Job Search Results for clinical
Dec 19, 2025
Hayward, CA
|
Computer Engineering
|
Contract,Perm Possible
|
$48 - $60 (hourly estimate)
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The Business Intelligence Engineer plays a critical role in designing, developing, and maintaining advanced data analytics and reporting solutions that support healthcare operations and... decision-making. This position is responsible for transforming raw healthcare data into meaningful, actionable insights through deep expertise in the Qlik platform and healthcare data standards.Key Responsibilities:?BI Solution Development: Design, develop, and maintain interactive dashboards, visualizations, and reports using Qlik Sense and QlikView.?Data Modeling & ETL: Build and manage complex data models and ETL pipelines to integrate data from various sources, including databases, APIs, and flat files.?Report Automation: Utilize Qlik nPrinting to automate and distribute reports to stakeholders across the organization.?Healthcare Data Integration: Design, implement, and troubleshoot data exchange between healthcare information systems using the HL7 standard to ensure accurate, compliant, and seamless data flow.?Collaboration & Requirements Gathering: Work closely with operational, clinical, and business stakeholders to understand requirements, define key metrics, and translate business needs into effective BI solutions.?Performance Optimization: Optimize Qlik dashboards, data pipelines, and data models for performance, scalability, and usability.?Support & Documentation: Provide end-user support and maintain clear, detailed technical documentation for dashboards, data flows, interface specifications, and processes.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Jan 09, 2026
Coral Gables, FL
|
System Administrator
|
Contract
|
$52 - $65 (hourly estimate)
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Insight Global is seeking multiple Epic Bridges Consultants for the largest health system in South Florida. The ideal candidate has 5+ years of experience with Epic Bridges and is Epic Bridges... certified. This candidate will be creating and executing solutions for integrating financial and clinical data across multiple systems. This candidate must have the ability to understand data structures and technical specifications detailing data elements and HL7 message structures. They will provide proactive support by monitoring live connections and be responsible for creating/maintaining overall interface environment documentation. They must be able to prioritize tasks based on severity of user impact, resolve major incidents within the established time limits. They must be able to demonstrate thorough knowledge of computer systems, software, decision support systems, monitoring, report writing tools and electronic communication. This is a fully remote job with 1 week of travel required, occurring the first week of every month.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Dec 08, 2025
Chicago, IL
|
Project Manager
|
Contract
|
$46 - $57 (hourly estimate)
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Job Description:Responsible for the preparation and review of analysis for various PB Coding leadership and external customers by creating a reporting dashboard (PB Coding and Charge Capture... Dashboard). Work as an operational and technical analyst supporting the technology used by the PB Coding Department in the revenue cycle function. Partner with Revenue cycle, clinical leadership, and IT to identify and analyze root cause of user and system issuesSubmit and track system requests, submit system enhancements and new edits, and participate in system upgradesDevelop efficient workflows and claim scrubber edits Routine Epic maintenance for PB coding, including tasks like managing reports, work queues, revenue setup, and verifying IT configurationsManaging 2 shared inbox requestsDay to day: Request optimizations, innovation, create automation solutions to make the coders and medical reviewers life more efficientKey Responsibilities Include:Sitting in on meetings in new growth projects and ability to drive conversations and have a seat at the table with ITWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Dec 16, 2025
Philadelphia, PA
|
Training
|
Contract
|
$36 - $45 (hourly estimate)
