LogoFresh Jobs Ahead
Guide Healthcare
Guide Healthcare
51 – 200 कर्मचारी
भर्तीस्वास्थ्य बीमास्वास्थ्य सेवा
Guide Healthcare संबद्ध स्वास्थ्य सेवाओं और स्वास्थ्य सेवा भर्ती के क्षेत्र में काम करती है, और इसका ध्यान वृद्ध वयस्कों की सहायता और उपचार पर है। 2018 में स्थापित यह कंपनी स्वास्थ्य सेवा क्षेत्र में व्यावहारिक मूल्य प्रदान करने के लिए ग्राहकों, साझेदारों और टीमों के साथ काम करती है तथा सेवा प्रदान करने और भर्ती के लिए एक अलग दृष्टिकोण अपनाती है। इसका कार्य स्वास्थ्य सेवा, संबद्ध स्वास्थ्य, भर्ती और वृद्ध लोगों के लिए सेवाओं में रुचि रखने वाले पेशेवरों के लिए प्रासंगिक हो सकता है।
LinkedIn
कंपनी की नौकरियाँ

Client Business Manager - Healthcare Operations, Illinois Remote

Guide Healthcare is seeking a remote Client Business Manager to support value-based healthcare clients in Illinois. The role oversees delegated services, compliance, reporting, escalations, and operational performance.

USसंयुक्त राज्यILइलिनॉय
$65,000 – $70,000 / वर्ष
रिमोटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीप्रबंधक

विवरण

  • Support client success through onboarding, operational support, and service delivery
  • Work virtually with clients, health plans, and internal teams in a fully remote setting
  • Manage onboarding and service delivery from go-live through steady-state operations
  • Build relationships with client administrators, network providers, and management teams
  • Oversee delegated services across Eligibility, UM, PHM, Claims, Quality, CX, and Credentialing/Provider Relations
  • Maintain primary accountability for delegated-function performance
  • Ensure compliance with regulatory requirements and client contracts
  • Prepare monthly delegated-services reports and quarterly executive review materials
  • Assist with URAC, HCAPA, and health-plan pre-delegation audit preparation
  • Analyze, track, and report operational data and performance metrics
  • Manage eligibility, capitation, and reconciliation processes while resolving discrepancies with Finance and Eligibility
  • Support implementations, scope expansions, platform transitions, network builds, and accreditation renewals
  • Monitor SLA performance, address gaps, lead remediation, and report progress to clients and leadership
  • Lead client operations meetings and participate in UM committees, JOCs, and monthly close meetings
  • Conduct client check-ins, satisfaction reviews, and quarterly executive business reviews
  • Monitor CSAT and NPS against annual targets
  • Manage escalations involving claim denials, authorization, eligibility, provider complaints, roster discrepancies, and payments
  • Support renewals through SLA restructuring, PMPM negotiation input, scope proposals, and BAA updates
  • Represent Guidehealth at BCBSIL forums and turn regulatory and program changes into operational actions
  • Maintain client contracts, DORs, SOWs, and SLA schedules
  • Contribute to initiatives that improve operational performance
  • Use EMR systems, payer portals, Guidehealth applications, and Microsoft 365 for daily work
  • Partner with internal teams to deliver integrated services and a consistent client experience

आवश्यकताएँ

  • Bachelor’s degree preferred; an Associate degree or equivalent experience may be considered
  • At least three years of experience in healthcare operations, managed care, IPA operations, health plan operations, or a related area
  • Experience owning or substantially contributing to client-facing operational work with responsibility for outcomes
  • Strong verbal and written communication skills
  • Excellent organization with the ability to manage multiple workstreams, deadlines, and deliverables
  • Strong analytical and problem-solving capabilities
  • Ability to independently manage a client portfolio and competing priorities in a fast-paced environment
  • Proficiency with Microsoft 365, including Excel, Word, PowerPoint, Outlook, and Teams
  • Ability to learn and use multiple systems
  • Valid driver’s license and reliable transportation
  • Ability to travel 25% within the Chicago area
  • Experience with delegated services preferred
  • Familiarity with value-based care contracts and PMPM service arrangements preferred
  • Experience with SLA tracking, contract compliance reporting, and health-plan or NCQA/URAC audit preparation preferred
  • Familiarity with claims workflows, 834 eligibility files, capitation reconciliation, and payer portals preferred
  • Experience presenting operational and executive reporting to client leadership preferred
  • Basic knowledge of EMR systems and healthcare data platforms preferred
  • Ability to work during stated hours with internet service providing at least 100 Mbps download and 10 Mbps upload

लाभ

  • Fully remote work arrangement
  • Medical, dental, and vision coverage
  • 401(k) plan with a 3% employer match on the employee’s 6% contribution
  • Life and disability insurance
  • Voluntary life insurance options
  • Employee Assistance Program
  • Paid time off plans
  • Paid parental leave
  • Learning and development resources
  • Required work equipment provided at no cost
  • Commitment to equal opportunity employment

संबंधित नौकरियाँ

Hewlett Packard Enterprise

Remote Partner Business Manager, HPE Compute — Eastern US

Hewlett Packard Enterprise
H1B वीज़ा प्रायोजकउद्यमकृत्रिम बुद्धिमत्ताहार्डवेयर
USसंयुक्त राज्यMDमैरीलैंडNJन्यू जर्सीNYन्यूयॉर्कPAपेंसिल्वेनियाVAवर्जीनिया
$78,000 – $1,30,000 / वर्ष
रिमोटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीप्रबंधक

Lead HPE Compute sales with state, local, and education partners across the Eastern United States. Build joint sales plans, grow pipeline, and strengthen partner advocacy.

