Health Care Division Leader - Partner Track (Remote/Hybrid) GOOD WORKS TALENTHealth Care Division Leader - Partner Track (Remote/Hybrid)Albuquerque, NMRemoteIf you’re ready to move from managing work to building something meaningful, with the backing of a strong platform and a culture that actually supports your life outside of work, this role offers the chance to create both professional and financial upside in a way that few opportunities can. Deliver Strategic Client Impact - Act as a senior advisor on complex engagements, leveraging the firm’s full-service model to deliver comprehensive solutions across tax, advisory, wealth, and beyond.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Albuquerque, NMRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Director, Medical Document Optimization TriWest Healthcare AllianceDirector, Medical Document OptimizationAlbuquerque, NMRemoteFull timeLeadership: Ability to set strategic direction and translate organizational goals into operational plans; successfully leads and develops staff across varying styles and levels; provides clear expectations, effective coaching, and timely feedback; leads through a subordinate manager and drives accountability at all levels of the department. Problem Solving / Analysis: Ability to solve complex operational and systems-related problems through systematic analysis of data, workflows, and processes; exercises sound judgment in ambiguous or high-stakes situations; identifies root causes and implements durable solutions with a realistic understanding of organizational constraints.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorAlbuquerque, NMRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerAlbuquerque, NMRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.
Chief of Staff to the Chief Operating Officer TriWest Healthcare AllianceChief of Staff to the Chief Operating OfficerAlbuquerque, NMRemoteFull timeTechnical Skills: Proficient in current trends in health care management with emphasis in customer service, network management, utilization and financial trends; collaboration skills to work with TriWest management team across multiple locations; networking skills with all levels, including subcontractors. • Works on multiple high level projects including logistical coordination, data analysis, contract management and written communications in support of various business initiatives of high visibility, applying project management tools and methodologies and leadership skills to meet or exceed deadlines.
Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystAlbuquerque, NMRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.