LogoFresh Jobs Ahead
Highmark Health
Highmark Health
H1B vīzas sponsorsApdrošināšanaKonsultācijasLoģistika
Highmark Health ir veselības aprūpes organizācija, kas koncentrējas uz to, lai uzlabotu cilvēku pieredzi veselības aprūpē un piekļuvi aprūpei. Tās darbība ietver klīniskos pakalpojumus, tehnoloģijas, finanses, mārketingu un citas jomas, kas atbalsta veselības aprūpes nodrošināšanu. Kā neatkarīgs Blue Cross Blue Shield Association licences turētājs uzņēmums apvieno dažādu jomu profesionāļus, lai palīdzētu attīstīt veselības aprūpes sistēmu. Highmark Health uzsver arī daudzveidību, vienlīdzību un iekļaušanu, un ir saņēmis atzinību par cilvēku ar invaliditāti iekļaušanu un militārpersonām draudzīgu nodarbinātību.
LinkedIn
Vakances uzņēmumā

Clinical Quality Management Analyst, RN

Improve healthcare quality and compliance through clinical data analysis, medical record reviews, coding, audits, and accreditation work at Highmark Health. Support providers and quality initiatives with education and process improvement.

USAmerikas Savienotās ValstisALAlabamaAKAļaskaAZArizonaCAKalifornijaCOKolorādoCTKonektikutaFLFloridaHIHavajasIDAidahoILIlinoisaIAAiovaKSKanzasaKYKentukiLALuiziānaMEMeinaMDMerilendaMAMasačūsetsaMIMičiganaMNMinesotaMSMisisipiMOMisūriNENebraskaNVNevadaNHŅūhempšīraNJŅūdžersijaNMŅūmeksikaNYŅujorkaNCZiemeļkarolīnaNDZiemeļdakotaOHOhaioOKOklahomaOROregonaPAPensilvānijaRIRodailendaSCDienvidkarolīnaSDDienviddakotaTNTenesīTXTeksasaUTJūtaVTVērmontaVAVirdžīnijaWAVašingtonaWVRietumvirdžīnijaWIViskonsinaWYVaiominga
62 700 $ – 97 200 $ / gads
KlātienēPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuBiznesa analītiķis

Apraksts

  • Partner with departments on compliance, process improvement, medical record reviews and coding, and member and provider satisfaction.
  • Recommend and implement improvements to quality care, member services, and ICD-10-CM documentation.
  • Advise and educate on medical record documentation, CMS and NCQA standards, and continuous quality improvement.
  • Conduct special studies, audits, office site visits, and medical record reviews.
  • Coordinate credentialing and re-credentialing, member complaint investigations, Medical Director and facility site visit requests, reviews, audits, and accreditation activities.
  • Develop and oversee improvement initiatives using data and process analysis, report generation, medical record documentation, and HCC coding.
  • Analyze office site and medical record review findings to improve care, services, documentation, coding, STARS, value-based care, credentialing, quality improvement, and accreditation.
  • Track regulatory and accrediting-body changes and update compliance plans in line with CMS Coding Guidelines.
  • Conduct retrospective, concurrent, prospective, semiannual, and annual audits; identify gaps and share results.
  • Educate providers on STARS, HEDIS, and HCC coding.
  • Conduct follow-up audits as needed.
  • Complete other assigned or requested duties.

Prasības

  • Current state RN or LPN license, or a bachelor's degree in a healthcare-related field.
  • Six years of experience in HEDIS/quality abstraction, HCC or medical coding, or a healthcare-related field may substitute for a bachelor's degree.
  • Three years of experience in nursing or a healthcare-related field.
  • Current state RN or LPN license, multistate licensure through the enhanced Nurse Licensure Compact (eNLC), or CPC, CRC, RHIA, RHIT, or CCS certification; required certification or licensure must be obtained within four months of hire.
  • Understanding of Total Quality Management (TQM) concepts, techniques, and process and outcome measures.
  • Knowledge of statistics preferred for analyzing reports and validating study methods.
  • Strong verbal and written communication skills and a professional manner.
  • Ability to communicate with medical administrators, including Medical Directors and Physician Advisors, about identifying problems, implementing action plans, monitoring progress, and resolving issues.
  • Computer literacy and familiarity with information systems and comparative databases.
  • Working knowledge of Microsoft Office, including Word, Excel, Access, and PowerPoint.
  • Analytical and problem-solving skills, including the ability to understand and interpret clinical data.
  • Travel requirement of 0%–25%.
  • Physical work site required.

Saistītās vakances

Red Hat

Consulting Cloud Architect, OpenShift

Red Hat
H1B vīzas sponsorsMākonisUzņēmums
ILIzraēlaKlātienēPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuNepieciešamā Valoda: ivritsMākoņinženieris
AnsibleAtvērtais pirmkodsAWSAzureDockerKubernetesLinuxMākonisMikropakalpojumiOpenShift

Design and deliver Red Hat OpenShift, Kubernetes, and hybrid cloud solutions for enterprise customers. Lead customer engagements focused on infrastructure, automation, and application delivery.

Atvērt
Kreato Global | BPO and Language Solutions

Remote English-Spanish OPI/VRI Interpreter

Kreato Global | BPO and Language Solutions
201 – 500 Darbinieki
LoģistikaVeselības aprūpeViesmīlība
ARArgentīnaBOBolīvijaBRBrazīlijaCLČīleCOKolumbijaCRKostarikaCUKubaDODominikānaECEkvadoraGTGvatemalaHNHondurasaHTHaitiMXMeksikaNINikaragvaPAPanamaPEPeruPRPuertorikoPYParagvajaSVSalvadoraUYUrugvajaVEVenecuēlaAttālinātiPilna slodzeJaunākais speciālistsGrāds nav nepieciešamsNepieciešamā Valoda: angļuNepieciešamā Valoda: spāņuTulkotājs

Interpret remotely between English- and Spanish-speaking people in medical, financial, social service, and customer care settings. Provide language support for Kreato Global across Latin America.

Atvērt
RecruitGo

Remote Executive Assistant, Outreach and Marketing — Philippines

RecruitGo
51 – 200 Darbinieki
KonsultācijasLoģistikaMārketings
PHFilipīnas
45 000 ₱ / mēnesis
AttālinātiPilna slodzeJaunākais speciālistsVidējais līmenisGrāds nav nepieciešamsNepieciešamā Valoda: angļuVadības asistents

Handle administrative support, CRM, outreach, and marketing for RecruitGo, an Employer of Record serving global clients with talent from emerging markets. Support two UK-facing clients with day-to-day administration and creative campaigns.

Atvērt