The Intake Coordinator manages inbound requests from providers and clients to initiate the authorization process within the care management system. They also perform outbound follow-ups for clinical information and ensure all activities comply with HIPAA and URAC standards.
Lead full-cycle recruiting for professional and technical roles across various functions while partnering with hiring managers to define needs and sourcing strategies. Manage candidate pipelines, conduct screenings, and guide hiring teams through the selection and offer process.
The Clinical Bill Review Analyst reviews medical claims to identify billing discrepancies, coding errors, and savings opportunities. They also collaborate with internal teams to resolve complex claim issues and communicate findings to clients through detailed reports.
The Intake Coordinator manages inbound requests from providers and clients to facilitate the authorization process within the care management system. They also perform concurrent reviews by screening inquiries and collaborating with clinical staff to ensure adherence to health plan policies.
The Intake Coordinator manages inbound requests from providers and clients to facilitate the authorization process according to health plan policies. They also document demographic information, perform concurrent reviews, and communicate with internal and external partners.
The Case Management Nurse will assess patient needs, develop individualized care plans, and collaborate with multidisciplinary teams to ensure high-quality, patient-centered care. They will also advocate for patients, provide health education, and ensure compliance with regulatory standards and organizational policies.
The Senior Financial Analyst will lead enterprise headcount and compensation forecasting while serving as a key financial partner to senior leadership. They will develop complex financial models to support strategic decision-making, M&A analysis, and continuous process improvement.
The VP of Bill Review Operations will lead the Bill Review Services organization by setting strategic priorities and ensuring operational and financial performance. They will coach senior leaders and partner with the EVP of Payment Integrity to drive growth and operational excellence.
The Bill Review Operations Coordinator will manage operational communications, client support, and issue resolution to ensure efficient bill review processes. They will also track operational metrics, generate reports, and collaborate with cross-functional teams to drive process improvements.
Manage the end-to-end scheduling process for imaging services by coordinating referrals, appointments, and insurance verification. Serve as the primary point of contact for members while collaborating with providers and internal teams to ensure a seamless healthcare experience.
The Utilization Management Nurse oversees the utilization management process to ensure cost-effective and high-quality healthcare delivery for plan participants. They conduct prospective, concurrent, and retrospective reviews while collaborating with internal teams and healthcare providers to ensure compliance with regulatory standards.
Lead, coach, and develop a team of sales professionals to drive growth within the Employer Markets business. Manage pipeline health, sales execution, and performance metrics while fostering a culture of accountability and continuous development.
Lead, coach, and develop a team of high-performing sales professionals to drive growth within TPA markets. Manage pipeline health, sales execution, and performance metrics while fostering a culture of accountability and continuous development.
Develop and maintain data products using medical and pharmacy claims to support healthcare navigation and compliance. Transform complex datasets into actionable insights using SQL and Python while managing secure outbound data extracts for vendors.
Drive new business growth by developing strategic relationships with third-party administrators (TPAs) and executing territory strategies. Position the Valenz Health platform as a solution for cost management and quality improvement while meeting revenue goals.
Drive new business growth in the Employer Markets segment by building strategic relationships with employers, brokers, and consultants. Develop and execute territory strategies to position healthcare solutions that optimize health plan performance and reduce costs.
Drive new business growth in the Employer Markets segment by building strategic relationships with employers, brokers, and consultants. Develop territory strategies and execute a consultative sales process to help organizations optimize self-funded health plans.
Drive new business growth by developing strategic relationships with health plans and payer organizations to improve payment accuracy and reduce healthcare costs. Execute a strategic territory plan and manage the full consultative sales cycle from prospecting to closing.
Drive new business growth by developing strategic relationships with third-party administrators (TPAs) and executing territory strategies. Position the Valenz Health platform as a differentiated solution to help TPAs improve cost management and member outcomes.
Drive new business growth by developing strategic relationships with health plans and payer organizations to improve payment accuracy and reduce healthcare costs. Execute territory plans and manage the full consultative sales cycle from prospecting to closing revenue goals.
Provide physician leadership for medical management and utilization review programs to ensure alignment with evidence-based medicine and regulatory standards. Serve as the clinical authority for complex medical necessity determinations and advise operational leadership on clinical policies.
Lead enterprise revenue planning and long-range growth modeling to drive financial outcomes across multiple product lines. Partner with executive leadership and sales operations to translate commercial strategies into actionable financial insights and investment decisions.
Accountable for the overall success, growth, and profitability of the Valenz Bluebook platform, reporting directly to the CEO. Responsibilities include driving business strategy, product stabilization, market adoption, and cross-functional alignment to deliver healthcare cost transparency.
