LogoFresh Jobs Ahead
Guide Healthcare
Guide Healthcare
51 – 200 Xodimlar
Sog‘liqni saqlashTibbiy sug‘urtaXodimlarni yollash
Guide Healthcare ittifoqdosh tibbiy xizmatlar va sog‘liqni saqlash sohasida xodimlarni ishga jalb qilish yo‘nalishlarida faoliyat yuritadi hamda keksalarga ko‘maklashish va ularni davolashga e’tibor qaratadi. 2018-yilda tashkil etilgan kompaniya sog‘liqni saqlash sektorida amaliy qiymat yaratish uchun mijozlar, hamkorlar va jamoalar bilan ishlaydi, xizmat ko‘rsatish va ishga qabul qilish jarayonlariga o‘zgacha yondashuvni qo‘llaydi. Uning faoliyati sog‘liqni saqlash, ittifoqdosh tibbiy xizmatlar, ishga jalb qilish va keksalar uchun xizmatlarga qiziqadigan mutaxassislar uchun dolzarb bo‘lishi mumkin.
LinkedIn
Kompaniyadagi ish o‘rinlari

Clinical Compliance Auditor II - Texas Remote

Clinical Compliance Auditor II responsible for auditing utilization management and clinical operations at Guidehealth, a data-powered value-based healthcare company. This remote role supports regulatory, contractual, and clinical compliance.

USAmerika Qo‘shma ShtatlariTXTexas
82 000 $ – 87 000 $ / yil
MasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaAuditor

Tavsif

  • Lead comprehensive clinical compliance audits across utilization management, denial documentation, clinical reporting, authorization compliance, and delegated-services requirements.
  • Track compliance with UM and PHM Plans, Managed Services Agreements, and client-specific contractual and regulatory standards.
  • Complete routine, scheduled, and ad hoc audits.
  • Act as a secondary reviewer for denial documentation.
  • Review audit findings, clinical workflows, and reporting processes to identify trends, risks, documentation deficiencies, and process gaps.
  • Create and maintain audit tools, protocols, compliance-monitoring frameworks, UM and PHM Plans, and clinical compliance procedures.
  • Mentor Clinical Compliance Auditors and clinical operations staff while providing subject matter expertise.
  • Help leadership assess training needs and opportunities to improve clinical compliance.
  • Coordinate audit reviews, reporting activities, and compliance committee support.
  • Evaluate audit results and clinical data to uncover trends and root causes.
  • Prepare and present audit findings and compliance reports for clinical leaders and operational stakeholders.
  • Assist with developing reporting tools, dashboards, and audit metrics.
  • Respond to changing business needs and contribute to cross-functional initiatives.

Talablar

  • Hold an active, unrestricted Registered Nurse (RN) license.
  • Demonstrate strong knowledge of utilization management, clinical documentation, and regulatory compliance.
  • Bring 3–5 years of experience in utilization management, clinical auditing, clinical compliance, or managed care.
  • Understand Medicare, commercial managed care, and delegated-services compliance requirements.
  • Work independently and apply sound professional judgment.
  • Use Microsoft Office proficiently, including Excel, Word, and reporting tools.
  • Have at least 2 years of clinical compliance or healthcare auditing experience preferred.
  • Maintain an internet connection with at least 100 Mbps download and 10 Mbps upload speeds.
  • Remain accessible during stated working hours.
  • Follow security policies and procedures protecting PHI, PII, and company intellectual property.

Imtiyozlar

  • Work fully remotely.
  • Receive necessary work equipment at no cost.
  • Access comprehensive medical, dental, and vision plans.
  • Participate in a 401(k) plan with a 3% employer match to a 6% employee contribution.
  • Receive life and disability insurance.
  • Access voluntary life insurance options.
  • Use the Employee Assistance Program (EAP).
  • Receive paid time off.
  • Take paid parental leave.
  • Access learning and development resources.
  • Use a flexible work arrangement.
  • Provide your own internet connection meeting the minimum requirement of 100 Mbps download and 10 Mbps upload.

O‘xshash ish o‘rinlari

FICO

Remote Analytic Consultant I – FICO Scores

FICO
1 001 – 5 000 Xodimlar
KonsaltingSog‘liqni saqlashSug‘urta
USAmerika Qo‘shma Shtatlari
88 000 $ – 121 000 $ / yil
MasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaKonsultant
AWSAzureC++Google Cloud PlatformJavaPython

Develop predictive and decision models for FICO’s financial services clients worldwide. Analyze large credit datasets and deliver scoring solutions using statistical methods and machine learning.

Ochish
Vanguard

Client Experience Consultant at Vanguard

Vanguard
H1B vizasi homiysiB2BB2CMoliya
USAmerika Qo‘shma ShtatlariAZArizonaNCShimoliy KarolinaPAPensilvaniyaGibridTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaKonsultant

Present Vanguard’s digital platforms to plan participants and sponsors, and support sales, relationship management, business development, and client retention. Work with internal teams to match digital solutions to client goals and resolve complex inquiries.

Ochish
Health Care Service Corporation

Senior Business Consultant at HCSC (Richardson Hybrid)

Health Care Service Corporation
H1B vizasi homiysiKonsaltingSog‘liqni saqlashSug‘urta
USAmerika Qo‘shma ShtatlariILIllinoysOKOklaxomaTXTexas
69 800 $ – 125 900 $ / yil
GibridTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaKonsultant

Lead complex, cross-divisional initiatives at HCSC, aligning business analysis with divisional strategies. Coordinate teams, resources, budgets, timelines, and senior stakeholders throughout transformational programs.

Ochish
Crowe

Senior Consultant, Master Scheduling and Inventory Optimization

Crowe
5 001 – 10 000 Xodimlar
H1B vizasi homiysiIshlab chiqarishKonsaltingOziq-ovqat va ichimliklar
USAmerika Qo‘shma ShtatlariTNTennessiTXTexas
95 000 $ – 147 000 $ / yil
OfisdaTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaKonsultant
Tableau

Help manufacturing clients improve performance through master scheduling, inventory optimization, and operational improvement initiatives. Advise clients and lead transformation projects within Crowe’s advisory practice.

Ochish