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We are seeking an experienced Infor CloudSuite Workforce Management (WFM) and Multi-View Scheduling (MVS) Trainer to support a large-scale scheduling system implementation for a major healthcare... organization. This role is responsible for delivering high-quality training to approximately 800 nurse schedulers as they transition to the new scheduling module. Training materials will be fully developed and provided?your primary responsibility is to lead engaging, effective training sessions and ensure end users feel confident adopting the new technology.This position is remote, with required onsite training days as scheduled.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Dec 23, 2025
New York, NY
|
Insurance
|
Perm
|
$270k - $280k (estimate)
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Insight Global is hiring a fully remote Physician Reviewers for a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after treatment to... confirm they follow medical guidelines and company policies. This includes checking different types of services like hospital stays, rehab care, medical equipment, and outpatient treatments. They document their decisions clearly so members can easily understand them, and they use the right templates to keep everything consistent. Physician Reviewers also talk directly with doctors when needed to explain decisions or suggest alternative treatments based on medical evidence. They work quickly to meet deadlines, follow all laws and regulations, and handle other related tasks as needed. This is a remote position that requires strong attention to detail, clear communication, and the ability to make informed decisions quickly.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Jan 08, 2026
Bloomington, MN
|
Data Warehousing
|
Contract,Perm Possible
|
$54 - $68 (hourly estimate)
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All team members must champion and model our values of partnership, curiosity, compassion, integrity, and excellence, and must contribute to a culture of continuous learning? Partners with domain experts, business groups, and data engineers to frame problems, model, clean and integrate data, and determine the best way to leverage that data in service of a goal ? Works with business partners to understand and create their ?user stories;? they support opportunities to leverage data analytics in service of customer or business value ? Creates, deploys, monitors, and maintains highly interactive data visualizations ? Participates in strategic measurement activities, including Return on Investment (ROI) analyses, Key Performance Indicator (KPI) development, risk assessment and indexing, as well as domain-specific measurements (example: readmission rates) ? Works with their teams to ensure data accessibility, accuracy, and quality, and may act as data stewards by contributing to management of central data stores and metadata? May provide consultative, data-driven support on product and business strategy development ? Sets up and executes test cases to validate that analytic and software solutions meet the business acceptance criteria ? Communicates solution tradeoffs to business partners to frame and influence project decisions ? Leverages internal and external sources to validate data accuracy and benchmark results? Promotes and champions our security and de-identification standards, while they handle sensitive administrative data (medical and pharmacy claims, clinical data, and other sensitive organizational data assets).We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global\u0027s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.","Title":"REMOTE Pharmacy Data Analyst","City":"Bloomington","ExpirationDate":null,"PriorityOrder":0,"Requirements":"? A degree in economics, mathematics, business, computer science, data or social science, operations research, statistics, or a related quantitative field. Alternate experience and education in equivalent areas is acceptable. Experience in more than one area is strongly preferred. ? Four years direct experience using technical and analytical skills to extract, integrate, layout and interpret complex and disparate data sources ? Demonstrated ability to tell stories using data visualization tools such as Microsoft Power BI, Tableau, etc.? Solid working experience with SQL and relational database design? Programming skills using Python, R, etc. (?or similar?)