RISE Job Board

 

Title: Director, Client Engagement for Pulse8

Reports to: Vice President, Client Engagement

Location: Annapolis, MD 21401 (Possible remote/virtual position for preferred candidates)

About Pulse8, Inc. 

Pulse8 is an innovative Healthcare Analytics and Technology Company that delivers visibility and transparency for Risk Adjustment and Quality Management programs.  We enable health plans and at-risk providers to achieve the greatest financial impact in the Health Insurance Exchange (HIX), Medicare Advantage, and Medicaid markets.  By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment.  Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. 

What's cool about working for Pulse8?  We're a close knit team of Healthcare and Technology experts dedicated to helping people live longer, healthier lives.  You'll get to help us design and build innovative solutions from the ground up and have the opportunity to do lots of interesting things in an entrepreneurial culture.  We offer competitive benefits and much, much more! 

Position Description The Director of Customer Engagement will have full accountability for the relationship with key accounts.  The primary responsibility is to serve as day-to-day client relationship manager, including maintaining regular and consistent contact with clients; troubleshooting client issues and ensuring superior client service. The Director of Customer Engagement is also responsible for implementation of new accounts as needed.

Position Responsibilities

  • To foster an open, collaborative relationship with clients that is only achieved through clear communication and delivering on commitments. 
    To facilitate regular touch points and follow up on client concerns or requests.
  • To analyze client performance and make recommendations on alternate strategies.
  • To keep track of any open issues and drive timely issue resolution.  Also ensure internal support teams are fully aware of customer issues and have a complete understanding of the concern.
  • To identify industry trends that may impact the client’s business and ensure they are aware of these potential business impacting events.
  • To perform monthly and quarterly account reviews to evaluate performance and guide strategic direction of the relationship.
  • To collaborate with internal support teams to troubleshoot issues and design creative solutions to
  • To undertake additional duties as required by the company.

Minimum Experience, Knowledge, Training and Qualifications

  • Proven and demonstrable experience in successful client relationship management and issue resolution. 
  • Deep knowledge of the Medicare Risk Adjustment and Commercial Risk Adjustment Programs and intervention strategies is preferred.
  • Previous experience working for a health plan or running an intervention program for risk adjustment is desired.
  • Clinical knowledge and medical record coding experience is a plus.
  • Superior project management and communication skills are required.
  • The ability to communicate complex concepts across all levels of an organization is necessary.
  • Proven and demonstrable experience in successful client relationship management and issue resolution. 
  • Deep knowledge of the Medicare Risk Adjustment and Commercial Risk Adjustment Programs and intervention strategies is preferred.
  • Previous experience working for a health plan or running an intervention program for risk adjustment is desired.
  • The successful candidate will have an aptitude for and an interest in analytical process and problem solving.
  • Superior project management and communication skills are required.
  • The ability to communicate complex concepts across all levels of an organization is necessary.

This position requires travel to client sites for significant account reviews or other strategic in person meetings.  When You Apply: Please provide specific details of career accomplishments in response to responsibilities and qualifications noted above.

Click on this link to download job description

Interested applicants please directly contact Shelley Binkley, Chief Operating Officer, Pulse8 at shelley.binkley@pulse8.com

 

Title: Business Analyst for Pulse8

Reports to: Vice President of Product Strategy
Location: Annapolis, MD 21401 (Possible remote/virtual position for preferred candidates)

About Pulse8, Inc.

Pulse8 is an innovative Healthcare Analytics and Technology Company that delivers visibility and transparency for Risk Adjustment and Quality Management programs.  We enable health plans and at-risk providers to achieve the greatest financial impact in the Health Insurance Exchange (HIX), Medicare Advantage, and Medicaid markets.  By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment.  Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. 

What's cool about working for Pulse8? We're a close knit team of Healthcare and Technology experts dedicated to helping people live longer, healthier lives.  You'll get to help us design and build innovative solutions from the ground up and have the opportunity to do lots of interesting things in an entrepreneurial culture.  We offer competitive benefits and much, much more! 

Position Description Business Analyst will assist our team of data scientists, researchers, risk adjustment experts, and developers in leading business cases for algorithm development and improvement, researching customer queries of analytics performance, creating requirements for new analytics and data products, and working in tandem with our data teams in executing these requirements.

