Prior Authorization Medical Director Physician- Los Angeles, CA Area - Work From Home
Remote job
Prior Authorization Medical Director Physician Opportunity in the Los Angeles Area
Please consider this unique opportunity to join a well-established and respected group of innovators in value-based care. This group of thought-leaders are in search of physician leaders to work alongside them to move the organization forward.
Requirements
MD/DO degree required
Remote position, but candidate must live in the greater L.A. area for onsite meetings.
Minimum of five years of prior clinical experience required, with at least two years of managed-care or health-plan experience preferred
About the Opportunity
Understand, promote, and manage the principles of medical management to facilitate the right care for patients at the right time and in the right setting.
Review prior authorization requests for medical necessity using appropriate clinical guidelines.
Identify high-risk patients and help coordinate care with the Employer's high-risk team.
Participate in meetings to review, develop, and continually improve internal quality improvement and peer review processes and programs.
Perform prior authorization functions for various Employer campuses, should the need arise in cross coverage, secondary/tertiary review, or medical director decision-making.
Perform retroactive claims review for outpatient and inpatient care, as needed.
Compensation and Benefits
Competitive salary and aggressive incentives
Comprehensive benefits including medical, dental, vision, and 401k
Sign on bonus
Ample paid time off
About the Area
Live in the entertainment capital of he world and enjoy dynamic mix of amenities that include outdoor adventures, fine dining, theme parks, the arts, world-class sports teams, and access to a major international airport
Unmatched cultural amenities in one of the most diverse areas of the world
Excellent public and private schooling options as highly respected colleges and universities
World-class beaches and mountain resorts are within a short drive
Enjoy a warm climate with over 300 sunny days a year
Advanced Practice Clinician Manager
Remote job
Unless otherwise noted, all positions are fully remote with work permitted from the following states: CA, CO, HI, IL, MA, MD, NJ, NM, NY, OR, and WA.
We are living through a pivotal moment for reproductive and sexual health-and Hey Jane is uniquely positioned to help.
From day one, we've been committed to providing safe, discreet medication abortion treatment-and have helped more than 100,000 people get the care they need. Today, we offer a range of reproductive and sexual health care services from the comfort and convenience of your phone. Our in-house clinical care team, composed of board certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away. We're committed to helping our patients get safe, discreet, judgment-free virtual health care, from a team that truly cares.
Role Overview
We are seeking a compassionate, detail-oriented, and experienced APC Manager who thrives in a fast-paced clinical environment and is motivated by the opportunity to expand access to high-quality, patient-centered care.
In this role, you will lead and manage a team of nurse practitioners and certified midwives, ensuring the delivery of safe, compliant, and compassionate care across all aspects of our services. You will oversee day-to-day clinical operations, drive performance management for your team, and serve as a critical bridge between the clinical team and organizational leadership-translating strategy into action through strong communication, sound judgment, and operational excellence. Working in a startup telehealth environment requires flexibility and adaptability, while offering the unique opportunity to shape and refine clinical workflows.
The ideal candidate is both a skilled Nurse Practitioner and an empathetic leader-comfortable mentoring others, managing tough conversations, and steering the team through change with grace and accountability. You'll excel at building trust within your remote team, fostering a culture of continuous improvement, and ensuring that every patient receives timely, evidence-based care delivered with empathy and respect.Qualifications
5+ years of clinical experience as a NP or CNM with 1+ years in reproductive or sexual health
2+ years of experience managing clinical teams, preferably in telehealth, reproductive healthcare, or a startup environment
Proven ability to motivate, mentor, and support clinical staff with a focus on team morale, development, and accountability
Proven ability to foster collaboration, trust, and a supportive team culture
Experience documenting protocols, implementing process updates, and training teams through changes in clinical or operational systems
Strong interpersonal and communication skills, with the ability to collaborate effectively across clinical, operational, and leadership teams
Knowledge of healthcare compliance, regulatory requirements, and quality assurance frameworks
Ability to analyze clinical and performance data and translate insights into actionable improvements
Deep understanding of trauma-informed care principles
Comfortable working in a fast-paced, mission-driven startup environment
Able to travel to on-site location at least once a quarter
At Hey Jane, we work towards the vision of having equitable healthcare, changing the status quo, and rebuilding the way people experience healthcare-and bring that same vision to our workplace. We're an equal opportunity employer committed to building an inclusive environment, and encourage all applicants from every background and life experience.
Auto-ApplyLegal Office Manager and Biller
Remote job
Job DescriptionBenefits:
Bonus based on performance
Flexible schedule
Paid time off
Training & development
Legal Office Manager and Biller (Law Firm) Lakeland, FL | Full-Time | Hybrid Work
About Us
RAK Law is a boutique business and construction law firm dedicated to delivering exceptional legal services. We are seeking an experienced and driven Operations & Billing Manager to join our team. This role is essential to maximizing firm efficiency, ensuring financial accuracy, and supporting long-term growth.
Job Summary
The Operations & Billing Manager will oversee the firms billing, financial tracking, internal systems, and team workflows. This individual will act as both billing gatekeeper and operations leader ensuring accurate time capture, smooth case flow, and compliance with legal and regulatory requirements.
This is not just an administrative role; it is a firm leadership position with decision-making authority over processes, systems, and operational improvements. The firms office is located in Lakeland, Florida. While you will primarily work remotely, you will be expected to come into the office once per week. ,
Key Responsibilities
Billing & Finance
Audit pre-bills, verify time entries, and ensure accurate client invoices.
Implement and maintain billing standards, including a firm billing playbook.
Manage trust-to-operating account transfers and maintain financial tracking spreadsheets.
Analyze expenses, prepare profitability dashboards, and set billing minimums per employee.
Examine financial data and budgets, providing financial forecasts and insights.
Operations & Process Development
Oversee all operational aspects of the firm, ensuring efficiency and accountability.
Map and optimize the case lifecycle from intake to closure.
Develop SOPs, checklists, and training guides for consistent execution.
Lead process improvements to eliminate inefficiencies and missed deadlines.
Create and monitor key performance indicators (KPIs) for firm operations.
Coordinate after-hours working sessions to tackle backlog and align priorities.
Systems & Technology
Serve as the primary administrator for MyCase, optimizing workflows, task management, and client communications.
Standardize and protect all firm templates with naming conventions, formatting rules, and permissions.
Act as the sole liaison to IT (internal and external), managing access, permissions, and troubleshooting.