? Demonstrated experience presenting findings and actionable recommendations? Must be motivated, self-driven, curious, and creative- Demonstrated ability to communicate, support and complement the work of diverse development teams and / or operations teams (end users/business partners)? Pharmacy data experience working with another PBM","Skills":"? Knowledge of health care operations? Exposure to agile/scrum (including tools like JIRA)? Experience using Azure Data Lake, DevOps, Power Automate, or other tools in the Azure Suite ? Working knowledge of medical terminology, medical coding systems; ICD-10, CPT4, DRG, GPI. Familiarity with software development, data and integration architecture","Industry":"Data Warehousing","Country":"US","Division":"IGH","Office":null,"IsRemoteJob":true,"IsInternalJob":false,"ExtraValues":null,"__RecordIndex":0,"__OrdinalPosition":0,"__Timestamp":0,"Status":null,"ApplicantCount":0,"SubmittalCount":0,"ApplicationToHireRatio":0,"JobDuration":null,"SalaryHigh":68.0000,"SalaryLow":54.4000,"PayRateOvertime":0,"PayRateStraight":0,"Filled":0,"RemainingOpenings":0,"TotalOpenings":0,"Visa":null,"ClearanceType":null,"IsClearanceRequired":false,"IsHealthcare":false,"IsRemote":false,"EndClient":null,"JobCreatedDate":"\/Date(-62135578800000)\/","JobModifiedDate":"\/Date(-62135578800000)\/"}
Insight Global is hiring a Sr. Data Analyst for a payer/provider. Data analysts are responsible for driving adoption and use of data and analytic services and products. Data analysts work in... collaborative scrum teams with developers, data scientists, and data engineers, and may share accountabilities in order to achieve sprint goals. They maintain a working knowledge of a business domain and its associated data, and provide visualization, analysis, validation, and consultation services. Together with their teams, they work on building scalable solutions to extract knowledge from data, and deliver that knowledge as needed and at scale.ACCOUNTABILITIES:? All team members must champion and model our values of partnership, curiosity, compassion, integrity, and excellence, and must contribute to a culture of continuous learning? Partners with domain experts, business groups, and data engineers to frame problems, model, clean and integrate data, and determine the best way to leverage that data in service of a goal ? Works with business partners to understand and create their ?user stories;? they support opportunities to leverage data analytics in service of customer or business value ? Creates, deploys, monitors, and maintains highly interactive data visualizations ? Participates in strategic measurement activities, including Return on Investment (ROI) analyses, Key Performance Indicator (KPI) development, risk assessment and indexing, as well as domain-specific measurements (example: readmission rates) ? Works with their teams to ensure data accessibility, accuracy, and quality, and may act as data stewards by contributing to management of central data stores and metadata? May provide consultative, data-driven support on product and business strategy development ? Sets up and executes test cases to validate that analytic and software solutions meet the business acceptance criteria ? Communicates solution tradeoffs to business partners to frame and influence project decisions ? Leverages internal and external sources to validate data accuracy and benchmark results? Promotes and champions our security and de-identification standards, while they handle sensitive administrative data (medical and pharmacy claims, clinical data, and other sensitive organizational data assets).We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Dec 19, 2025
Duarte, CA
|
Insurance
|
Contract,Perm Possible
|
$20 - $25 (hourly estimate)
{"JobID":477258,"JobType":["Contract,Perm Possible"],"EmployerID":null,"Location":{"Latitude":-117.94,"Longitude":34.13,"Distance":null},"State":"California","Zip":"91010","ReferenceID":"HSW-d5159326-1a22-42e1-98b0-a974a66ebed3","PostedDate":"\/Date(1766105041000)\/","Description":"City of Hope is looking for a Financial Clearance Representative to support their growing CAP team. This position supports the Authorizations Team responsible for obtaining service authorizations for patients seen at City of Hope clinics across multiple states and cities (3 clinics, possibly expanding to 4, in Arizona, 2 Clinics in Chicago, and 1 clinic in Atlanta). The current team size is 6 members, but looking to eventually expand to 12 team members. This person will be working with all types of insurance plans: HMOs, PPOs, Medi-Cal, Medicare, etc. across the given states. This person will need to quickly become familiar with the different plan types for the different locations. This practice uses Epic EMR system, and training will be provided. There will be City of Hope Training modules, once completed will participate in 1 on 1 training with the team lead, then transition to independent work once the team member feels comfortable. High volume of radiology and chemotherapy authorizations, as City of Hope specializes in oncology treatment and research. Key Responsibilities: - Process and submit authorizations for services ordered by providers after patient visits. - Verify insurance eligibility for all scheduled patients on a monthly basis. - Monitor and manage two primary work queues: Patient Queue ? Insurance verification and registration updates and Referral Queue ? Authorization and order submissions. - Look up registration errors, update insurance/registration errors and details, and complete data entry tasks. - Work through queues by appointment date or expected future date, ensuring all tasks are completed thoroughly before moving to the next patient.