Clinical quality analyst jobs

Mar 30, 2023

Senior Business Analyst - Hybrid - Eden Prairie, MN or Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) This is an exciting role within the rapidly growing Optum HouseCalls division within UnitedHealth Group. HouseCalls is a service offered by Optum to eligible members, where a Nurse Practitioner visits the members home once a year to conduct a thorough medical health assessment on the member. This is a highly sought after service in the Medicare market with positive clinical benefits for our members and the company. As a...

UnitedHealth Group Remote * (San Francisco, CA, USA)

Mar 30, 2023

Senior Business Analyst - Hybrid - Eden Prairie, MN or Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) This is an exciting role within the rapidly growing Optum HouseCalls division within UnitedHealth Group. HouseCalls is a service offered by Optum to eligible members, where a Nurse Practitioner visits the members home once a year to conduct a thorough medical health assessment on the member. This is a highly sought after service in the Medicare market with positive clinical benefits for our members and the company. As a...

UnitedHealth Group Remote * (Orlando, FL, USA)

Mar 30, 2023

Compliance Analyst III - Work From Home

Organization: SHSO-Sutter Health System Office-Valley Position Overview: Assists the Compliance Officer or Ethics & Compliance leadership in coordinating, implementing, administering and evaluating the Sutter Health Ethics and Compliance Program at system-level or assigned affiliates to ensure compliance with applicable laws, regulations, and standards (e.g., Department of Health and Human Services Departments, including the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG)) and Sutter Health's policies and procedures. Collaborates with affiliate organizational staff, Ethics and Compliance staff, and OGC team members (e.g., Legal, Risk Services) regarding changes in federal and state laws and regulations for healthcare providers and the organization's policies and procedures. Plans, executes, and oversees a variety of regulatory compliance based projects. Assists with conducting internal investigations and compliance risk assessments,...

Sutter Health Remote * (Sacramento, CA, USA)

Mar 30, 2023

Coder *Remote Hybrid/Onsite Must reside in TX

Description Remote Work is Available for Candidates Residing within the State of Texas Only, This is a full-time position and is a Hybrid work-from-home 3-4 days a week and live within 60 miles from Plainview, TX Out-of-State Candidates Will Not be Considered. Under general supervision, coordinates the processing, review and application of ICD-9 & ICD-10 coding rule sets, CPT and HCPCS codes to medical records based on documentation provided by the providers and adheres to coding compliance for a specified clinical area. Adheres to strict federal coding rules in selecting codes that appropriately and accurately reflect the condition that the patient had and the medical service that was provided. Will communicate heavily with Coding/Compliance Department and coding peers to abstract clinical and statistical data for outcome measure and monitoring. Provides coding education including but not limited to: Patient Representatives, Billing/Collection Specialists, and/or...

Providence Remote * (Plainview, TX, USA)

Mar 30, 2023

Actuarial Consultant, Nashville TN or Remote

naviHealth, part of Optum and the UnitedHealth Group family of businesses, combines the talents of our dedicated staff and leading-edge technology to deliver compassionate care to seniors nationwide. With millions of lives touched, we are innovating the way health care is delivered from hospital to home so seniors can lead more fulfilling lives. A career with us means making an impact in the lives of those we serve, including vulnerable populations who benefit from care that is more efficient, more effective and more human. Our environment empowers our team members to elevate our interactions with each other and the experiences we deliver to our patients, giving them more days at home. Join our team, its your chance to improve the lives of millions while doing your lifes best work.(sm) Why naviHealth? At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health...

UnitedHealth Group Remote * (San Diego, CA, USA)

Mar 30, 2023

Digital Health Applications Analyst - Remote - 121102

UCSD Layoff from Career Appointment: Apply by 02/02/2023 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Special Selection Applicants: Apply by 02/14/2023. Eligible Special Selection clients should contact their Disability Counselor for assistance. DESCRIPTION Involves design, building, testing, and implementation of clinical application systems. Provides support to clinical users through knowledge of clinical processes, documentation needs, workflows, and clinical practice standards, when adapting software to meet their needs. Works with clinicians to create or adapt written protocols. Prepares detailed specs encompassing clinical processes, information flow, risk and impact analysis. May provide customer service, troubleshooting, and maintenance. Candidates hired into this position will have the option to work remotely. MINIMUM QUALIFICATIONS * Seven (7) years of related experience building and integrating an...

