Responsible, in part, as a member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services provided through OrthoNet. Performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company. The Medical Director will participate in the monitoring of patient care progress, treating physician medical decision making in the context of utilization management and provider appeals The Medical Director also provides/assists in the direction and oversight in the development and implementation of Policies, procedures and clinical criteria for all medical programs and services. S/he may serve as a liaison between OrthoNet, physicians, and other medical service providers in selected situations You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges Primary...

Quality Abstraction & Clinical Data Reviewer needed at excellent hospital in Boston, MA. This is a full-time, remote, contract position. The pay rate is up to $20.00/hour. Medical, RX, Dental, Vision, Life and Disability benefits available! Remote Position! Shift: Days - Monday-Friday - 40 hours per week Must have HEDIS experience in pulling records RHIT, certified medical coder, CPHQ, CCS, CCS-P, RHIT, CDEO, CPMA, CPC, CRC, CHCA or similar credential required Who We Are: Health Advocates Network matches highly skilled applicants to positions at the best healthcare companies on a temporary and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well matched to your skills - helping you advance in your career. Our experience, combined with our client relationships, makes Health Advocates Network a great resource for your career. We Are Looking for Individuals Who Are: · Self-motivated and achieve goals · Strong communicators, with high...

Vytalize Health - Job Type: Full-time (Remote Position; Training on-site in Cleveland, Ohio, if local to the area) Job Requirements Fluency in English Spanish-speaking is preferred but not required Certified Medical Assistant with excellent communication skills and the ability to learn about Vytalize's patient care services Experience working in a call center as a customer service representative is a plus Ability to simplify information and communicate effectively Ability to make a high volume of outbound calls efficiently Charismatic and positive personality with an ability to build rapport with elderly patients and get them excited about preventive health care Experience working with senior patients a plus; familiarity with Medicare and senior care service About Our Company Vytalize Health is a new kind of primary care provider partnering with independent Primary Care Physicians (PCPs) to provide high-quality, proactive care to Medicare patients. Vytalize specializes in...

Company DescriptionAs a support desk agent, your duties would includeAnswering phones and monitoring Electronic Submissions for a Healthcare client's Clinical productCreating Support Tickets in Salesforce (Case tracking tool)Multi-tasking between multiple online toolsWorking with PHI and PII DataEnsuring that cases are assigned and worked within standard operating process guidelinesHandling issues reported by Patients regarding account management, authentication, and basic site navigation that can typically be addressed quickly with first call resolution.Product Support includes but not limited too - Password Resets, Messaging Providers, Dependent Management, Locating Health RecordsActive Directory Experience to help with our team's workload.Job DescriptionWillingness to work in a highly structured and tightly supervised environmentAbility to follow documented standard operating procedures to ensure PHI IntegrityExcellent Communication skills; both verbal and writtenStrong...

Overview: Advanced Clinical is a global clinical development organization that provides CRO, FSP, Quality & Validation, and Strategic Resourcing services for biopharmaceutical and medical device organizations. Our mission is to deliver a better clinical experience for our clients. With global experience in over 50 countries, we are committed to improving all lives touched by clinical research. We understand the complex nature of the clinical research industry and approach each opportunity with compassion. Together, we answer the hopes of patients and healthcare professionals with industry-leading services in global life-sciences. As part of the Advanced Group family of companies, Advanced Clinical employees provide the support, structure, and professional background and experience for better clinical trials and research. They are the foundation of our energetic and collaborative environment, where constant learning and service to others take top priority. We seek dynamic,...

---THIS POSITION IS REMOTE IN THE NORTHEAST WITHIN 2-3 HOURS FROM BOSTON--- If you are a Software Architect with EHR/FDA/IVDR experience, please read on! Founded in 2011, we are an international company that combines deep expertise in life sciences and medical disciplines with mathematical capabilities in data computing. Our mission is to bring data analytics solutions to market, to support healthcare professionals by maximizing the power of Data-Driven Medicine. By helping healthcare professionals leverage their expertise and work together as a community, patients all over the world can receive equal access to better diagnoses and treatments. Combining the first two pillars of Data-Driven Medicine, Genomics and Radiomics, we can ensure that the data used to help patients today will also benefit the patients of tomorrow. Top Reasons to Work with Us Competitive compensation! Medical Dental Vision 20 days PTO 401k Matching and more! What You Will Be Doing Design...

CareHarmony's Licensed Practical Nurses are experts in helping patients and caregivers navigate the healthcare system and better manage the patient's chronic illnesses. LPN Care Coordinators work cooperatively with the patient's providers to help achieve health goals. Position Details This is a telephonic coordinator position with no face-to-face patient contact . CareHarmony is seeking a Licensed Practical Nurse, with at least one year of prior clinical work experience, to support providers in delivering comprehensive chronic care management services for their patients. All work will be Remote. You must have internet, preferably Fiber or Cable, in order to be considered for an interview. Applicants will not proceed to the interview stage without proof of a reliable home network. Each LPN Care Coordinator is assigned a set census of patients. You will be responsible for providing all telephonic support required to coordinate care for their patients. You have experience...