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global\u0027s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.","Title":"Financial Clearance Rep","City":"Duarte","ExpirationDate":null,"PriorityOrder":0,"Requirements":"-2-3+ years of experience with insurance verification, authorizations, and referrals -High School diploma or GED -Strong understanding of medical terminology -Experience in clinical medical setting","Skills":"-Experience with oncology, radiology, chemotherapy, or any other specialties -Experience with Epic EMR system -Experience working as a medical assistant","Industry":"Insurance","Country":"US","Division":"IGH","Office":null,"IsRemoteJob":true,"IsInternalJob":false,"ExtraValues":null,"__RecordIndex":0,"__OrdinalPosition":0,"__Timestamp":0,"Status":null,"ApplicantCount":0,"SubmittalCount":0,"ApplicationToHireRatio":0,"JobDuration":null,"SalaryHigh":25.0000,"SalaryLow":20.0000,"PayRateOvertime":0,"PayRateStraight":0,"Filled":0,"RemainingOpenings":0,"TotalOpenings":0,"Visa":null,"ClearanceType":null,"IsClearanceRequired":false,"IsHealthcare":false,"IsRemote":false,"EndClient":null,"JobCreatedDate":"\/Date(-62135578800000)\/","JobModifiedDate":"\/Date(-62135578800000)\/"}
City of Hope is looking for a Financial Clearance Representative to support their growing CAP team. This position supports the Authorizations Team responsible for obtaining service authorizations for... patients seen at City of Hope clinics across multiple states and cities (3 clinics, possibly expanding to 4, in Arizona, 2 Clinics in Chicago, and 1 clinic in Atlanta). The current team size is 6 members, but looking to eventually expand to 12 team members. This person will be working with all types of insurance plans: HMOs, PPOs, Medi-Cal, Medicare, etc. across the given states. This person will need to quickly become familiar with the different plan types for the different locations. This practice uses Epic EMR system, and training will be provided. There will be City of Hope Training modules, once completed will participate in 1 on 1 training with the team lead, then transition to independent work once the team member feels comfortable. High volume of radiology and chemotherapy authorizations, as City of Hope specializes in oncology treatment and research. Key Responsibilities: - Process and submit authorizations for services ordered by providers after patient visits. - Verify insurance eligibility for all scheduled patients on a monthly basis. - Monitor and manage two primary work queues: Patient Queue ? Insurance verification and registration updates and Referral Queue ? Authorization and order submissions. - Look up registration errors, update insurance/registration errors and details, and complete data entry tasks. - Work through queues by appointment date or expected future date, ensuring all tasks are completed thoroughly before moving to the next patient.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Jan 05, 2026
Nottingham, MD
|
Claims/Denials
|
Contract-to-perm
|
$19 - $24 (hourly estimate)
{"JobID":478666,"JobType":["Contract-to-perm"],"EmployerID":null,"Location":{"Latitude":-76.48,"Longitude":39.38,"Distance":null},"State":"Maryland","Zip":"21236","ReferenceID":"HSE-5e373f72-8741-4002-8108-9c1615c93382","PostedDate":"\/Date(1767644054000)\/","Description":"Day to Day: Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will be overseeing and managing the insurance denial and appeals process to minimize financial risk and improve reimbursement outcomes.Primary Responsibilities:?Coordinate and monitor denial management and appeal processes, leveraging clinical, business, and regulatory acumen to reduce financial exposure.?Evaluate all external denials related to medical necessity and assess the feasibility of submitting appeals. ?Draft medical summaries of denied cases for review by hospital leadership and for escalation to legal or regulatory bodies (e.g., Maryland Insurance Administration) when necessary.?Identify root causes and trends in denials and create strategies to prevent future occurrences and enhance care delivery efficiency.?Maintain tracking records for both concurrent and retrospective denial activity in collaboration with case management and patient financial services teams.?Provide data and case reporting to leadership and relevant committees (e.g., Operations Review Committee)?Work closely with physicians, utilization review RNs, case managers, revenue cycle staff, and payers during the appeals process?Serve as a resource for staff, educating teams on denials and utilization review best practices; support orientation for new staff.?Participate in departmental and community meetings or committees as needed.