 Position Responsibilities

  1. Developing business cases and requirements for new products and current product enhancements.
  2. Leading customer requests for ad hoc reporting or research.
  3. Owning customer financial improvement modeling and engaging directly with current or new customers to update models.
  4. Leading research initiatives to monitor Pulse8’s algorithm performance over time and recommend future enhancements.
  5. Collaborate with Pulse8 clinicians in outcomes, algorithm performance, and new product development.
  6. Develop customer presentations and reporting enhancements to streamline Pulse8 operations and support processes.

 Minimum Essential Knowledge / Skills:

  • Experience with actuary or financial modeling and concepts
  • Experience or degree in statistics, epidemiology, or similar analytic field
  • Experience interacting with large amounts of healthcare data
  • Experience working with clinical classification systems like HCCs, DRGs, ETGs, ACGs
  • Experience with R or SAS, or similar statistical language
  • Proven technical, analytical and problem solving
  • Strong written and verbal communication
  • Professional and interpersonal
  • Self-initiative and leadership
  • Ability to work within a team environment

 Required Education / Experience:

  • Bachelor’s degree in a related field of study or is required.
  • Ability to interface with both external and internal personnel at all levels.
  • 4 to 6 years experience in field-related processing
  • Prior experience in implementing database solutions a plus
  • Prior experience in healthcare industry.
  • 3 to 5 years of process improvement, database development, data process engineering, CRM solutions, software development, or Master Data Management required.

 Desired Skills:

  • Experience with Tableau Desktop or related Business Intelligence tools

Click on this link to download job description

Interested applicants please directly contact Shelley Binkley, Chief Operating Officer, Pulse8 at shelley.binkley@pulse8.com

 

Clinical RA Coding and Quality Educator - North Texas Specialty Physicians 

General Functions:

  • Assist in the collection and analysis of qualitative and quantitative data as it relates to risk adjustment specifically around missed opportunities, prevalence and suspects. 
  • Assist in the design and development of ad hoc reports and presentations for risk adjustment initiatives.
  • Meet with organizational leadership to partner on Physician Risk Education strategy
  • Ability to communicate and interact positively and professionally throughout all levels of the organization and with external customers.
  • Assist with the development and utilization of training and attendee tracking metrics and methodologies.
  • Assist with the development of physician and staff coding remediation plans where appropriate including provider assessment and scorecard. 
  • Monitor education programs, timelines, learner progress and report to leadership when appropriate.
  • Provides onsite instruction per location (practice/clinic) for physician practice and office staff with ICD-9-CM /  ICD-10-CM coding training focusing on Medicare Risk Adjustment documentation and coding opportunities.
  • Provides instructional review of ICD-10-CM translations specific to Medicare Risk Adjustment-type diagnosis codes.
  • Performs outreach on Risk Adjustment Education based on review of pre-selected charts coupled with data management, data reporting and analysis, and provider scorecards. 
  • Consistently demonstrates the ability to speak and present at outreach events professionally with strong analytical, problem-solving and critical thinking skills.

MINIMUM EDUCATION: 

  • Certified Coder / Trainer

 PREFERRED EDUCATION: 

  • Bachelor degree in Nursing or Healthcare degree with 5 to 7 years’ experience training providers on Medicare Advantage Risk Adjustment documentation. 

 MINIMUM EXPERIENCE:

  • Education and training experience with strong organizational skills in multiple settings, as well as the ability to exercise sound judgment and initiative.
  • Strong presentation skills.
  • Excellent problem solving and the ability to handle multiple projects, heavy workloads and deadlines in a fast paced dynamic environment.
  • Self-motivated with excellent follow through skills with ability to work independently with minimal to moderate supervision with demonstrated ability to work as an effective team member.
  • Strong working knowledge of MS Office products, including PowerPoint, Excel and Word
  • Adobe Captivate, Articulate and/or MLS relational database knowledge desired.
  • Have minimum of 5 years’ Healthcare / Coding / Education / Quality experience. 

