The Utilization Review Clinician evaluates medical records to determine medical necessity and coordinates care transitions for post-acute services. They collaborate with healthcare providers and medical directors to ensure high-quality, cost-effective care in compliance with established guidelines.
WellSky
12 Remote Job Openings at WellSky
The Engagement Manager fosters strong relationships with healthcare providers to improve utilization management processes and compliance. They serve as an in-market expert, educating providers on workflows and analyzing data to identify opportunities for improved patient outcomes.
The Reimbursement Coordinator manages the end-to-end billing process, including claims generation, submission, and payment posting for home health services. They are responsible for resolving claim denials, performing collection follow-ups, and ensuring accurate documentation for all financial transactions.
Serve as a trusted partner for clients by providing medical coding training and addressing related issues. Collaborate with internal teams to optimize the coding experience and conduct clinical record audits for compliance.
Lead the design and architecture of scalable microservices and event-driven systems for AI-driven healthcare solutions. Collaborate with stakeholders to define technical requirements and provide guidance to engineers through code reviews and mentorship.
Drive revenue growth by identifying and closing high-value SaaS sales opportunities within the home health, hospice, and personal care sectors. Lead complex client relationships and navigate multiple stakeholders through the full sales cycle from inception to closure.
Lead the design and architecture of scalable software solutions while integrating agentic AI tooling to improve development efficiency. Collaborate with stakeholders to define technical requirements and provide guidance to engineers through code reviews and mentorship.
Design, build, and maintain scalable data pipelines and infrastructure to support data-driven decision-making. Collaborate with stakeholders to optimize data quality, security, and accessibility through automation and BI solutions.
Design, build, and maintain scalable data pipelines and infrastructure to support data-driven decision-making. Lead the development of data architecture and standards for the enterprise data warehouse while ensuring data security and quality.
Drive revenue growth by identifying and closing high-value SaaS sales opportunities within the long-term care and post-acute care sectors. Lead complex sales processes, manage stakeholder relationships, and track account activities using Salesforce to achieve quarterly quotas.
Perform medical coding quality audits to ensure compliance with regulatory standards and contractual requirements. Provide feedback and guidance to coding teams to improve performance across all service lines.
The Sleep Coach conducts outbound calls to patients for CPAP supply reorders and promotes CPAP equipment sales. They ensure patient compliance and satisfaction through effective outreach and relationship building.