University of California Remote * (San Diego, CA, USA)

Mar 28, 2023

Epic Revenue Cycle Analyst - Duke Health Technology Solutions - Remote

DHTS: Duke Health Technology Solutions is a robust, specialized division of Duke University Health System dedicated to the development and management of enterprise IT systems. A 2020 Most Wired health system, Duke is nationally recognized for IT and information management as the first healthcare system to achieve the Davies Award highest honor by the Healthcare Information and Management Systems Society (HIMSS) for inpatient, ambulatory, and analytics health information technology capabilities. Our employees are among the top-skilled IT experts in the Triangle and partner with leading scholars, clinicians, and researchers across Duke University and Duke Health to develop innovative technologies that support our mission of delivering tomorrow's healthcare today. Occupational Summary The Revenue Cycle Analyst couples knowledge of business practices/operations with knowledge of information systems to implement,...

Duke Health Remote * (Durham, NC, USA)

MH

Mar 22, 2023

Manager Clinical Services - PA Licensed, Remote in PA area

This position requires PA State licensure and is a remote position in PA or NJ area, just need to be available to attend in person meetings at times. Responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in designated programs. Assists clinical management in the development and on-going management of designated staff. Performs care management review activities consistent with Magellan policies, procedures, and standards. Conducts recruitment, interviewing, and selection of properly qualified staff members and ensures appropriate orientation is provided. Regularly monitors the performance of care management staff. Monitors adherence to the efficiency goals for all staff including case volume, case closure rates, average handle time and other metrics. Supervises care management staff through approved audit processes...

Magellan Health Newtown, PA, USA

Mar 08, 2023

Sr. Data Engineer - Remote option

Position Title: Sr. Data Engineer - Remote option Department: Health Informatics Job Description: *This position may be performed remotely anywhere within the United States except the States of Arizona, California, Connecticut, Illinois, New Jersey, New York, Pennsylvania, or Washington D.C. General Description: The Senior Data Engineer is responsible for expanding and optimizing our data warehouse and building data integrations, developing data best practices and governance, performing clinical and administrative reporting, specifically optimizing data flows and collection for cross functional teams. Will lead our developers, data analysts and data scientists ensuring optimal data delivery architecture is consistent throughout ongoing projects. Will lead multiple large scale projects. Essential Responsibilities: Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation...

OU Health Oklahoma City, OK, USA

Mar 30, 2023

*** REMOTE POSITION *** Operations Support Specialist I

We are looking for detail-oriented and motivated candidates to join our growing team as a Operations Support Specialist. This person is responsible for setting up accounts, website registration, and account maintenance. The ideal candidate would take pride in strong customer service, ensuring all client inquiries are handled with the highest degree of quality and compliance . If you are a naturally high producer with a strong sense of urgency, then this position might be for you. This is a REMOTE position and the hours are Monday-Friday, 8am-4:30pm CT. Essential Functions Onboard new client s website registrations, Wincopy setup and billing preferences. Monitor billing and operational information to ensure client requirements are followed. Participate in weekly/bimonthly & monthly statement printing and delivery. Analyze, investigate and correct client order entry, billing or onboarding issues. Rebill and/or void billing errors. Research and correct...

Examworks Remote * (Springfield, MA, USA)

Mar 30, 2023

Billing Account Manager - National Remote

You ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This Billing Manager role will help manage day to day Revenue Cycle Management (RCM) billing operations. This position will help ensure RCM processes are operating accurately/effectively and aid in continually improving our billing and operating controls. The role will...

UnitedHealth Group Remote * (Dallas, TX, USA)

Mar 30, 2023

Billing Account Manager - National Remote

You ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This Billing Manager role will help manage day to day Revenue Cycle Management (RCM) billing operations. This position will help ensure RCM processes are operating accurately/effectively and aid in continually improving our billing and operating controls. The role will...

UnitedHealth Group Remote * (Tampa, FL, USA)

MP

Mar 30, 2023

Medical Coding Specialist - work from home

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company that helps our customers thrive by interpreting our client's needs and tailoring innovative cost management solutions. We are MultiPlan and we are where bright people come to shine! JOB SUMMARY: The Medical Coding Specialist is responsible for providing billing analysis of claims and applying coding standards and federal regulations to ensure correct billing practices. In this role, you will perform bill and chart reviews in identifying any variation from quality of billing as well as monitor patient bills for accuracy and compliance. JOB ROLES AND RESPONSIBILITIES: Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of treatment; analysis of charges of various revenue...