TITLE: CLINICAL FIELD STAFF SUPERVISOR (CS)REPORTS TO: DIRECTOR OF NURSES (DON)QUALIFICATIONSEDUCATION / TRAINING / EXPERIENCE1. Must be currently licensed as an RN through the Board of Nursing in the state of practice.2. Must have at least an Associates Degree in Nursing.3. Prefer one year clinical experience in the health care industry, and one year experience in home health. Must understand the issues related to the delivery of home health services and be able to problem solve effectively and possess knowledge of the Medicare guidelines governing home health agencies or have experience/abilities that indicate with training they would excel.4. Prefer supervisory experienceCHARACTERISTICS1. Must be organized, detail oriented and possess effective communication skills, both orally and in writing. The ability to communicate with a diversity of individuals is required.2. Must have good clinical judgment and observation skills3. Must have a positive attitude, is self-directed and has...

TITLE: CLINICAL FIELD STAFF SUPERVISOR (CS)REPORTS TO: DIRECTOR OF NURSES (DON)QUALIFICATIONSEDUCATION / TRAINING / EXPERIENCE1. Must be currently licensed as an RN through the Board of Nursing in the state of practice.2. Must have at least an Associates Degree in Nursing.3. Prefer one year clinical experience in the health care industry, and one year experience in home health. Must understand the issues related to the delivery of home health services and be able to problem solve effectively and possess knowledge of the Medicare guidelines governing home health agencies or have experience/abilities that indicate with training they would excel.4. Prefer supervisory experienceCHARACTERISTICS1. Must be organized, detail oriented and possess effective communication skills, both orally and in writing. The ability to communicate with a diversity of individuals is required.2. Must have good clinical judgment and observation skills3. Must have a positive attitude, is self-directed and has...

Vytalize Health - Job Requirements - Fluency in Spanish is preferred but not required - An individual with excellent communication, time-management, decision-making and problem-solving skills that can thrive in a team-based environment -Strong knowledge and familiarity with the New Jersey medical landscape About Our Company: Vytalize Health is an advanced primary care provider partnering with independent Primary Care providers (PCPs) to provide state of the art care to Medicare patients. Vytalize specializes in providing expanded primary care services that improve the quality of care for patients and is leading the transition to value-based medicine. Visit and for more information. Job Description Vytalize Health is currently looking for Case Managers to assist Nurse Practitioners in supporting the work of primary care physicians and other healthcare professionals from a remote outpatient setting. Among others, your primary responsibilities will be facilitating client care by...

TITLE: CLINICAL FIELD STAFF SUPERVISOR (CS)REPORTS TO: DIRECTOR OF NURSES (DON)QUALIFICATIONSEDUCATION / TRAINING / EXPERIENCE1. Must be currently licensed as an RN through the Board of Nursing in the state of practice.2. Must have at least an Associates Degree in Nursing.3. Prefer one year clinical experience in the health care industry, and one year experience in home health. Must understand the issues related to the delivery of home health services and be able to problem solve effectively and possess knowledge of the Medicare guidelines governing home health agencies or have experience/abilities that indicate with training they would excel.4. Prefer supervisory experienceCHARACTERISTICS1. Must be organized, detail oriented and possess effective communication skills, both orally and in writing. The ability to communicate with a diversity of individuals is required.2. Must have good clinical judgment and observation skills3. Must have a positive attitude, is self-directed and has...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)UnitedHealthcare Community & State, part of the UnitedHealth Group family of companies, is looking for an experienced Clinical Operations Program Manager to join our dynamic health plan clinical team. Things are exciting at UHG as we are experiencing unprecedented growth and looking for the ideal candidate to fill a key supporting role on our clinical team in North Carolina.The Clinical Operations Program Manager position reports directly to the Health Services Director and is responsible for supporting the optimization of the clinical operations and the various aspects of our North Carolina Medicaid Health Plan. We are seeking a candidate with...

Project Manager - 100% Remote - 37333 BB37333 6+ Months Must have the following experience: SAP integration/implementation Master Data experience Data Migration Change Management Prefer to have experience working in a healthcare, pharmaceutical, medical device company Job Description Summary The Senior Project Manager works with executive and director level business leaders to understand the strategic objectives for major business change initiatives and define the tactical projects to realize these objectives. The Senior Project Manager leads the projects through building effective relationships with business leaders, project team and project stakeholders. The Senior Project Manager drives the delivery of the projects/program through advanced program/project management techniques and methodologies. The Senior Program/Project Manager balances the demands of multiple medium/large projects ($.5M - $1M) or larger programs ($1M-$10M). Responsibilities • Partners with project...

This role is responsible to support end-to-end clinical analytics and performance measurement and serve as a liaison with Finance, HCE, and local market leadership. Assists in supporting, validating and improving affordability initiatives with appropriate dashboard and metrics, diagnosing process improvement opportunities and developing measures to monitor progress in achieving medical expense cost management opportunities. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities: This position is also responsible for medical expense management performance monitoring, in partnership with HCE and Finance, including: Developing and maintaining a process for validating results and tracking performance for national programs and local affordability initiatives Monitoring and communicating medical management performance to target Primary lead in coordinating across Clinical Performance/Finance/HCE Analyze,...

