Job Search Results for clinical

PB System integration Analyst II

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... More 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/.Less

Trainer

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... More 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/.Less

Remote UM Physician Reviewer

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... More 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/.Less

Financial Clearance Rep

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... More 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/.Less

REMOTE Pharmacy Data Analyst

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... More 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/.Less

Remote CDI Education Specialist

The CDI Education Specialist develops and implements an effective and comprehensive audit & education program for coding consistent with regulatory, contractual, professional standards and healthcare... More 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/.Less

Professional Medical Coder level 3

Under general supervision, the Medical Coding Specialist will independently code patient records to provide accurate physician, technical, supply, surgical, and resident billing. The position... More involves working in a centralized coding unit that may include two or more of the following areas: professional fees, technical fees, multi-specialties, surgical, and/or resident staff coding and billing.Prior to submitting charges, the specialist will review documentation for all patient visits and procedures, identify billable services, and communicate with providers when discrepancies occur. The role also includes coding and entering charges in the online charge entry system, managing work queues, and performing charge reconciliation.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/.Less

Sr QA Engineer - Design Control

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... More 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/.Less

REMOTE Pharmacy Data Product Owner

Insight Global is hiring a Pharmacy Product Owner for a payer/provider. The Product Owner drives the delivery of high-quality analytic products by prioritizing work, shaping user stories, and... More ensuring alignment with business objectives. Acting as the primary liaison to sponsor, the PO ensures clear communication of goals, trade-offs, and progress. They collaborate with developers, analysts, and engineers in Agile teams to build scalable data solutions, maintain domain expertise, and provide consultative support for strategic decisions. Key responsibilities include managing the product roadmap, planning sprints, validating deliverables, and championing data accuracy, security, and compliance?all while driving adoption and measurable business value.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? Acts as domain experts, partnering with 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 identify and clarify opportunities to leverage data analytics in service of customer or business value ? Independently creates, deploys, monitors, and maintains highly interactive data visualizations and analytic services ? Leads and 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? Provides consultative, data-driven support on product and business strategy development ? Defines, 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 resultsPromotes 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/.Less

Lead Cloud Data Engineer (Remote)

We are looking for a lead data engineer highly collaborative and comfortable with ambiguity and change in a fast-paced environment to partner closely with various teams to design, build and maintain... More data systems and applications. Must be a self-starter and highly organized with strong problem-solving and learning skills to work with various teams analyze and design data storage structures and build performant automated data pipelines that are reliable and scalable in a fast growing data ecosystem. Leverage strong understanding of data modeling principles and modern data platforms to properly design and implement data pipeline solutions. Experience using analytic SQL, working with traditional relational databases and/or distributed systems such as AWS S3, Hadoop / Hive, Redshift. Provide production support and adhering to the defined SLA(s). Strong technical skills and demonstrated ability to be detail-oriented. Good understanding of data security, compliance, and policies in healthcare services. Demonstrated ability to test and validate according to industry best practices and to communicate effectively with peers in technology teams. Strong interpersonal, written, and oral communication skills with ability to work with all levels of the organization. Prior experience in the healthcare industry is a plus.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/.Less