Team Leadership & Development
Partner with the Managing Partner to support the professional growth of attorneys, paralegals, and staff.
Schedule one-on-one coaching, create growth plans, and track accountability.
Hold team members responsible for meeting deadlines, billing expectations, and performance milestones.
Help ensure each employee is working within their strengths while addressing developmental needs.
Qualifications
Required:
Bachelors degree in Business, Finance, or a related field.
Minimum 3 years experience in law firm operations, billing, or management.
Strong knowledge of legal billing practices and accounting basics (trust accounts, AR, expense analysis).
Experience with MyCase (or similar practice management software).
Proven ability to design, implement, and enforce processes and SOPs.
Excellent organizational, analytical, and leadership skills.
Preferred:
Prior experience managing small law firm teams.
Strong Excel skills (dashboards, expense analysis, billing minimums).
Familiarity with Florida legal practice requirements.
Deep understanding of organizational effectiveness and operations management.
Who You Are
A natural problem solver and process builder who sees inefficiencies and fixes them.
A confident leader who can hold attorneys and staff accountable.
A detail-oriented financial manager who understands the importance of accurate billing and profitability tracking.
A strategic thinker who can set goals, monitor KPIs, and align operations with growth.
A collaborator who can support both team development and firm-wide success.
Benefits & Perks
Competitive Compensation
Paid Time Off
Career Growth Opportunities
Professional Development Support
Please do not call. Applications missing required questions or tests will not be considered.
Flexible work from home options available.
Manager _ Tax Practice
Remote job
Department
Escalon Tax Practice
Employment Type
Full Time
Location
Remote
Workplace type
Fully remote
What You'll Bring Why You'll Enjoy Working at Escalon: More about us: About Escalon Services, LLC.
CE Practice Manager
Remote job
The Role The CE & Power Platform Practice Manager will play a key role in ensuring the successful delivery of projects, maintaining high levels of employee engagement, and contributing to the growth of the CE & Power Platform practice. This role will uphold Western Computer's gold standard of customer satisfaction, drive forward the Customer Engagement functional area, manage team performance, and collaborate with peers and leadership to maintain and improve the overall health of the practice.
In 2026, we look forward to expanding this practice to be the connector for a customer's business applications, establishing a strong foundation for the use of AI. Experience in Power, CoPilot, and integrations or a passion for learning these areas will drive success in this role.
Key Responsibilities
Drive Practice Success
* Partner with the Practice Director to identify and drive strategic initiatives that improve delivery efficiency, profitability, and client satisfaction.
* As we focus on growth in CE, Power, and Integrations, we will be filling the Director role. There will be an interim period prior to the Director being added to the team.
* Collaborate with senior leaders to define and design the future state of the CE and Power teams, ensuring alignment with Microsoft's strategic initiatives
* Monitor and react to KPIs to ensure customer satisfaction, employee engagement, and overall practice health.
* Contribute to the creation and achievement of annual OKRs for the practice.
* Collaborate across practices to ensure consistent delivery methodology and alignment with company goals.
Maintain Project Health
* Uphold the gold standard of customer satisfaction across assigned projects.
* Partner with Solution Architects and Project Managers to ensure timely, high-quality project delivery aligned with client expectations.
* Monitor active projects to identify risks, proactively addressing potential delivery or resource challenges.
* Assist in resolving project escalations by developing "get-to-green" recovery plans, negotiating financial adjustments when needed, and rebuilding client trust and confidence.
Client Management
* Develop and maintain strong relationships with clients to ensure consistent communication and satisfaction.
* Support the management of escalated client issues and ensure resolution aligns with Western's delivery standards.
* Champion the client experience by gathering feedback and driving continuous improvement across delivery teams.
Team Management
* Lead and coach assigned team members including Project Managers, Consultants, and Solution Architects.
* Oversee team performance and engagement through consistent feedback, performance discussions, and career path planning.
* Manage employee satisfaction issues promptly and effectively, fostering an environment of trust and accountability.
* Evaluate team skillsets to identify training opportunities, capacity needs, and potential expansion areas.
Process Improvement
* Contribute to the enhancement of delivery processes and methodologies to drive standardization, efficiency, and quality across projects.
* Collaborate with peers to identify gaps and implement best practices that strengthen delivery consistency.
* Promote knowledge sharing and encourage cross-team collaboration within the practice
Support Sales Processes
* Provide presales support by assisting with scoping, estimating, and reviewing Statements of Work (SOWs).
* Collaborate with Sales and Solution Architects to ensure proposals reflect achievable project plans and align with client needs.
* Engage with prospects as a subject matter expert, articulating the CE & Power solutions, project approach, and value proposition with confidence.
* Understand when integrations will need custom development tools and determine feasibility.
* Understand integration trends and customer needs and work with the team to create scalable solutions to deliver results in an efficient way
Qualifications
* 8+ years of experience leading or delivering Microsoft Dynamics 365 CE (CRM) and Power Platform implementations.
* Proven experience in practice management, people management, project management, or consulting leadership within a professional services environment.
* Experience with Celigo, Dual Write, and Power Automate or other integration and automation tools
* Strong leadership and interpersonal skills with the ability to mentor, motivate, and develop high-performing teams.
* Experience in CE sales is a plus.
* Excellent communication, presentation, and negotiation abilities.
* Skilled in conflict resolution and driving results through collaboration.
* Deep understanding of project management methodologies and change management principles.
* Passion for delivering innovative CE & Power solutions that drive measurable business value for clients.
The Perks:
* Stellar Salary: Get ready to be rewarded handsomely, with a competitive OTE ranging from $150k - $170k USD per year. Your skills and experience are pure gold, and we want to show you the appreciation you deserve.
* Super Healthcare Benefits: Say goodbye to worries about medical, dental, and vision costs. We've got your back with access comprehensive healthcare coverage, and yours is covered!
* Retirement Treasure: Invest in your future with access to a 401(k)-retirement plan. Your financial security is important, and we're here to help you build it.
* Time to Chill: We believe in the power of relaxation. Enjoy generous paid time off for vacations, holidays, and those inevitable sick days. Work hard, but don't forget to play hard!
* Remote Work Magic: Embrace the freedom to work remotely from the location of your choice.