खोलें
American Express

Compliance Analyst, American Express (Hybrid, India)

American Express
B2Bबैंकिंगवित्त
INभारतहाइब्रिडपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीअनुपालन
BigQueryPythonSQL

Support American Express compliance and risk teams with AML reviews, data analysis, and outcome-based testing. Develop testing methods and monitor banking compliance risks.

खोलें
Heidi Health

Remote Performance Marketing Specialist in the Philippines at Heidi Health

Heidi Health
11 – 50 कर्मचारी
कृत्रिम बुद्धिमत्तापरामर्शस्वास्थ्य सेवा
PHफ़िलिपींसरिमोटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीपरफ़ॉर्मेंस मार्केटिंग

Grow Heidi Health’s AI healthcare platform through paid campaigns on Meta, Google, TikTok, Amazon and other channels. Manage ecommerce campaigns, marketplaces, tracking and performance metrics.

खोलें
Flutter Entertainment

Senior HR Risk and Compliance Manager

Flutter Entertainment
कुशल कामगार वीज़ा प्रायोजकई-कॉमर्सगेमिंगजुआ
INभारतहाइब्रिडपूर्णकालिकवरिष्ठलीडआवश्यक भाषा: अंग्रेज़ीमानव संसाधन

Lead employment law compliance, audits, privacy, and governance, risk, and compliance programs at Flutter Entertainment. The role supports HR operations in Hyderabad and Cluj-Napoca.

खोलें
NZ Transport Agency Waka Kotahi

Compliance Officer – NZTA, Auckland

NZ Transport Agency Waka Kotahi
1,001 – 5,000 कर्मचारी
निर्माणपरामर्शलॉजिस्टिक्स
NZन्यूज़ीलैंड
$80,388 – $89,320 / वर्ष
ऑन-साइटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीअनुपालन

Audit and assess commercial transport operators for NZTA, using risk-based compliance decisions and investigations to support safer outcomes. Build regional relationships with operators and travel as required.

खोलें
ElevenLabs

Growth Marketer, Reception.ai

ElevenLabs
1 – 10 कर्मचारी
कृत्रिम बुद्धिमत्तामीडिया
GBयूनाइटेड किंगडमUSसंयुक्त राज्यरिमोटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीग्रोथ मार्केटिंग

Lead self-serve acquisition for Reception.ai, ElevenLabs’ conversational AI voice agent for small businesses. Grow the product through paid campaigns, SEO, creator partnerships, platform partnerships, and viral launches.

खोलें
General Dynamics Information Technology

Remote Compliance Subcontracts Administrator

General Dynamics Information Technology
H1B वीज़ा प्रायोजकपरामर्शलॉजिस्टिक्सस्वास्थ्य सेवा
USसंयुक्त राज्य
$64,230 – $75,999 / वर्ष
रिमोटपूर्णकालिकजूनियरमध्य स्तरआवश्यक भाषा: अंग्रेज़ीअनुपालन

Audit procurement records for compliance and help prepare for Contractor Purchasing System Reviews. Join GDIT’s Acquisition Compliance Quality team supporting government missions.

खोलें
NZ Transport Agency Waka Kotahi

Compliance Officer, NZ Transport Agency

NZ Transport Agency Waka Kotahi
1,001 – 5,000 कर्मचारी
निर्माणपरामर्शलॉजिस्टिक्स
NZन्यूज़ीलैंड
$80,388 – $89,320 / वर्ष
ऑन-साइटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीअनुपालन

Audit and assess commercial transport operators for NZTA, applying legislation and risk analysis to support safer transport outcomes. Work with operators across regional teams.

खोलें
Tallgrass Freight Company

Air Compliance Intern

Tallgrass Freight Company
11 – 50 कर्मचारी
B2Bपरिवहनलॉजिस्टिक्स
USसंयुक्त राज्यCOकोलोराडो
$25 – $37 / घंटा
ऑन-साइटपूर्णकालिकप्रारंभिक स्तरडिग्री आवश्यक नहींआवश्यक भाषा: अंग्रेज़ीअनुपालन

Support emissions calculations, permitting, and regulatory reporting as an Air Compliance Intern. Gain practical experience with environmental compliance in Tallgrass’s energy infrastructure operations.

खोलें
NZ Transport Agency Waka Kotahi

Compliance Officer – NZ Transport Agency Waka Kotahi

NZ Transport Agency Waka Kotahi
1,001 – 5,000 कर्मचारी
निर्माणपरामर्शलॉजिस्टिक्स
NZन्यूज़ीलैंड
$80,388 – $89,320 / वर्ष
ऑन-साइटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीअनुपालन

Conduct audits and reviews of New Zealand commercial transport operators, using evidence and risk assessments to evaluate compliance. Gather and analyse information, document findings, and escalate significant risks; regional travel is a key part of the role.

खोलें