 PREFERRED EXPERIENCE : 

  • Medicare Advantage coding and documentation

 REQUIRED CERTIFICATIONS/LICENSURE:

  • CPC, CPC-I, CPC-H, CPC-P, CCS, CCS-P, RHIT, RHIA, CPMA or CRC required

 PREFERRED CERTIFICATIONS/LICENSURE:

  • RN, LVN, BSN, PA or NP

Please return all resumes to our NTSP Career email of careers@ntsp.com.  Altenatively, they can be directed to: Carol Trevino, recruiter at ctrevino@ntsp.com

  

Position Title:  RISE Program Manager - The RISE Association

Reporting Relationships:  Managing Director of FRA Wilmington, LLC

Location:  Preference for headquarters sited in Charlotte, NC

RISE Program Manager Job Duties:

Support of Membership Growth Initiatives, Cross-functional and Organization Management, Management of Multiple Parallel Projects, Matrixed Management Proficiency, Developing Budgets and Projections, Process Improvement, Tracking Budget Expenses, Self-Development, Planning, Performance Management, Communication Control, Verbal Communication Internally and Externally with Stakeholders.

Job brief

We are looking for an experienced professional with marketing and project management expertise who will take on the management of key strategic and tactical projects under the direction of the Managing Director of Wilmington FRA and in close coordination with the Executive Director of the RISE Association. Project management responsibilities include working extensively in a cross-functional, matrixed environment internally, as well as with strategic external stakeholders and third parties.  The projects will vary in length and complexity, and involve all phases from incubation to implementation and evaluation.  The business context is one of significant growth, change and transformation.  Expectations for this position include delivering every project on time, within budget and within scope.

  • Support the chairpersons of the multiple advisory boards in organizing meetings, drafting agendas, coordinating scheduling, advancing agenda items, taking minutes and helping organize appropriate follow-up actions
  • Facilitate organization of user group arrangements for chairpersons, including scheduling and operational support
  • Coordinating with Web-Ex support to leverage online tools to create effective virtual meetings with remote board members and user group members
  • Create shared project control documents and provide project support for key initiatives such as training, education and certification across multiple domains
  • Establish workflow and coordination across all functional roles in marketing and communication of new Association programs, benefits, services and initiatives

Responsibilities

  • Coordinate internal resources and third parties/vendors for the flawless execution of projects
  • Ensure that all projects are delivered on-time, within scope and within budget
  • Assist in the definition of project scope and objectives, involving all relevant stakeholders and ensuring technical feasibility
  • Ensure resource availability and allocation
  • Develop a detailed project plan to monitor and track progress
  • Manage changes to the project scope, project schedule, and project costs using appropriate verification techniques
  • Measure project performance using appropriate tools and techniques
  • Report and escalate to management as needed
  • Successfully manage the relationship with the client and all stakeholders
  • Perform risk management to minimize project risks
  • Establish and maintain relationships with external stakeholders, third parties and vendors
  • Create and maintain comprehensive project documentation
Click on this link to download job description

Application Process: 

Send Resume and Contact :

Stephanie Kohlenstein, VP of Operations Financial Research Associates, Financial Research Associates, LLC 

E-Mail:  SKohlenstein@frallc.com

Phone:  704-341-2380

 

 

Job Title: Risk Adjustment Data Analyst

Company:  Health Partners Plans             Location: Philadelphia

General Description: 

The Risk Adjustment analyst will be responsible for compiling, verifying, and analyzing data for trend and other analyses related to Risk Adjustment.  This person will be collecting and analyzing healthcare related data by performing data management and quality improvement studies on that data and producing the resulting reports.  The Analyst will develop expert knowledge of the Center for Medicare & Medicaid Services (CMS) – Hierarchal Condition Categories (HCC) and University of California San Diego (UCSD) Chronic Illness and Disability Payment System (CDPS) risk adjustment model, its concepts and methodology in order to reconcile CMS and Department of Human Services (DHS) risk score reports, project future revenue related to risk adjustment and evaluate financial impacts of risk adjustment initiatives.  Reports, Analysis results and actionable information will be shared with providers and senior management.

Posting Link:   click here to go to job posting on company website      

 

Job Title:  Email Marketing Manager for EpiSource

Division:  Sales & Marketing

 Your opportunity at Episource is to simplify healthcare!  

Are you a rockstar marketer with hands-on email marketing experience? If so, Episource is looking for a results-oriented, driven individual to manage email marketing programs that will drive brand awareness, engagement, and retention. If you’re analytical and metrics oriented with a desire to work for a dynamic and fast-growing healthcare company, this role may be for you.