Who we are:
We've been on an exciting mission since 1987 to partner with customers as they transform and grow their businesses. As a Microsoft Solution Partner, we're recognized as a top partner. We owe that success to our team of 150+ Microsoft Dynamics 365 and Power Platform solutions experts who pair business needs with system capabilities to create the recipe for success. We are continuously innovating to maximize our customers' technology investments. From our IP products to our teams who always have a little fun, we are not your average ERP company.
We encourage you to apply even if you feel that you do not meet all of the above qualifications. Frequently cited statistics show that women and underrepresented groups are more likely to only apply to jobs if they meet 100% of the listed qualifications. Western Computer encourages you to break that statistic and to apply. No one ever meets 100% of the requirements. We look forward to your application!
Practice Manager
Remote job
Union Square Endodontics, a busy specialty practice in San Francisco, California, is looking for a talented and skilled Practice Manager to help us fulfill our mission of improving the lives of our patients by providing a world-class specialty experience. If you're passionate about delivering exceptional patient care and leading a dynamic team, we'd love to connect with you!
Why Union Square Endodontics?
At Union Square Endodontics, we believe in the power of collaboration and continuous learning. Our diverse team includes Dental Assistants, Sterilization Technicians, Specialists, Office Managers, and Patient Care Coordinators who work together to ensure exceptional patient experience and outstanding clinical results. We're committed to fostering an environment where all employees are valued, respected, and given the opportunity to thrive-at work, at home, and everywhere in between.
Your Role: Practice Manager
As our Practice Manager, you will play a crucial role in ensuring our operations run smoothly, efficiently, and in compliance with all regulations. You'll be responsible for mentoring team members, enhancing patient experiences, and implementing best practices across all levels of our organization. Here's what you can expect in this role:
Overseeing daily operations to ensure they are carried out in a cost-effective manner.
Managing budgets, financial data, and forecasts to improve profitability.
Purchasing materials, planning inventory, and optimizing warehouse efficiency.
Ensuring the practice remains compliant with all legal and healthcare regulations.
Implementing quality controls and monitoring key performance indicators (KPIs).
Training and supervising staff, while fostering a culture of continuous improvement.
Enhancing the quality of patient care through innovative and compassionate leadership.
Coordinating and facilitating additional office responsibilities as needed.
Your Background:
We're looking for a resourceful and compassionate Practice Manager who excels at leading teams and achieving financial goals. You thrive on seeing patients leave our office healthier and happier, and you're a problem-solver who can adapt to changing priorities. Here's what we're looking for:
3+ years of experience managing a dental practice, specialty experience a plus.
Expertise in insurance verification, claims, and resolution processes.
Strong understanding of patient and insurance accounts receivable (AR) management.
Proven ability to maintain positive employee relations and oversee payroll.
Solid knowledge of profit and loss (P&L) management, with a focus on controlling expenses.
Familiarity with standard OSHA and HIPAA practices and policies.
Exceptional people skills, with the ability to work with a wide range of personalities and build trust with long-tenured team members.
Open, transparent, and warm leadership style that fosters collaboration and mutual respect.
Comfort managing a busy, high-volume practice (50+ patients a day).
Flexibility to partner with multiple doctors and staff.
Cultural awareness and inclusivity, with bilingual skills in Chinese or Spanish considered a strong plus.
If this describes you, you'll fit right in with our team!
Schedule Requirements:
This is a full-time position with a Monday-Friday schedule.
Your Benefits & Perks:
We offer a comprehensive benefits package designed to support you in all aspects of your life, including:
BCBS High Deductible & PPO Medical insurance Options
VSP Vision Coverage
Principal PPO Dental Insurance
Complimentary Life Insurance Policy
Short-term & Long-Term Disability
Pet Insurance Coverage
401(k)
HSA / FSA Account Access
Identity Theft Protection
Legal Services Package
Hospital/Accident/Critical Care Coverage
Paid Time Off
Diverse and Inclusive Work Environment
Strong culture of honesty and teamwork
#priority
We believe in transparency through the talent acquisition process; we support our team members, past, future, and present, to make the best decision for themselves and their families. Starting off on the right foot with pay transparency is just one way that we are supporting this mission.
Position Base Pay Range
$75,000 - $85,000 USD
Specialty1 Partners is the direct employer of non-clinical employees only. For clinical employees, the applicable practice entity listed above in the job posting is the employer. Specialty1 Partners generates job postings and offer letters to assist with human resources and payroll support provided to the applicable practice. Clinical employees include dental assistants and staff assisting with actual direct treatment of patients. Non-clinical employees include the office manager, front desk staff, marketing staff, and any other staff providing administrative duties.
Specialty1 Partners and its affiliates are equal-opportunity employers who recognize the value of a diverse workforce. All suitably qualified applicants will receive consideration for employment based on objective criteria and without regard to the following (which is a non-exhaustive list): race, color, age, religion, gender, national origin, disability, sexual orientation, gender identity, protected veteran status, or other characteristics in accordance with the relevant governing laws. Specialty1 Partners' Privacy Policy and CCPA statement are available for view and download at **************************************************
Specialty1 Partners and all its affiliates participate in the federal government's E-Verify program. Specialty1 further participates in the E-Verify Program on behalf of the clinical practice entities which are supported by Specialty1. E-Verify is used to confirm the employment authorization of all newly hired employees through an electronic database maintained by the Social Security Administration and Department of Homeland Security. The E-Verify process is completed in conjunction with a new hire's completion of Form I-9, Employment Eligibility Verification upon commencement of employment. E-Verify is not used as a tool to pre-screen candidates. For up-to-date information on E-Verify, go to **************** and click on the Employees Link to learn more.
Specialty1 Partners and its affiliates uses mobile messages in relation to your job application. Message frequency varies. Message and data rates may apply. Reply STOP to opt-out of future messaging. Reply HELP for help. View our Privacy & SMS Policy here. By submitting your application you agree to receive text messages from Specialty1 and its affiliates as outlined above.
Auto-ApplyAdvanced Practice Consultant
Remote job
ARIZONA BOARD OF NURSING
The mission of the Arizona State Board of Nursing is to protect and promote the welfare of public by ensuring that each person holding a nursing license or certificate is competent to practice safely. The Board fulfills its mission through the regulation of the practice of nursing and the approval of nursing education programs. The mission, derived from the Nursing Practice Act, supersedes the interest of any individual, the nursing profession, or any special interest group.
Advanced Practice Consultant
Job Location:
1740 West Adams Street Suite 200
Phoenix, Arizona 85007
Posting Details:
Hourly Pay Rate: $47.59
Grade: 29
This position will remain open until filled
Job Summary:
The Advanced Practice Consultant (APC) investigates both alleged nurse practice and non-nurse practice violations of the Nurse Practice Act, and recommends appropriate disciplinary action to the Board.
