problem-solving skills Proficient in interpreting benefits, contract language specifically symptom-driven, treatment driven, look back periods, rider information and medical policy/medical review criteria Number of Openings Available 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.