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global\u0027s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.","Title":"Denial Coordinator","City":"Nottingham","ExpirationDate":null,"PriorityOrder":0,"Requirements":"?High school diploma or equivalent ?3+ years? experience working in denials (following up on appeals, making adjustments, etc.) ?Experience with prior authorization and insurance follow-up ?Experience writing appeal lettersoNot just filling out form letters, someone who can put a case together ?Experience utilizing payor portals (EVS, Availity, etc.) ?Tech Savvy (Excel, Teams, etc.) ?Detail-oriented ?Comfortable training virtually","Skills":"?Hospital billing experience ?Experience with systems: Med-Connect for medical records, RCI (repository where denials go), Envision (SMS), Epic?Experience with MD reimbursements","Industry":"Claims/Denials","Country":"US","Division":"IGH","Office":null,"IsRemoteJob":true,"IsInternalJob":false,"ExtraValues":null,"__RecordIndex":0,"__OrdinalPosition":0,"__Timestamp":0,"Status":null,"ApplicantCount":0,"SubmittalCount":0,"ApplicationToHireRatio":0,"JobDuration":null,"SalaryHigh":24.0000,"SalaryLow":19.2000,"PayRateOvertime":0,"PayRateStraight":0,"Filled":0,"RemainingOpenings":0,"TotalOpenings":0,"Visa":null,"ClearanceType":null,"IsClearanceRequired":false,"IsHealthcare":false,"IsRemote":false,"EndClient":null,"JobCreatedDate":"\/Date(-62135578800000)\/","JobModifiedDate":"\/Date(-62135578800000)\/"}
Day to Day: Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will be overseeing and managing the insurance denial and appeals... process to minimize financial risk and improve reimbursement outcomes.Primary Responsibilities:?Coordinate and monitor denial management and appeal processes, leveraging clinical, business, and regulatory acumen to reduce financial exposure.?Evaluate all external denials related to medical necessity and assess the feasibility of submitting appeals. ?Draft medical summaries of denied cases for review by hospital leadership and for escalation to legal or regulatory bodies (e.g., Maryland Insurance Administration) when necessary.?Identify root causes and trends in denials and create strategies to prevent future occurrences and enhance care delivery efficiency.?Maintain tracking records for both concurrent and retrospective denial activity in collaboration with case management and patient financial services teams.?Provide data and case reporting to leadership and relevant committees (e.g., Operations Review Committee)?Work closely with physicians, utilization review RNs, case managers, revenue cycle staff, and payers during the appeals process?Serve as a resource for staff, educating teams on denials and utilization review best practices; support orientation for new staff.?Participate in departmental and community meetings or committees as needed.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Jan 06, 2026
Farmington, CT
|
Claims/Denials
|
Perm
|
$80k - $100k (estimate)
{"JobID":479409,"JobType":["Perm"],"EmployerID":null,"Location":{"Latitude":-72.8374,"Longitude":41.7277,"Distance":null},"State":"Connecticut","Zip":"06032","ReferenceID":"HNJ-854d2935-fe63-4d8a-bc5f-cb55dc49f48c","PostedDate":"\/Date(1767739084000)\/","Description":"The CDI Education Specialist develops and implements an effective and comprehensive audit \u0026 education program for coding consistent with regulatory, contractual, professional standards and healthcare revenue cycle industry practices. The education specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. They must have excellent communication as they will be articulating guidelines and standards directly with providers of Hartford Healthcare. This candidate must have multi-specialty experience in CDI education.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global\u0027s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.","Title":"Remote CDI Education Specialist","City":"Farmington","ExpirationDate":null,"PriorityOrder":0,"Requirements":"-At least 5 years? experience coding experience-CPC certification absolute must have!