Job Duties:
• Reviews complaints and develops an investigative plan. Interviews complainants, witnesses, providers, and respondents and obtain written statements, records, and evidence relevant to the investigation. Prepares and issues subpoenas to obtain or inspect pertinent information (police reports, medical records, personnel records, etc.). Gathers and preserves documentary and physical evidence
• Enters relevant case information and documents into the database to track and monitor open cases to ensure accurate status, and timely resolution of complaints. Analyzes medical records, medical documentation, legal documents, evaluations, healthcare and employment-related records, government records, and practice reviews
• Writes reports of findings to summarize the evidence obtained and submit for review and use in disciplinary proceedings. Conducts multi-agency investigations regarding various subject matter in high-profile cases. Prepares Interim Orders requesting licensees consider voluntarily submitting to an evaluation or drug test, based on prior board actions and presents findings for final action
• Presents cases at Board Meetings and testifies in administrative hearings as an official witness. Works with applicable staff to refer criminal actions to appropriate law enforcement entities. Submits cases for summary suspensions, consent agreements and non-disciplinary actions
• Takes part in projects and presentations
• Other duties as related to the position
Knowledge, Skills & Abilities (KSAs):
Knowledge:
• Knowledge in applicable laws, rules, policies, procedures and standards related to standards of practice and nursing scope of practice
• Knowledge in health care issues and standards of care for various populations including acute care and long term services
• Knowledge in project management principles, professional report writing principles
• Knowledge reporting regulations for abuse and neglect of vulnerable populations
• Knowledge of Nurse Practice Act rules and regulations
Skills:
• Strong interpersonal skills in order to effectively relate to licensees and certificate holders, complainants and inter-agency stakeholders
• Basic computer operations skills, including working with Word and Google documents, and use of databases
• Skilled in nursing process including assessment, monitoring and evaluation
• Skilled in medical chart review
Ability:
• Ability to work well with others; prioritize, plan, analyze, coordinate and manage a caseload; maintain objectivity; produce timely and accurate reports and documentation; and in presenting cases in a Board meeting or hearing
• Ability to interpret rules, laws, and policies and apply to unique case circumstances
• Ability to work independently and with a variety of internal and external customers
• Ability to organize, prioritize and track files and information from various sources
• Critically analyze problems and develop plans for remedial action
• Ability to work in a fast-paced environment
Selective Preference(s):
• Experience as Advanced Practice Nurse, legal nurse consulting, investigations, substance abuse, and in acute, outpatient, public health or long-term care settings preferred
• Minimum of 5 years nursing experience
Licenses/Certifications:
• Current unencumbered license/certification as a Registered Nurse and Advanced Practice Nurse with prescribing privileges through the Arizona State Board of Nursing
• Masters Degree in Nursing
If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver's License Requirements.
Benefits:
The State of Arizona offers a comprehensive benefits package to include:
• Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance
• Life insurance and long-term disability insurance
• Vacation plus 10 paid holidays per year
• Health and dental insurance
• Retirement plan
• Sick leave
By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page
Retirement:
• Positions in this classification participate in the Arizona State Retirement System (ASRS)
• Please note that enrollment eligibility will become effective after 27 weeks of employment
Contact Us:
• If you have any questions, please feel free to contact Shawn McConnell at ****************** for assistance
UAT Mgr Patient Access - CW
Remote job
The Manager of Patient Access is responsible for counseling patients on financial liability by using available financial counseling tools to achieve maximum reimbursement for patient services. Leads a team in planning, implementing and facilitating organizational change while using knowledge of coaching approaches, tools and techniques to improve individual performance and foster development. Utilizes Human Resources and performance management processes/systems to align individual performance with achieving goals. Leads project teams and implementing project plans, in accordance with established goals and measures.
Job Responsibilities
Oversees assigned department or functional area to ensure it is performing effectively, which may include but not limited to, hiring and training team members, creating and implementing business strategies, managing performance of team members, and delegating tasks.
Tracks multiple projects and priorities in a master project plan.
Facilitates group decision making by using various decision making tools and processes.
Assimilates data from multiple sources (e.g. individuals, work groups, teams) to identify trends and patterns.
Coaches managers and leaders to reflect on problem resolution outcomes and develop problem solving competence.
Develops and documents project mission, objectives and goals needed to define project scope and gain next level approval for resources.
Collects and interprets feedback from multiple sources (internal/external customers, peers, superiors and subordinates) to use in the coaching process.
Leads process improvement projects/teams to improve the efficiency/effectiveness of financial counseling and achieve maximum reimbursement.
Implements monitoring processes to ensure that all team members receive timely performance reviews and have current development plans.
May perform additional duties as assigned.
Additional Requirements
Certification - N/ALicensure - N/AExperience - 3 years of healthcare experience to include 1 year of supervisory/lead experience.Education - High School diploma or equivalent.
Auto-ApplyRadMachine Clinical Success Manager
Remote job
About RadformationRadformation is transforming the way cancer clinics deliver care. Our innovative software automates and standardizes radiation oncology workflows, enabling clinicians to plan and deliver treatments faster, safer, and more consistently, so patients everywhere can receive the same high-quality care.
Our software focuses on three key areas: • Time savings through automation. • Error reduction through automated systems. • Increased quality care through advanced algorithms and workflows.
We are a fully remote, mission-driven team united by a shared goal: to reduce cancer's global impact and help save more of the 10 million lives it claims each year. Every line of code, every product release, and every conversation with our customers brings us closer to ensuring no patient's treatment quality depends on where they live.
About RadMachineRadformation specializes in Radiation Oncology workflow automation. Our solutions save clinics time, eliminate planning errors, and enable them to design the optimal treatment for their patients. Radformation's RadMachine QA software is a cloud platform that standardizes QA across all sites, machines, and users. RadMachine has the ability to track all machine tests and equipment to ensure an efficient workflow while automating data upload and analysis. Instant notifications alert the clinic when a test is due or failing.
Why This Role MattersIn this role you will mentor clinics as they join the Radformation community to assist them in establishing the most efficient machine QA workflow and increase standardization. You will work closely with clinics, the programming team, and the sales team to give presentations to clinics, solve problems on the fly, proactively check in with customers, and incorporate feedback into redefining how to best complete machine QA. With your clinical background, you will be able to teach and improve efficiency in Radiation Oncology clinics throughout the country.
