Curana Health

• Oversee the intake and referral process from receipt through completion. • Coordinate referrals with internal departments, external providers, and health plan partners. • Monitor referral workflows to identify delays, barriers, or trends impacting patient access.

• Assist in building and maintaining ETL/ELT pipelines for healthcare datasets including claims, eligibility, provider, risk adjustment, HEDIS, EHR, and clinical data • Support the development of data models and data transformations aligned with healthcare standards (e.g., HL7, FHIR, X12) • Contribute to data quality checks, validation rules, and documentation for healthcare data assets • Work with analysts and business users to understand data requirements and translate them into technical tasks • Assist in ingestion and integration of new data sources from EMR systems, CMS feeds, and vendor partners • Develop SQL queries, transformations, functions, and stored procedures to support reporting and analytics workflows • Support data platform tools such as Azure Data Factory, Databricks, Python/Spark jobs, and version control workflows • Participate in issue resolution related to data pipeline failures or data quality errors • Maintain data dictionaries, mapping files, and documentation as part of data governance processes • Collaborate with senior engineers to implement best practices in security, compliance (HIPAA), and architecture

Role Description Utilization Management Nurse open to either a Sun–Thursday or Tuesday–Saturday shift. The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. This includes: - Providing prior authorizations - Concurrent review - Proactive discharge/transition planning - High dollar claims review There is a heavy emphasis on concurrent review and proactive transition planning for members in the hospital and skilled nursing facility. This is primarily a remote telephonic position with normal business day hours, with one weekend day per month coverage. This position serves as a liaison to the Plan Medical Director working closely with appeals and medical decisions. Qualifications - Minimum 2 years clinical experience as RN, LPN/LVN required - Minimum 1-year managed care or equivalent health plan experience preferred - Demonstrated experience in health plan utilization management, facility concurrent review discharge planning, and transfer coordination required - Medicare Advantage experience preferred - Experience with InterQual or MCG authorization criteria preferred - Excellent computer skills and ability to learn new systems required - Strong attention to detail, organizational skills and interpersonal skills required - Demonstrated ability to problem solve and manage professional relationships Requirements - Active unrestricted Nursing license required Essential Duties & Responsibilities - Performs concurrent and retrospective reviews on all facility and appropriate home health services - Monitors level and quality of care - Responsible for the proactive management of acutely and chronically ill patients with the objective of improving quality outcomes and decreasing costs - Evaluates and provides feedback to member’s providers regarding a member’s discharge plans and available covered services - Determines “observational” vs “acute inpatient” status as part of the hospital prior authorization process - Actively engages with member’s providers in proactive discharge/transition planning - Participates in notification processes resulting from clinical utilization reviews with the facilities - Prepares CMS-compliant notification letters of NON-certified and negotiated days within established time frames - Reviews all NON-certification files for correct documentation - Maintains accurate records of all communications - Monitors utilization reports to assure compliance with reporting and turnaround times - Addresses care issues with Director of Quality and Care Management and Chief Medical Officer/Medical Director as appropriate - Coordinates an interdisciplinary approach to support continuity of care - Provides utilization management, transition coordination, discharge planning and issuance of all appropriate authorizations for covered services as needed for providers and members - Coordinates identification and reporting of potential high dollar/utilization cases for appropriate reserve allocation - Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum - Clarifies health plan medical benefits, policies and procedures for members, physicians, medical office staff, contract providers, and outside agencies - Responsible for the early identification of members for potential inclusion in a Chronic Care Improvement Program - Assists in the identification and reporting of Potential Quality of Care concerns - Responsible for assuring these issues are reported to the Quality Improvement Department - Work as interdisciplinary team member within Medical Management and across all departments - Other duties as assigned

• Drive high-priority initiatives across our Medicare Advantage product portfolio. • Manage complex, deadline-driven projects in a regulated healthcare environment. • Coordinate closely with clinical, compliance, finance, and operations teams to deliver results on time and at scale. • Translate regulatory and operational complexity into clear updates for internal and external partners. • Run effective working sessions, drive decisions, and document outcomes. • Manage multiple annual project cycles against tight deadlines. • Monitor risks and prepare mitigation plans. • Use project management tools such as Smartsheet, Jira, MS Project, Asana, or similar platforms. • Monitor and evaluate data and trends while partnering with Finance, Product, and other leadership teams.

• Review, analyze, and process healthcare insurance claims for accuracy, completeness, and compliance with regulatory and plan requirements. • Monitor pending and reprocessed claims to ensure timely adjudication and payment. • Communicate with healthcare providers and insurance companies to resolve claim discrepancies and denials. • Validate the legitimacy of claims and the accuracy of invoiced amounts. • Identify and escalate potential irregularities or fraud indicators in claims data. • Compile and analyze claims-related data to identify trends, recurring issues, and opportunities for improvement. • Develop reports to track claim volumes, turnaround times, payment accuracy, and other key performance indicators. • Serve as a liaison between internal departments including Customer Service, Accounts Payable, Finance, and Legal to resolve claims issues. • Maintain current knowledge of CMS, Medicare, and payer-specific claim processing regulations. • Participate in training sessions to stay up to date on regulatory changes and system updates.