MultiPlan Remote * (Atlanta, GA, USA)

Mar 30, 2023

Data Entry Operator - Work from Home

DATA ENTRY OPERATOR - REMOTE Systems & Methods, Inc. (SMI) SMI is one of the most highly regarded technology producers in the human services field. We develop state-of-the-art solutions for complex human service operations. To maintain our prominence in this competitive industry, SMI recruits individuals who are technical, creative, client-focused, and most importantly willing to go the Extra Mile. In our 51st year as a family-owned and operated business, SMI considers its employees and clients part of an extended family. We are a family serving families. Our culture is one of teamwork, dedication, empowerment, and a strong emphasis on work-life balance. We offer an optimal atmosphere for career growth and achievement while remaining competitive in terms of compensation and benefits. We are multi-state operation and administrative private company with a staff of over 650 employees throughout the United States. We depend on the expertise of our SMI team to support and...

SMI USA Remote * (Tallahassee, FL, USA)

Mar 30, 2023

Data Entry Lead - National Remote

You''ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.At Optum, the mission is clear: Help people live heathier lives and help make the health system work better for everyone.LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well - being of Americans. By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system. LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on - location services, patient - specific in - clinic appointments, telehealth assessments, or any combination based on customer need. LHI''s customizable solutions serve the diverse needs of commercial customers, as well as federal and state...

UnitedHealth Group Remote * (Houston, TX, USA)

Mar 30, 2023

Remote / Work-From-Home - Medical Billing - Payor Verification - Commercial

Medical Billing - Payor Verification - Commercial Remote / Work From Home Starting Pay: $18.00 Job Summary The Medical Billing - Payor Verification - Commercial will work with payor portals and payors via phone communications to verify benefits, deductible and out of pocket amounts, primary, secondary, and tertiary payors. Problem solve and research and resolve coordination of benefits issues. Work as a team to meet team goals and deadlines. Essential Functions/Duties Utilize payor portals or phone calls for benefit verification Analyze work processes to maximize efficiency Work to achieve team and departmental goals Work effectively as a member of a team Communicate clearly and concisely, both orally and in writing Serve as a "champion" for best practices within our "I-Care" Cultural Pillars. (Integrity / Compassion / Accountability / Responsibility / Excellence) QUALIFICATIONS Required Experience One year of experience in...

Global Medical Response Remote * (West Plains, MO, USA)

Mar 30, 2023

Accounts Receivable Clerk - Remote

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.SM This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Primary Responsibilities: Review and analyze accounts, work queues, and/or reports to identify and resolve unapplied...

Career Staffing Remote * (Arlington, VA, USA)

Mar 30, 2023

LHI Customer Service Representative - Remote

$1500 Sign On Bonus For External Candidates You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. At Optum, the mission is clear: Help people live heathier lives and help make the health system work better for everyone. LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well - being of Americans. By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system. LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on - location services, patient - specific in - clinic appointments, telehealth assessments, or any combination based on customer need. LHI's customizable solutions serve the diverse needs of...

Career Staffing Remote * (Minneapolis, MN, USA)

Mar 30, 2023

Proposal Coordinator - Remote in Washington DC or Eden Prairie, MN or Frederick, MD

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) The primary role of the Proposal Coordinator (PC) is to assume responsibility for overseeing proposal coordination and production efforts for proposals. The PC is accountable for the initial in-depth RFP and solicitation requirement analysis as well as managing day-to-day document coordination activities related to an active proposal engagement and its resulting production and delivery. The PC performs desktop publishing...

UnitedHealth Group Remote * (Orlando, FL, USA)

Mar 30, 2023

Customer Service / Work From Home / Contractor

Description_x000D_ _x000D_ Mommy Jobs Online (mommyjobsonline.com) This is a remote, independent contractor role that provides personalized customer service through phone, email and/or live chat support. Identifies and resolves problems, as well as provides a consultative sales approach regarding various options to guide callers to the right solutions for their individual needs. Works in a fast-paced, work-at-home, customer-service environment._x000D_ Responsibilities_x000D_ _x000D_ Practicing excellent verbal and written communication skills._x000D_ Providing top-notch customer service skills while guiding callers to the right solutions for their specific needs._x000D_ Having a positive attitude; being flexible and adaptable to change._x000D_ Researching, navigating and independently locating answers from webpages and resources in a variety of situations._x000D_ Communicating effectively, based on a customer's mindset._x000D_ Exercising strong, multitasking skills while...

Career Staffing Remote * (Arlington, VA, USA)

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108 clinical quality analyst jobs found