Job BriefWe are looking for a highly motivated individual who has a passion for machine QA and enjoys a fast-paced environment. The full-time RadMachine Clinical Success Manager will bring their upbeat personality to this role to give presentations to clinics, solve problems on the fly with customers, and proactively call clinics to check in and hear feedback. The RadMachine Clinical Success Manager will help mentor clinics as they join the Radformation community to assist them in establishing the most efficient machine QA workflow and increase standardization. As the RadMachine Clinical Success Manager, you will develop relationships with clinics and incorporate feedback into redefining how to best complete machine QA. With your clinical background, you will be able to teach and improve efficiency in radiation oncology clinics throughout the country.
Responsibilities Include:• Demo, install, and train clinics on Radformation's RadMachine machine QA software • Implement RadMachine at clinics by developing QA templates and customizing clinics' settings • Work with clinics to understand their issues and provide a solution independently and/or with the help of the programming team • Work with the sales team to demonstrate software to prospective customers and provide training to newly installed clinics • Proactively check in with current customers to hear feedback and share new features • Host webinars to answer clinics' questions and highlight features • Test new versions of the software to aid in development and quality assurance • Develop training materials to distribute to clinics • Research new QA guidelines and stay current as updates are released • On-site visits to clinics when permitted
Required Experience:• Minimum 2 years of experience in performing and analyzing daily, monthly, and annual radiation oncology machine QA • 2 years of experience as a medical physics assistant or similar • Strong critical thinking skills • Exceptional presentation skills • Positive attitude and a passion for excellence in patient care
Preferred Experience:• Minimum 5 years of experience in performing and analyzing daily, monthly, and annual radiation oncology machine QA • Degree in medical physics or dosimetry • Minimum 2 years of experience with ARIA OIS • Experience with Python • Customer service experience
Abilities• Enthusiastic about learning new technologies and sharing them with the healthcare community • Thrives with a busy schedule and a constant learning environment • Excels at multitasking and managing multiple projects simultaneously • Enjoys listening to clinics' needs and developing relationships with clinical leaders • Master of machine QA and radiation oncology clinical workflow • Ability to maintain a positive attitude in a fast-paced and ever-changing work environment • Strong organizational skills and ability to work independently • Highly motivated to help clinicians improve their workflow • Excellent communication skills, both written and oral • Non-judgmental personality and welcoming of ideas and feedback
AI & Hiring IntegrityAt Radformation we believe AI can be an incredible tool for innovation, but our hiring process is all about getting to know you, your skills, experience, and unique approach to problem solving. We ask that all interviews and assessments be completed without tools that generate answers in real time. This helps ensure a fair process for everyone and allows us to see your authentic work. Using such tools during the process may affect your candidacy.
Benefits & Perks - What Makes Us RADWe care about our people as much as we care about our mission. We offer competitive compensation, benefits, and the opportunity to make an impact in the fight against cancer. The salary range for this role is $130,000 - $150,000 base plus bonus eligibility. For Canadian candidates, compensation will vary and will be assessed during the screening process based on local market conditions and individual experience.
For US teammates:Health & Wellness • Multiple high-quality medical plan options with substantial employer contributions • Health coverage starting on day one • Short-term and long-term disability and supplementary life insurance Financial & Professional Growth • 401(k) with employer match vested immediately • Annual reimbursement for professional memberships • Conference attendance and continued learning opportunities Work-Life Balance & Perks • Self-managed PTO and 10 paid holidays • Monthly internet stipend • Company-issued laptop and one-time home office setup stipend • Fully remote work environment with virtual events and yearly retreats
Our Commitment to DiversityCancer affects people from every walk of life, and we believe our team should reflect that diversity. Radformation is proud to be an equal opportunity workplace and an affirmative action employer. We welcome candidates from all backgrounds and are committed to fostering an inclusive environment for all employees.
Agency & Candidate Safety NoticeRadformation does not accept unsolicited resumes from agencies without a signed agreement in place. We do not partner with third-party recruiters unless explicitly stated. All legitimate communication from Radformation will come from an @radformation.com email address. If you receive outreach from another domain or via unofficial channels, please contact ************************.
Auto-ApplyClinical Excellence Manager | CA License
Remote job
About the role
The Clinical Excellence Manager reports to the Associate Clinical Director. This role is responsible for overseeing the performance and development of Collaborative Care Clinicians. The Clinical Excellence Manager will ensure organizational effectiveness and efficiency and align with company goals and initiatives.
The Clinical Excellence Manager will support the pod and partner with the Associate Clinical Director around the organization and partner-specific workflows, policies, and procedures. The Clinical Excellence Manager must follow strict patient privacy procedures and maintain a friendly and professional working atmosphere.
Scope
Receives assignments in the form of objectives with goals and the process by which to meet goals. Provides direction to employees according to established policies and management guidance. Administers company policies that directly affect subordinate employees. Recommends changes to work unit or department practices. Management reviews work to measure the meeting of objectives.
Job Complexity
Work on issues where analysis of situations or data requires the review of relevant factors. Exercises judgment within defined procedures and policies to determine appropriate action.
Supervision Level
Provides direct supervision to skilled employees (e.g., clinical personnel). Acts as an expert advisor to the work unit and is actively involved, as required, to meet deadlines and resolve problems. Holds accountability for performance management activities of employees within the work unit, including performance evaluations and disciplinary actions.
Interaction
Interacts daily with subordinates and/or functional peer groups. Sets direction and priorities and allocates resources. Determines work assignments for the work unit, needed responsibilities, and skills. Makes assignments to subordinates, distributes workload, determines work quality expectations, and sets deadlines.
Responsibilities
Direct oversight of Collaborative Care Clinician's performance including clinical metrics, schedule management, coaching, performance management, and clinical supervision
Responsible for supporting pod and partner workflows and needs in partnership with the Associate Clinical Director
Manages employee schedules including shift coverage for assigned practices, approving time off and vacation requests, and ensuring the attendance policy is being adhered to
Supervises and mentors employees including patient care, performance evaluations, development of career goals, and disciplinary action, including and up to termination
Partners with Associate Clinical Director to ensure department objectives are being met; recommends ways to improve efficiency and minimize barriers
Serves as a resource to direct reports in resolving and documenting complex patient situations including escalated complaints, patient terminations, and incident reporting.