Responsibilities:

  • Full ownership of email marketing campaigns including planning, setup and execution using a marketing automation platform (Pardot) and CRM (Salesforce)
  • Manage and segment our lead database to maintain data integrity, optimize targeting, and improve delivery and response rates
  • Collaborate with various teams to create email template designs, call-to-actions, content, and subject lines that follow email best practices
  • Provide tactical planning solutions for future workflows and strategy based on results (clicks, opens, site visits, page visits, return visits, conversions)
  • Analyze and report on specific campaigns, objectives, results and KPIs highlighting success, trends and opportunities
  • Ensure communication with our audience is excellent and in alignment with brand guidelines

 Qualifications:

  • BA/BS in Marketing/Communications/Business or equivalent relevant working experience
  • 2-4 years of hands-on experience with email marketing automation
  • Experience with Salesforce a big plus, Google analytics experience a plus
  • Highly analytical with the ability to read data and make recommendations for future enhancements to our messaging and content
  • Positive attitude with the ability to manage change, thrive in a fast-paced environment, deal with ambiguity, and prioritize multiple projects 
Click here to download full description

If interested, please send your resume and cover letter to accountsupport@episource.com

January 31, 2017

 

Job Title:  Sales Development Representative for EpiSource (Exempt)

Division:  Sales & Marketing  Reports to:   SVP Sales & Marketing

Your opportunity at Episource is to simplify healthcare!  

  • Episource leverages data to provide patient insights and drive interventions. As thought leaders and subject matter experts, we are constantly striving to identify actionable insights. We service the $3.0 trillion healthcare space and our clients represent leading organizations throughout the United States.
  • Episource is at the forefront of the ever-evolving healthcare marketplace. We help clients paint an accurate picture of patient health profiles by analyzing medical records, claims, and clinical data sets.
  • We have grown significantly to support the regulatory changes over the last 10 years, and are poised to continue our expansion as the leader in the marketplace.


The Challenge you will face:

  •  We have proven that we can close, deliver, and grow customer accounts. We need a strong communicator to engage prospects captured from marketing and drive interest in Episource’s services.
  • Through dialog, create brand awareness and quickly establish Episource as an industry leader with companies that may or may not be familiar with us.
  • This is a new opportunity within Episource that allows someone to implement sales techniques and tools that they’ve used in the past to help guide the growth of this function within the company.
  • We are an entrepreneurial and fast-growing company. You need to be disciplined and tenacious to overcome client objections. You need to roll up your sleeves and deliver.

 Doing the right things:

  • Build a valuable and convertible pipeline. You will be the expert at engaging potential customers through email and phone to qualify for relevance and fit.
  • Conduct research (social, online, Linkedin) to identify the right target accounts and contacts to pursue.
  • Effectively communicate (speak and listen) with potential customers, think on your feet, and overcome objections to quickly establish credibility and build rapport.
  • Strong written communication skills to provide insight to sales executives once sales opportunity is created.
  • Put your stamp on building scalable, repeatable processes.
  • Take initiative and accountability for own success.

 Changing the World (and Your Career):

  •  You will be the face of Episource and our efforts to simplify healthcare.
  • You will be responsible for initiating 10 prospect meetings per month.
  • You will create a qualified sales pipeline in excess of $3M.
  • Your contribution will support closing of $1M in revenue annually.
  • Your contribution will have huge impact on Episource’s growth.
  • You’ll love crushing goals with us!  
Click here to download full description

If interested, please send your resume and cover letter to accountsupport@episource.com

January 31, 2017

 

Job Title:  Sales Executive for EpiSource (Exempt)

Division:  Sales & Marketing    Reports to:   SVP Sales & Marketing

Your opportunity at Episource is to simplify healthcare!  

  • Episource leverages data to provide patient insights and drive interventions. As thought leaders and subject matter experts, we’re constantly striving to identify actionable insights.  We service the $3.0 trillion healthcare space and our clients represent leading organizations throughout the United States.   
  • Episource is at the forefront of the ever-evolving healthcare marketplace. We help clients paint an accurate picture of patient health profiles by analyzing medical records, claims, and clinical data sets.
  • We’ve grown significantly to support the regulatory changes over the last 10 years, and are poised to continue our expansion as the leader in the marketplace.  

