div class="flex max-w-full flex-col grow">Pathologists (Freelance - Remote).
We've built a unique platform that connects researchers and companies with a global pool of participants, enabling the collection of high-quality, ethically sourced human behavioural data and feedback.
div class="flex max-w-full flex-col grow">Cardiologists (Freelance - Remote).
We've built a unique platform that connects researchers and companies with a global pool of participants, enabling the collection of high-quality, ethically sourced human behavioural data and feedback.
Technical 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.
The 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. 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.
Leadership: 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.
o 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.
Technical 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.
The team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.
Assist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.
The UM Nurse will integrate the functions of utilization review, discharge planning and resource management into a singular effort to ensure, based on patient assessment and best practice, that care is provided in the appropriate setting utilizing medically indicated, contracted resources. Overall Purpose:
The UM Nurse is responsible for compliance with the Medical Management Program Description of P3 Health Partners regarding Utilization Review, inclusive of prior authorization, concurrent and retrospective review, discharge planning and transitions of care to the appropriate level.
li>Communicates with and supports physician reviewers by summarizing case facts, preparing case questions, and resolving physician input issues. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.
This fully remote opportunity is ideal for a highly skilled clinical science writer with extensive experience authoring Clinical Study Reports (CSRs), protocols, and regulatory submission documents across Phase I III studies. The ideal candidate is a hands-on writer who spends the majority of their time authoring and developing scientific and regulatory documents rather than primarily editing or managing teams.
Main Responsibilities: The Medical Science Liaison (MSL) is a field-facing role whose main responsibilities are: Scientific Stakeholder Engagement: Serve as a trusted scientific partner to Key Opinion Leaders and healthcare providers, conducting high-quality scientific exchanges to enhance understanding of Sanofi's medical and scientific value. Sanofi's Medical Field base teams enhance the understanding of the scientific and medical value of our products in the therapeutic area and gather new insights by bringing cutting edge scientific exchange today that accelerates medical innovation tomorrow.
At BillionToOne, we''ve built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. Unity Confirm enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells using BillionToOne's Fetal Cell Capture Technology.