-Working experience with analyzing data, reviewing results, and providing education to both clinical providers and coders-Experience working at teaching Healthsystem- Cornell, Yale New Haven Health, etc.","Skills":"","Industry":"Claims/Denials","Country":"US","Division":"IGH","Office":null,"IsRemoteJob":true,"IsInternalJob":false,"ExtraValues":null,"__RecordIndex":0,"__OrdinalPosition":0,"__Timestamp":0,"Status":null,"ApplicantCount":0,"SubmittalCount":0,"ApplicationToHireRatio":0,"JobDuration":null,"SalaryHigh":100000.0000,"SalaryLow":80000.0000,"PayRateOvertime":0,"PayRateStraight":0,"Filled":0,"RemainingOpenings":0,"TotalOpenings":0,"Visa":null,"ClearanceType":null,"IsClearanceRequired":false,"IsHealthcare":false,"IsRemote":false,"EndClient":null,"JobCreatedDate":"\/Date(-62135578800000)\/","JobModifiedDate":"\/Date(-62135578800000)\/"}
The CDI Education Specialist develops and implements an effective and comprehensive audit & education program for coding consistent with regulatory, contractual, professional standards and healthcare... revenue cycle industry practices. The education specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. They must have excellent communication as they will be articulating guidelines and standards directly with providers of Hartford Healthcare. This candidate must have multi-specialty experience in CDI education.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Dec 19, 2025
South San Francisco, CA
|
QA
|
Perm
|
$120k - $153k (estimate)
{"JobID":477495,"JobType":["Perm"],"EmployerID":null,"Location":{"Latitude":-122.42,"Longitude":37.65,"Distance":null},"State":"California","Zip":"94080","ReferenceID":"SDG-dbe196df-0c85-477b-878d-a3d05132fd69","PostedDate":"\/Date(1766177795000)\/","Description":"We are seeking a Sr. Quality Engineer - Design Control to lead the design control activities across the IVD product lifecycle, ensuring compliance with ISO 13485, IVDR, FDA QSR, ISO 14971 and other global regulatory requirements. This role will serve as the primary Quality partner to R\u0026D and cross-functional teams, driving robust design control execution, effective risk management, end-to-end traceability, and sustained audit readiness. The ideal candidate will bring hands-on experience leading design control and risk management activities in a regulated IVD environment, including products developed under ISO 13485 and IVDR. Responsibilities:? Serve as the QA lead on cross-functional product development teams, ensuring design control requirements (FDA 21 CFR 820.30, ISO 13485, IVDR) are incorporated from planning through commercialization.? Ensure compliance with all applicable standards, regulations, and internal SOPs throughout the design and development (D\u0026D) process and design changes. Provide guidance on Quality System requirements related to design and development (design history file, design inputs, design outputs, V\u0026V plans and reports, design transfer, device master record etc.) and design changes.? Lead risk management activities for projects under design control, ensuring risk management activities comply with internal procedures, ISO 14971, and applicable regulations. This involves issuing the Risk Management Plan and Risk Management Report, leading cross-functional risk management activities including hazard analysis, risk assessments, and ensuring effective risk control measures, residual risk acceptance, and link risk to design changes and CAPAs. ? Support design verification and validation activities by reviewing protocols and reports to confirm that design outputs meet design input requirements and that analytical and clinical performance is demonstrated. Help resolve any discrepancies through root cause analysis and corrective actions.? Ensure ongoing design control compliance for design and post market changes, maintaining DHF integrity throughout product lifecycle.? Participate in internal and external audits, serving as the SME for design control and risk management, preparing audit responses, and leading remediation activities.? Proactively identify any gaps in compliance and lead CAPA initiatives related to design control or development process issues.? Evaluate and implement process improvements to enhance efficiency, compliance, and scalability as the portfolio grows.? Develop metrics and KPIs related to design control effectiveness and compliance.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global\u0027s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.","Title":"Sr QA Engineer - Design Control","City":"South San Francisco","ExpirationDate":null,"PriorityOrder":0,"Requirements":"? Bachelor?s degree in Life Sciences, Engineering, Biomedical Engineering, Biotechnology, or related technical field.? 