Responsible for keeping an open line of communication with all Clinical Excellence Managers, Associate Clinical Directors, and upper management.
Handles escalated employee relations concerns with guidance from the Associate Clinical Director and HR.
Travel Required - Up to 15%
Required Qualifications:
Masters degree in social work, counseling, or related field.
Licensed to practice in the state of California as an independent clinician (LCSW, LPCC, or equivalent).
Additional state licenses and/or willingness to acquire additional licenses.
Minimum of 5+ years of clinical experience, with at least 3 years of experience in clinical supervision or clinical leadership capacity
Demonstrated competency working in health care technological platforms such as electronic health records or CRMs (i.e. Salesforce)
Demonstrated competency guiding clinical care in line with the Collaborative Care Model
Proficiency in evidence-based treatment approaches (Problem-Solving Treatment, Motivational Interviewing, Cognitive Behavioral Therapy, and Behavioral Activation).
Technical proficiency in a variety of platforms including EHRs, ability to quickly learn new technology.
Knowledge of/experience with behavioral health tools (PHQ9, GAD7, CSSRS, etc.).
Capability to provide clinical care to patients in primary care settings, including those as young as 6 years old, as well as in women's health.
Preferred Qualification:
Fluent in both English & Spanish preferred.
Benefits:
100% remote with employer supplied computer equipment.
Opportunities for Supervision.
Work/life balance with 14 paid holidays, sick time, and additional PTO plans.
Medical, Dental, and Vision plans effective on the first day of employment.
Employer paid Short Term Disability and Long Term Disability plans.
Employer paid Life and AD&D insurance of $50,000.
Employer paid Parental Leave of 12 weeks.
401K.
Compensation:
We offer a variable model that includes base salary plus performance driven bonuses.
Annualized base salary is determined by licensure level, geographic location, and budget, and is paid on a biweekly basis: $85,000 - $105,000.
Performance driven incentives on data supportive targets paid on a quarterly basis.
Annualized Quarterly Incentive Band: $12,700 - $15,700.
The Incentive is paid in arrears on the second paycheck following each quarter so long as the required performance measures are achieved.
Estimated Total Compensation: $97,700 - $120,700.
Schedule:
Monday - Friday | 11:00am - 7:00pm PST
100% Remote
Come As You Are - You Are Welcome Here
Concert Health is a diverse and inclusive Equal Opportunity Employer; we prohibit discrimination and harassment of any kind in our culture. We are dedicated to providing a safe, equitable, respectful, and supportive work environment to all without regard to race, color, religion, sex, gender, national origin, age, pregnancy, disability, sexual orientation, military or veteran status, genetics, or any other status protected by federal, state, or local laws. This policy applies to all terms and conditions of work, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. All Concert Health employees are expected to comply with this policy. If you share our vision and are good at what you do, come as you are. You are welcome here.
Clinical Delegation Manager
Remote job
It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
Job Summary:
The Clinical Delegation Manager supports delegated provider performance by monitoring relationships with delegated partners ensuring compliance, and achievement of organizational strategy as outlined in contracts. This position serves as a delegation subject matter expert and provides a broad range of coordination and operational support to the Office of Clinical Affairs (OCA), including the National Committee for Quality Assurance (NCQA) accreditation, quality improvement, and care management teams. The Clinical Delegation Manager is the key clinical delegation contact to the delegated provider's leadership team regarding escalated issues as they arise. The position is responsible for both NCQA delegation oversight to the delegated providers and as a SME for all Population Health Management standards for internal and external partners. The Clinical Delegation Manager collaborates with various Boston Medical Center Health System population health management teams to ensure alignment of activities related to delegated quality contract requirements and adherence to NCQA accreditation requirements.
Our Investment in You:
· Full-time remote work
· Competitive salaries
· Excellent benefits
Key Functions/Responsibilities:
Contribute to development and implementation of delegation best practices
Build and maintain collaborative relationships with delegated provider and internal care management leadership to promote engagement with WellSense Population Health programs, optimize performance, and foster information exchange.
Serve as the point person/subject matter expert (SME) for NCQA standards delegated to the providers, and issues submitted by the providers. Promptly resolve concerns or elevate to the appropriate level.
Assist in the design of interventions to advance quality and efficiency initiatives and provide consultative support to delegated providers.
Develop and maintain organizational policies and procedures related to delegation oversight.
Lead regular delegation joint oversight meetings
Quality performance
Track common themes/structures/tactics across highest performing delegated providers and create best practice definition
Engage delegated provider leaders and internal care management in the process of sharing best practices
Monitor success of implemented quality measures
Support NCQA delegation activities and ensure compliance with standards and regulations
Conduct delegation oversight assessments
Care Management performance
Support the implementation and maintenance of care management programs (focused on particular disease states or more general) that will impact utilization metrics and health outcomes
Conduct delegation oversight annual evaluation and ongoing audits; develop corrective action plans to remediate identified deficiencies
Provider engagement
Work with delegate provider leadership and staff to identify and implement best practices for engaging providers in population health programs
Track engagement measures and share insights with WellSense leaders
Track and Analyze Delegated Provider and Internal Care Management Performance
Track performance metrics.
Review and analyze data to assess quality performance.
Advise WellSense leadership on performance improvement opportunities via the Care Management Steering Committee and/ or the Quality Improvement Committee.
Work with Clinical Informatics, Network Management, Quality, Care Management, and Clinical Operations staff to assess performance and craft solutions to improve metrics.
Other duties as assigned
Supervision Exercised:
None
Supervision Received:
General direction received weekly from the Senior Manager Delegation and Quality Partnerships
Qualifications:
Education Required:
Bachelor's degree required.
Education Preferred:
Bachelors of Science degree in Nursing (BSN) preferred
Master's degree (MSN, MBA, MPH, etc.) preferred
Experience Required:
7+ years of healthcare experience; some care management or outpatient ambulatory care experience preferred
Advanced knowledge of NCQA PHM standards
Experience Preferred/Desirable:
Experience within a managed care organization is strongly preferred
Conditions of Employment:
Successful completion of pre-employment background check
Preferred Licensure, Certification
Registered nurse with active license as applicable
Competencies, Skills, and Attributes:
Project management training or comparable experience in managing complex interdisciplinary projects or programs.
A strong working knowledge of Microsoft Office products.
Detail oriented with excellent proof reading and editing skills.
Effective collaborative and proven process improvement skills.
