The Access Design Specialist partners with operational and technical teams to optimize patient access through workflow design and system configuration. They serve as a bridge between stakeholders to translate operational goals into scalable access solutions and drive continuous process improvement.
The Quality Improvement Provider Strategist analyzes performance data to identify trends and gaps while developing actionable strategies to improve provider network quality outcomes. This role serves as a subject matter expert for quality programs like HEDIS and Medicare Stars, collaborating with stakeholders to drive continuous improvement and effective tool utilization.
The LPN will perform clinical duties such as drawing blood, administering medications, and assisting physicians with examinations and diagnostic procedures. They are also responsible for documenting patient activities in medical records and providing patient education to promote wellness.
The Clinical Pharmacy Specialist manages therapeutic drug interventions and clinical programs to control pharmacy trends and improve quality measures. They also collaborate with interdisciplinary teams to coordinate member care and develop innovative clinical strategies for pharmacy benefit management.
The role involves serving as a subject matter expert for Oracle Learning and Talent Management to design, implement, and optimize system solutions. Responsibilities include troubleshooting complex HCM issues, managing Oracle Service Requests, and coordinating quarterly system updates and testing.
The Coder II is responsible for accurately assigning ICD-10-CM and CPT codes for diagnoses and procedures to ensure proper reimbursement. They also manage physician queries for incomplete documentation and maintain coding accuracy and productivity standards.
The staff nurse will provide clinical care, formulate holistic care plans, and assist physicians while participating in quality improvement efforts. They are also responsible for teaching patients and families and maintaining comprehensive documentation of patient care.
The staff nurse will apply clinical judgment to formulate holistic care plans and support patients, families, and staff. They are also responsible for documenting patient care comprehensively and participating in quality improvement efforts.
The supervisor will provide direct leadership, coaching, and performance management for Capacity Management Analysts while overseeing work intake and resource allocation. They will also partner with cross-functional stakeholders to drive process improvements, ensure compliance with scheduling standards, and facilitate complex problem resolution.
The Systems Analyst will support transplant clinical workflows, troubleshoot system issues, and partner with operational stakeholders to meet business needs. They are responsible for managing projects, documenting requirements, and mentoring staff on Level 2 and Level 3 support issues.
Manage complex Epic application support, projects, upgrades, integrations, reporting, and process improvements while ensuring documentation, data quality, and confidentiality. Partner with clinical, operational, technical, and vendor stakeholders, provide training, and mentor less experienced analysts.
The coder will be responsible for assigning accurate ICD, CPT, and PQRS codes for cardiology records while ensuring documentation completeness. They will also provide feedback and education to physicians regarding coding, documentation, and reimbursement issues.
The Coder III is responsible for accurately assigning ICD-10-CM and CPT codes to diagnoses and procedures to ensure proper reimbursement. They also monitor billing reports, assist with training, and perform coding corrections to maintain high accuracy standards.
The DRG Specialist reviews clinical documentation to ensure accurate DRG assignment and compliance with coding guidelines and regulations. They also provide education to staff, manage audit processes, and investigate reimbursement issues to optimize revenue cycle performance.
The Actuary will lead the development of financial tools to drive medical cost improvement strategies and analyze healthcare utilization trends. They are also responsible for presenting findings to leadership and supervising less experienced actuarial staff.
The Lost Time Claims Specialist II is responsible for the investigation, evaluation, negotiation, and resolution of assigned workers' compensation claims. They will manage litigation activities, establish reserves, and ensure all claims are processed in accordance with company policies and state regulations.
Responsible for the investigation, evaluation, and disposition of lost time workers' compensation claims across several US jurisdictions. The role involves managing litigation activities, setting reserves, and coordinating with medical experts and legal counsel.