7+ years of experience in Quality Assurance or Quality Engineering in the medical device or IVD industry, with a strong focus on design controls and new product development. Prior experience driving QA in cross-functional product development teams is essential.? In-depth working knowledge of in-vitro diagnostic device quality requirements, including ISO 13485:2016, IVDR (EU 2017/746) and, ISO 14971:2019 risk management.? Hands-on experience with risk management per ISO 14971, design history files, verification \u0026 validation, CAPA, and change control.? Demonstrated ability to review DHF documentation (design inputs, design outputs, Verification/Validation protocols and reports etc.) for compliance. Comfortable interpreting engineering documentation, specifications, and test data for compliance.? Experience managing complex DHF structures digitally.? Experience with IVD assay lifecycle (development through commercialization).? Experience with SaMD or algorithm lifecycle management.? Strong written and verbal communication skills; demonstrated ability to author clear SOPs, technical documents, and audit responses.? Strong problem-solving and organizational skills to manage multiple priorities. ? Ability to work independently and proactively in a fast-paced environment.? Attention to detail in understanding and documenting complex quality issues","Skills":"? Relevant certification (e.g., ASQ Certified Quality Engineer, Six Sigma, ISO 13485 Lead Auditor)","Industry":"QA","Country":"US","Division":"IT","Office":null,"IsRemoteJob":true,"IsInternalJob":false,"ExtraValues":null,"__RecordIndex":0,"__OrdinalPosition":0,"__Timestamp":0,"Status":null,"ApplicantCount":0,"SubmittalCount":0,"ApplicationToHireRatio":0,"JobDuration":null,"SalaryHigh":153000.0000,"SalaryLow":120000.0000,"PayRateOvertime":0,"PayRateStraight":0,"Filled":0,"RemainingOpenings":0,"TotalOpenings":0,"Visa":null,"ClearanceType":null,"IsClearanceRequired":false,"IsHealthcare":false,"IsRemote":false,"EndClient":null,"JobCreatedDate":"\/Date(-62135578800000)\/","JobModifiedDate":"\/Date(-62135578800000)\/"}
We are seeking a Sr. Quality Engineer - Design Control to lead the design control activities across the IVD product lifecycle, ensuring compliance with ISO 13485, IVDR, FDA QSR, ISO 14971 and other... global regulatory requirements. This role will serve as the primary Quality partner to R&D and cross-functional teams, driving robust design control execution, effective risk management, end-to-end traceability, and sustained audit readiness. The ideal candidate will bring hands-on experience leading design control and risk management activities in a regulated IVD environment, including products developed under ISO 13485 and IVDR. Responsibilities:? Serve as the QA lead on cross-functional product development teams, ensuring design control requirements (FDA 21 CFR 820.30, ISO 13485, IVDR) are incorporated from planning through commercialization.? Ensure compliance with all applicable standards, regulations, and internal SOPs throughout the design and development (D&D) process and design changes. Provide guidance on Quality System requirements related to design and development (design history file, design inputs, design outputs, V&V plans and reports, design transfer, device master record etc.) and design changes.? Lead risk management activities for projects under design control, ensuring risk management activities comply with internal procedures, ISO 14971, and applicable regulations. This involves issuing the Risk Management Plan and Risk Management Report, leading cross-functional risk management activities including hazard analysis, risk assessments, and ensuring effective risk control measures, residual risk acceptance, and link risk to design changes and CAPAs. ? Support design verification and validation activities by reviewing protocols and reports to confirm that design outputs meet design input requirements and that analytical and clinical performance is demonstrated. Help resolve any discrepancies through root cause analysis and corrective actions.? Ensure ongoing design control compliance for design and post market changes, maintaining DHF integrity throughout product lifecycle.? Participate in internal and external audits, serving as the SME for design control and risk management, preparing audit responses, and leading remediation activities.? Proactively identify any gaps in compliance and lead CAPA initiatives related to design control or development process issues.? Evaluate and implement process improvements to enhance efficiency, compliance, and scalability as the portfolio grows.? Develop metrics and KPIs related to design control effectiveness and compliance.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.