Our client in San Diego is looking for remote Patient Registrars to help through April, 2021 with vaccine support. START DATE: ASAP END DATE/CONTRACT LENGTH: 13 Week Contract LOCATION: Remote SHIFT: 5x8H Shifts May Be Scheduled on weekends. Manager is open to flexible schedules flexible working hours between 6am - 8pm COMPLIANCE REQUIREMENTS: Candidate will be expected to complete typical compliance for remote workers for health care systems upon hire including providing updated physical background check drug screen etc. in order to meet onboarding requirements. JOB DESCRIPTION: Under the supervision of the Patient Access Manager the Registrar/Verifier is responsible for registration duties in the clinical services area. Typical duties include registration completion, authorization and billing verification, collect payment fees, operate CRT to gain or input patient information. Duties may be by phone. REQUIRED QUALIFICATIONS: - 3 years previous admissions/registration...

If you have at least 1 year of experience recruiting Travel Nurses in the healthcare industry and you've enjoyed working from home and don't want to return to the office - we have the job you've been looking for! This is a permanent role, full benefits. PLEASE DO NOT APPLY IF YOU DON'T HAVE TRAVEL NURSE RECRUITING EXPERIENCE . Also, because this is remote, we are posting in several large cities across the US. No need to apply to more than 1 location please. To be a good fit for this remote role, (and it will remain remote after COVID craziness goes away!) you must have: 1 or more years recruitment experience with nurse travelers (13 week contract) A home office set up (reliable, high speed internet and a quiet place to professionally conduct phone calls) Ability to start late March Work for the industry leader, with the tools and resouces at your disposal that will not only allow you to offer more options to your travelers (and probably better pay), but to also...

Why Sensible Care? We are a team of passionate professionals dedicated to delivering accessible, quality care. By building a team of mental health professionals from different disciplines, we can provide comprehensive care to each patient under one roof. *We offer a 40-hour-like salary and a comprehensive benefits package for a 32-hour workweek to prevent provider burnout. Cancellations and no-shows do not affect provider salary.* Benefits for Full-time (32-hour work week): Salary: Up to $264,000 License fees paid (MD, DEA) Liability insurance coverage 401(k) account with matching Up to $3,000 in CME expenses reimbursed 14 vacation days, five sick days, and paid holidays annually Health, Dental, and Vision coverage Part-time employment options OR 1099 Contractor option Interested in working for Sensible Care as a Part-time Employee OR Independent Contractor? Let us know in your interview as we have several options available! We offer Opportunity to work from...

Med/Surg Nurse/NCLEX Reviewer $40/hr UWorld is looking for motivated Medical-Surgical nurses to write and edit content for our web-based products. This is an excellent opportunity for nurses to contribute to the next generation of nurses by reviewing and developing content for our NCLEX question banks (Qbanks). Nurse reviewers follow a schedule that provides a balance of clinical and non-clinical work to maintain their clinical expertise while educating tomorrow's nurses via our innovative and interactive platform. The Medical-Surgical Nurse Reviewer will utilize his or her experience with the NCLEX to review questions and rationales for our web-based NCLEX Qbank. The ideal candidate has strong writing skills and is passionate about excellence in nursing education. Qualifications Minimum Education Required BSN required Must have an Undergraduate GPA of 3.8 or higher Minimum Experience Required Must be a registered nurse (BSN) with at least 2 years of clinical...

Alphanumeric is hiring licensed Healthcare Professionals HCPs (Nurse or Pharmacist) to work remotely on a Covid-19 Vaccine Contact Center supporting major life science organizations. Candidates can be based either in Poland, Spain or Portugal We also support other several languages, and we are looking for Bilingual candidates: Russian, German, Italian, Spanish, Arabic, Turkish, Ukranian, Polish and other As an HCP you will report to the Team Lead. Primary responsibility will be to answer inbound calls from health care providers (HCPs), patients and others regarding vaccines and communicate complex medical information. Highlights Of The Role Paid training on pharmaceutical products as well as support processes Health Insurance 100% Remote Work - candidates can be based either in Poland, Spain, Portugal Responsibilities Respond to inquiries via phone, email, or web chats from healthcare professionals, consumers, and patients handling adverse...

Merakey is seeking a PRN Registered Nurse to join our Remote care Center Nursing Team for assistance within our Intellectually and Developmentally Disabled division . This position is PRN as needed and will work Remote Are you looking for a position where you can utilize your skills and passion for supporting people? Do you believe that we are better together by including everyone? Are you searching for a rewarding career in the service of others? If this sounds like something that you would enjoy -- then join our team! Position Overview Ensures all incoming calls are received and responded to in a professional and timely manner by addressing caller inquiries. Utilizes expert nurse software to review all dashboard entries and alerts, conduct sound nursing assessments, phone triage, video triage (if needed), and advice to support staff for IDD individuals who have abnormal reported clinical values to the dashboard, symptom-based or injury-based problems. Thorough, concise...