The Challenge you will face:

  •  We’ve proven that our value proposition resonates, our services deliver great value and we can grow customer accounts. 
  • We need a strong hunter to help broaden our customer base to further our growth and successes in simplifying healthcare. It will require aptitude to learn our healthcare market in order to converse credibly with clients.
  • Identifying the right target accounts and contacts will require your leadership and understanding of our value proposition and healthcare marketplace. Building a sustainable pipeline is critical to your success.
  • In a demand-rich market, selecting the best opportunities to pursue that are winnable, desirable, and deliverable is key to success. Your leadership is required to focus the team on winning.
  • We are an entrepreneurial and fast-growing company. You need to create value-based relationships that allow our services to shine. You need to deliver.

Doing the right things:

  • Build a valuable and convertible pipeline. You will be the expert at engaging potential customers throughout their buyer journey to create successful long-term client relationships
  • Conduct research (social, online, Linkedin) to identify the right target accounts and contacts to pursue
  • Effectively communicate (speak and listen) with potential customers, think on your feet, and overcome objections to quickly establish credibility and build rapport
  • Drive the lengthy buying process from prospecting to closing of deals valued at $200k - $1M+. This involves education, support in developing RFPs and competently working with buyers in understanding the benefits of switching to our solution vs. competitive offerings or the status quo. It also involves aligning to our sales process and salesforce platform to communicate internally on progress.
  • Proven history of sales success
  • Take initiative and accountability for own success while knowing when to ask for help.   
Click here to download full description

If interested, please send your resume and cover letter to accountsupport@episource.com

January 31, 2017

 

 

Clinical RA Coding and Quality Educator,

North Texas Specialty Physicians, Ft. Worth, TX

 General Functions:

  • Assist in the collection and analysis of qualitative and quantitative data as it relates to risk adjustment specifically around missed opportunities, prevalence and suspects. 

  • Assist in the design and development of ad hoc reports and presentations for risk adjustment initiatives.

  • Meet with organizational leadership to partner on Physician Risk Education strategy

  • Ability to communicate and interact positively and professionally throughout all levels of the organization and with external customers.

  • Assist with the development and utilization of training and attendee tracking metrics and methodologies.

  • Assist with the development of physician and staff coding remediation plans where appropriate including provider assessment and scorecard. 

  • Monitor education programs, timelines, learner progress and report to leadership when appropriate.

  • Provides onsite instruction per location (practice/clinic) for physician practice and office staff with ICD-9-CM /  ICD-10-CM coding training focusing on Medicare Risk Adjustment documentation and coding opportunities.

  • Provides instructional review of ICD-10-CM translations specific to Medicare Risk Adjustment-type diagnosis codes.

  • Performs outreach on Risk Adjustment Education based on review of pre-selected charts coupled with data management, data reporting and analysis, and provider scorecards. 

  • Consistently demonstrates the ability to speak and present at outreach events professionally with strong analytical, problem-solving and critical thinking skills.

 MINIMUM EDUCATION: 

  • Certified Coder / Trainer

 PREFERRED EDUCATION: 

  • Bachelor degree in Nursing or Healthcare degree with 5 to 7 years’ experience training providers on Medicare Advantage Risk Adjustment documentation. 

 MINIMUM EXPERIENCE:

  • Education and training experience with strong organizational skills in multiple settings, as well as the ability to exercise sound judgment and initiative.

  • Strong presentation skills.

  • Excellent problem solving and the ability to handle multiple projects, heavy workloads and deadlines in a fast paced dynamic environment.

  • Self-motivated with excellent follow through skills with ability to work independently with minimal to moderate supervision with demonstrated ability to work as an effective team member.

  • Strong working knowledge of MS Office products, including PowerPoint, Excel and Word

  • Adobe Captivate, Articulate and/or MLS relational database knowledge desired.

  • Have minimum of 5 years’ Healthcare / Coding / Education / Quality experience.  

Contact:  Please have all resumes return to our NTSP Career email of careers@ntsp.com.  You may also contact Carol Trevino, Recruiter, at ctrevino@ntsp.com

Click here to download full description
 January 23, 2017

 

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Quality measurement and risk adjustment regulations are increasing and the financial impact upon health plans is progressively driving accountability and influencing profitability through payments, penalties, and bonuses. To improve performance and optimize risk and quality payments, Health Plans need to streamline processes, employ best practices for data capture, and focus on strategic interventions that use a member-centric approach.  

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