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The Hospital Bill Audit Nurse reviews medical records to verify the accuracy of hospital charges against industry guidelines and payor contracts. The role involves independent scheduling, onsite travel to provider locations, and documenting audit findings to identify discrepancies.
The analyst determines the accuracy of provider claims by comparing them against medical records and state/government compliance guidelines. They are responsible for identifying aberrant billing patterns, managing caseloads, and providing clinical expertise for pre-payment claim reviews.
The Registered Nurse will manage patient care within a specialty, utilizing the nursing process and coordinating with the clinical team to ensure high-quality outcomes. Responsibilities include building therapeutic relationships, performing clinical procedures, conducting telephone triage, and maintaining accurate documentation in the EMR.
The Nurse Case Manager supports patients living with HIV by coordinating care, managing treatment enrollment, and facilitating insurance coverage. They act as a central liaison between physicians, patients, and healthcare stakeholders while ensuring compliance with pharmacovigilance and reporting standards.
The Triage Nurse assesses patient medical problems and complaints by phone to determine the appropriate level of care. They also provide patient education, manage care coordination, and accurately document all interactions in the electronic health record.
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Leads and manages complex pharmacy systems and special projects to ensure successful delivery within scope, quality, and schedule constraints. Collaborates with cross-functional teams to evaluate operational workflows and implement process improvements that enhance clinical performance.
Provide telehealth mental health services to children and adolescents experiencing anxiety, depression, trauma, and behavioral concerns. Maintain a caseload of at least 10 clients while participating in required training and supervision sessions.
Provides support for the analysis, maintenance, and configuration of EHR revenue management applications. Manages projects for system updates and facilitates educational programs for clinical end users.
The Regional Enrollment Manager will manage an assigned territory by conducting high school visits, college fairs, and individual appointments to recruit students to the University of Dayton. They will also advise families on the admission and financial aid process while coordinating regional events to increase brand recognition.
The RN Care Manager will assess member health and safety needs to develop comprehensive care plans and coordinate with primary care providers. They will also provide ongoing education to members regarding disease processes, lifestyle modifications, and health risks while maintaining accurate documentation.
The Care Manager assesses member clinical needs against established guidelines to ensure appropriate care and develops individualized plans to improve health outcomes. They also facilitate transitions of care, monitor medical activities, and serve as a mentor to new nursing staff.
The Clinical Nurse Consultant develops professional relationships with healthcare providers to deliver clinical education and support for hematology and oncology products. They are responsible for driving peer-to-peer interactions, optimizing patient outcomes, and executing account-based business plans within their assigned territory.
The physical therapist will deliver quality home healthcare to patients of all ages and observe, record, and report patient responses to treatment. They are responsible for determining the plan of care and completing documentation through an electronic medical record system.
The Physical Therapist will deliver quality home healthcare to patients of all ages by observing, recording, and reporting responses to treatment. They are responsible for determining the plan of care and maintaining accurate documentation through an electronic medical record system.
The physical therapist will deliver quality home healthcare to patients of all ages and observe, record, and report patient responses to treatment. They are responsible for determining the plan of care and completing documentation through an intuitive electronic medical record system.
Perform independent clinical reviews of medical records to make objective, evidence-based determinations for utilization and quality review programs. Ensure all documentation is accurate, compliant with regulatory standards, and submitted within contractual turnaround times.
The Physician Advisor conducts medical necessity reviews, facilitates peer-to-peer discussions with payor medical directors, and manages appeals. They also ensure clinical care aligns with regulatory standards and evidence-based medicine while collaborating with hospital case managers.
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The Estimator is responsible for providing analysis and pricing for construction projects ranging from $100K to $30M through budgeting and bidding. They must also maintain relationships with subcontractors and suppliers while ensuring accurate project cost tracking and reporting.
Provide intensive, evidence-based virtual therapy for individuals with high-acuity OCD using modalities like ERP, CBT, and ACT. Manage caseloads, conduct risk assessments, and collaborate with a multidisciplinary team to ensure clinical excellence and treatment adherence.
The role involves leading the development and execution of the advanced technology roadmap for medical imaging while mentoring a multidisciplinary innovation team. You will drive the commercialization of emerging technologies, including AI and biomedical optics, from concept through to regulated product launch.
The Transitional Care RN acts as a patient advocate by facilitating and coordinating the transition of patients to the next level of care. This role involves collaborating with facility discharge planners and case management staff through telephonic outreach and in-person assessments.
The Clinical Specialist provides clinical sales support and case coverage for interventional technologies to drive product adoption and patient outcomes. They also deliver training and education to healthcare professionals while collaborating with the sales team to meet revenue goals.
The Nurse Practitioner conducts comprehensive in-home or telehealth health risk assessments to identify chronic conditions and physical, mental, or social needs. They are responsible for diagnosing patients, documenting visits per NCQA standards, and coordinating care with physicians and caregivers.
Conduct telehealth visits to assess patient needs and develop comprehensive care plans. Document patient encounters accurately while delivering professional and compassionate virtual care.
Provide speech and language therapy services via teletherapy platforms while collaborating with a multi-disciplinary team. Deliver individualized care plans and guide families through technical challenges to ensure holistic patient outcomes.
The Case Manager will assess member health and safety needs to develop comprehensive care plans and coordinate support services. They will conduct regular face-to-face and phone assessments to ensure members receive appropriate, cost-effective care in the least restrictive environment.
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The Clinical Payments Specialist manages end-to-end investigator payments, including setup, deployment, and reconciliation for assigned clinical studies. They act as a liaison between investigative sites and internal teams while ensuring payments align with clinical trial agreements and budgetary forecasts.
The Senior Specialty Representative acts as the primary customer contact, responsible for implementing marketing strategies and promoting Amgen products to medical professionals. They must achieve territory sales targets through effective communication of clinical benefits and by managing complex account relationships.
The Pharmacy Audit Analyst conducts onsite and desktop audits to identify discrepant pharmacy claims and ensure compliance with regulatory requirements. They are responsible for gathering documentation, reporting findings to providers, and performing quality control on completed audits.
The Project Associate will lead a team in reviewing improper payments on health insurance exchanges and evaluating eligibility for premium tax credits. They are also responsible for managing project documentation, coordinating team activities, and presenting findings to stakeholders.
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