Strong oral and written communication skills; ability to interact within all levels of the organization.
Demonstrated commitment to excellent customer service.
Knowledge and understanding of current trends in healthcare.
Aptitude for aligning process, projects, and people to meet business goals in cross-functional team settings.
Demonstrated past experience in delivering team success via data-driven metrics & reporting.
Experience with matrix team management.
Working Conditions and Physical Effort:
Regular and reliable attendance is an essential function of the position.
Work is normally performed in a typical interior/office work environment.
No or very limited physical effort required. No or very limited exposure to physical risk.
About WellSense
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees.
SDI Clinical Manager
Remote job
Role Type: Part-Time, Guaranteed 15 hours a week
About This Role
Are you ready to make a difference? Come join Parallel!
We're searching for an experienced teacher to join our team! As our Specially Designed Instruction (SDI) Manager, you'll deliver the best services to our students and school partners, as well as work directly with our Director of Behavioral Mental Health Services to build, develop, and improve our program(s). This is a great opportunity for someone who wants to:
Make an impact
Help transform an antiquated industry
Work somewhere mission-driven
Work somewhere flexible, supportive, and collaborative
Work somewhere with unparalleled opportunities for growth
Join a female-led and DEI-focused organization
Work somewhere that is team-oriented and where people are equipped to succeed
Join a fast-growing startup, backed by top VCs, on the ground floor
Why Join Us?
Parallel makes it easy to administer quality care! By taking care of the daily hassles of running a business, we empower you to focus on providing services. We provide:
Easy Scheduling through our in-house scheduling system
Templates & Databases so you can spend less time on administrative tasks
Smart Matching to pair you with clients
Patient History & Eligibility information so you have the information you need
Billing Services so you can focus on what matters
Testing and Therapy Materials so you have the tools to succeed!
Medical, vision, dental benefits and flexible PTO
We also offer:
Innovation: Your feedback will help shape the program for providers and clients in the future!
Community Events: Collaborate with top clinicians and educators to solve acute problems
Growth: Access leadership and growth opportunities as we rapidly scale
A Great Mission: Empower students who learn or think in different ways
What You'll Do
Lead a Team and Support the growth of Parallel's Special Education Programs
Provider mentorship, coaching, and clinical support to assigned portfolio of providers; including providing corrective feedback, feedback on instructional strategies, lesson planning, and IEP implementation, as well as sharing evidence-based resources and best practices
Host team roundtables and provider meetings; includes provider training (workshops, continuing education sessions)
Assist Parallel's talent team in recruiting and selecting new Special Education teachers; assist in screening applicants and reviewing applicant case studies
Orient and train new service providers on Parallel processes and procedures
Collaborate with the Sales and Customer Success Teams to align instructional service offerings with district needs, ensuring smooth implementation of SDI and academic support service
Collaborate and support Provider and School Operations teams with day to day needs; including billing for services, scheduling, caseload management
Work closely with school district administrators and teams to resolve potential concerns and to ensure students receive the services they need
Support improvement and development of existing policy, procedure, and provider training content
Assist with instructional quality assurance through review of lesson plans, progress reports, data collection practices, and IEP goal alignment; provide coaching and feedback to strengthen teaching practices
Report to the Director of Clinical Excellence and Behavioral Mental Health Services
What You'll Need
To succeed in this role, you'll need:
State Special Education license; National Board Certification preferred
Preference for Special Education teachers who have experience in more than one state in a designated region
Minimum of 5 years of classroom teaching or special education service experience, including work with students requiring SDI, resource support, or inclusion services
Flexible schedule to internal and school meetings
Prior leadership and mentorship experience to mentor and grow a team
Experience participating in eligibility/IEP meetings, acting as a case manager, strong understanding of IDEA compliance, IEP processes, and instructional accommodations/modification
Excellent communication skills and self-awareness to communicate with individuals from a variety of backgrounds and life experiences; including children, families, and school partners
Proficiency with virtual learning platforms and digital instructional tools for tele-education
A private workspace with a secure and reliable internet connection
👋 About Us
Parallel is the first tech-forward provider of care for learning and thinking differences across the United States. We believe learning differences are parallel ways of thinking that should be celebrated! Our mission is to provide students with the resources and encouragement to succeed in the classroom and beyond. To us, this means helping them build confidence in their unique strengths and create strategies to work around their challenges.
Parallel simplifies the process of getting support for learning differences by consolidating providers and resources on a single platform. We connect students with qualified professionals while significantly reducing waiting times, costs, and confusion. We provide a variety of services, including:
Psychological Assessment & Therapy
Counseling
Speech-Language Therapy
Special Education
And more!
Want to know what it's like working here? Check out our Glassdoor reviews!
Our commitment to diversity, equity, and inclusion
At Parallel, we believe in celebrating differences. This belief extends from schools into our workplace and through the ways we work together toward our mission. We are committed to fostering a diverse, accessible environment that represents many different cultures, backgrounds, viewpoints, and abilities by championing diversity, equity and inclusion.
This is why we are committed to having and fostering a diverse workforce, including those from historically marginalized groups, and are committed to a work environment where employees' strengths are championed, differences are celebrated, and no one is discriminated against based on age, race, ancestry, religion, sex, gender identity and expression, sexual orientation, pregnancy, marital status, physical or mental disability, military or veteran status, national origin, or any other characteristic.
We are a proud equal opportunity employer, and we are committed to building a diverse, equitable, and inclusive organization in order to build the foundation for different learners and thinkers to thrive.
By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message & data rates may apply. Reply STOP to opt out of further messaging.
Auto-ApplyClinical, Manager, Prior Authorization Technician
Remote job
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 *********************************************
Auto-ApplyClinical Manager (remote - travel required)
Remote job
About Us We're building the technology and clinical services platform to make preventive, connected healthcare accessible for everyone in the US. We deliver hybrid care (in-home + virtual) backed by data products across 15+ states, serving 60%+ of the US population through major health plans and systems. With 1M+ patients and 92+ NPS, we're rapidly scaling our impact. Our team of technologists, clinicians, and operators is backed by investors including a16z, General Catalyst, GV, and Accel that have funded companies like Devoted Health, Livongo, Benchling, Stripe, Ramp, Airbnb, Lyft, Instagram, and Databricks.
We have a rapidly growing team of visionary leaders who are passionate about increasing access to care, lowering healthcare costs, and improving outcomes for patients.
About The Role
We're rapidly growing our clinical team as we cultivate new partnerships with enterprises across the healthcare spectrum. We're looking for an experienced Registered Nurse (RN) to work as a Clinical Manager to oversee our NC and NH region as well as future markets in the nation as we continue to expand.
This role will report to the Clinical Manager Supervisor and you will collaborate closely with all Clinical Managers and internal stakeholders to effectively lead the charge of the Sprinters in your assigned regions. The ideal candidate will be an experienced leader with demonstrated ability to effectively manage teams, identify and create solutions.
Clinical Operations Management
Oversee the daily operations of the clinical field team, ensuring smooth workflow.
Develop and implement policies and procedures to maintain high standards of care.
Monitor patient care quality, ensuring adherence to clinical guidelines and best practices.
Staff Supervision & Development
Recruit, train, and manage the clinical Sprinter team.
Conduct performance evaluations and provide ongoing coaching and support.
Compliance & Quality Assurance
Ensure compliance with healthcare regulations (OSHA, HIPAA, Joint Commission, etc.).
Monitor incident reports and implement corrective actions as needed.
Lead quality improvement initiatives to enhance patient safety and service delivery.
Financial & Resource Management
Control expenses, and allocate resources effectively.
Optimize clinical workflows to improve efficiency and reduce costs.
Patient Care Coordination
Address patient concerns and ensure a patient-centered approach to care.
Respond to abnormal labs, tests, vitals- assess, triage patients to ensure proper follow up care is received.
Implement strategies to improve patient satisfaction and outcomes.
Collaboration & Communication
Work closely with the Clinical Manager team and cross functional teams to ensure Sprinters are supported in the field and all teams are aligned.
Attend management meetings and provide updates on clinical operations for your market.
You will thrive at Sprinter Health if you have:
The desire to work collaboratively with a tight-knit but quickly growing team across many different areas of the business
Flexibility, humility, and a sense of humor
Excitement for working in a fast-paced startup
Experience and Skills
5+ years of Registered Nurse experience
Experience in a healthcare startup or virtual management experience preferred
Direct report management experience Proficient at working with modern technology
Able to do extensive travel of up to 50%
This position will be a hybrid role where you will work some days from home and others travel to various coverage regions to meet
$110,000 - $140,000 a year
The base salary range for this full-time position is $110,000 - $130,000 + benefits. The range displayed on each job posting reflects the minimum and maximum target for new hire salaries for the position across all US locations. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training.
Sprinter Health is an equal opportunity employer. We 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, disability status or other protected classes.
If you're looking for a career that offers opportunities for growth, continual development, professional challenge and the chance to make a real difference in the lives of people, apply today!
Beware of recruitment fraud and scams that involve fictitious job descriptions followed by false job offers.
If you are applying for a job, you can confirm the legitimacy of a job posting by viewing current open roles here. All legitimate job postings will require an application to be made directly on our official Sprinter Health Careers website. Job-related communications will only be sent from email addresses ending **********************. Please ensure that you're only replying to emails that end ************************.
Auto-ApplyRegional Clinical Manager - Remote (Travel Required)
Remote job
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Auto-ApplyClinical Manager - Seating and Positioning
Remote job
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.
Auto-ApplyClinical Staff Manager, Cardiac Rehab
Remote job
Job Title: Clinical Staff Program Manager Classification: Full Time Work Structure: Fully Remote Schedule/Shift: Standard Business Hours Team: Clinical Operations Reporting to: Senior Manager, Cardiac Rehab Compensation: $65,000-$75,000 annually
About Us:
Recora was founded in 2020 by seasoned digital health entrepreneurs. In past roles, we've founded and scaled high-growth startups, run large health systems, advised government programs, built technology you use every day, and provided healthcare for millions of lives.
We're backed by leading VCs including SignalFire, Pear, GFC , 2048, Great Oaks, MGV and more. Over the last year, we've built the leading virtual cardiac recovery and management platform for members with cardiac conditions. For every member we serve, we add an average of five years to their lifespan.
We're growing - fast. Our member base is doubling every month and we're looking to 3x our team size quickly. This will allow us to scale nationally and accelerate product development across the continuum of heart health.
Position Overview
Recora Health is seeking a dedicated and experienced Clinical Staff Program Manager to lead our virtual cardiac rehabilitation program. This role involves managing a team of care providers, ensuring high-quality patient care, and driving program success through strategic planning and execution. The ideal candidate will have a strong background in exercise physiology and a passion for improving patient outcomes in a virtual setting.
Key Responsibilities
* Care Provider Management
* Develop and manage care provider schedules to ensure adequate coverage and optimal patient care.
* Conduct performance reviews to support professional development, uphold program standards, and address underperformance by implementing targeted improvement plans for care providers to include contract termination.
* Ensure care providers meet performance targets and work with them to create plans for achieving those goals.
* Provide guidance and support to the Lead Exercise Physiologist and Lead Intake Specialist, ensuring alignment with program goals, effective onboarding and training, session shadowing, and completion of other assigned responsibilities.
* Hiring, Onboarding, and Training
* Lead the recruitment process for new care providers, ensuring the selection of qualified candidates.
* Oversee onboarding and training programs to equip new hires with necessary skills and knowledge.
* Operational Oversight
* Review and approve invoices related to program operations, ensuring accuracy and compliance with budgetary constraints.
* Develop and update standard operating procedures (SOPs) to reflect workflow changes and ensure program efficiency.
* Data and Metrics Tracking
* Monitor and analyze program data and metrics to assess performance and identify areas for improvement.
* Use data-driven insights to inform decision-making and strategic planning.
* Communication and Meetings
* Facilitate regular meetings with care providers to discuss program updates, share best practices, and collaborate on projects.
* Prepare agendas and lead monthly huddles to ensure team alignment and effective communication.
* Monitor care team slack channels and respond to escalations from care providers.
Qualifications
* Proven experience in managing virtual care programs.
* Proven experience managing a staff of 50+ 1099 contractors.
* Strong leadership and communication skills.
* Ability to analyze data and metrics to drive program improvements.
* Experience in patient care and retention strategies.
* Familiarity with virtual health platforms and technologies.
We are an equal opportunity employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected veteran status, or any other characteristic protected by federal, state, or local law.
Auto-ApplyClinical Manager - Seating and Positioning
Remote job
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.
Auto-ApplyTelehealth Clinical Manager - Remote
Remote job
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.
Clinical Review Manager
Remote job
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.
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