Role Description Curana’s provider learning model is evolving. In short, we’re focused on building learning that is clinically grounded, easy to absorb, easy to maintain, and actually utilized. This role blends two strengths that don’t often show up in the same person: - APP‑level clinical credibility - Strong learning design capability, particularly in self‑paced learning The Clinical Educator – Learning Design & Facilitation designs and builds self‑paced clinical learning, facilitates targeted live learning where it adds value, and partners with teammates across Learning & Development to continuously improve how providers are onboarded, trained, and supported over time. This is a hands‑on role for a clinician who enjoys designing learning systems, not just delivering training — someone who can translate real clinical workflows into clear, practical learning experiences and help raise the bar for how learning is done at Curana. Essential Duties & Responsibilities - Learning design and content development - Design, develop, and maintain high‑quality self‑paced clinical learning, including e‑learning modules, short instructional videos, assessments, job aids, and tip sheets. - Translate clinical workflows, expectations, and standards into learning experiences that are clear, practical, and usable in real provider contexts. - Apply adult learning and instructional design principles in a pragmatic way to improve retention, confidence, and on‑the‑job behavior. - Structure learning content so it is durable and easy to update over time, balancing stable core training with flexible, updateable supporting resources. - Facilitation and live learning - Facilitate select virtual and live learning experiences such as orientation sessions, case‑based discussions, cohort learning, and office hours. - Use facilitation intentionally to reinforce self‑paced learning, support application and discussion, and surface areas of confusion or opportunity. - Support high‑impact learning moments where live interaction meaningfully improves understanding or adoption. - Partnership and team enablement - Partner closely with teammates across Learning & Development to support learning priorities and shared standards. - Share learning design best practices, templates, and approaches that improve consistency and quality across learning assets. - Collaborate with subject matter experts, Clinical Leadership, CDI/Coding, Compliance, Product/IT, and other stakeholders to ensure learning content is clinically accurate and operationally realistic. - Learning systems and continuous improvement - Build and publish courses in Curana’s Learning Management System (LMS), ensuring learning is trackable and reportable. - Use completion data, assessment results, and learner feedback to continuously refine and improve learning experiences. - Partner with Learning Operations to support reliable tracking, reporting, and learner experience. What Success Looks Like - Providers reach readiness faster and feel clear on expectations. - Priority clinical learning exists in scalable self‑paced formats, with live sessions used where they add real value. - Live learning is interactive, focused, and reinforcing rather than duplicative. - Learning content stays current without constant rebuilds. - Learning & Development operates with shared design standards and stronger learning design capability over time. Qualifications - Nurse Practitioner (NP) or Physician Assistant (PA) with an active, unencumbered license. - Relevant clinical experience, preferably in primary care, geriatrics, or value‑based care. - Demonstrated experience in instructional or learning design, ideally in healthcare. - Experience creating self‑paced learning (modules, videos, assessments, job aids). - Experience working with a Learning Management System (LMS). - Strong written, verbal, and facilitation skills. Preferred Qualifications - Formal training or certification in adult learning, instructional design, or learning experience design. - Experience designing education related to clinical workflows, documentation, quality measures, or provider enablement. - Comfort coaching peers on learning design approaches and tools. Work Environment & Travel - Remote role with a professional, reliable virtual work setup. - Up to approximately 10% travel for team meetings, planning sessions, or key learning events.

• Serve as the primary marketing partner to the field • Own and evolve the in-building marketing toolkit, including digital and print materials, family event collateral, and scalable templates • Build and manage a family communication program across email, SMS, and patient portals, including nurture and event-driven campaigns • Support and onboard Community Engagement Managers (CEMs) on marketing best practices and execution • Identify and scale best-performing strategies across communities • Track and report on field engagement and growth KPIs in partnership with Partner Success and Operations • Partner with creative teams to ensure high-quality, consistent brand execution across all community-facing assets

• Own paid digital campaigns across LinkedIn, programmatic channels, and industry publications • Build and run targeted campaigns focused on high-value accounts (ABM) • Set up and manage systems to track and report on paid marketing performance • Manage relationships with marketing and advertising partners to ensure campaigns run effectively • Build and grow a social influencer program, including healthcare providers and caregiver content creators • Track and report on key demand generation metrics (leads, engagement, pipeline impact) on a regular basis • Coordinate speaker submissions and participation for industry conferences • Partner with Business Development to ensure leads are routed, scored, and followed up effectively • Create clear monthly and quarterly reports for marketing and executive leadership

Title: RN Clinical Quality Coordinator Location: Remote, United States Department: Nursing Job Description: ID2026-3609 Position Type Full-Time At Curana Health, we’re on a mission to radically improve the health, happiness, and dignity of older adults—and we’re looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities. Founded in 2021, we’ve grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for. If you’re looking to make a meaningful impact on the senior healthcare landscape, you’re in the right place—and we look forward to working with you. For more information about our company, visit CuranaHealth.com. Summary The Quality Registered Nurse (RN) is responsible for overseeing clinical quality, clinic support staff base education, and operational compliance across multiple primary care clinics in different states. This role partners closely with providers, clinic managers, and leadership to ensure high-quality, evidence-based care, regulatory compliance, and consistent clinical workflows across all locations. The Quality RN plays a key role in quality improvement initiatives, audits, staff education, and performance monitoring. Essential Duties & Responsibilities Clinical Quality & Patient Safety - Monitor and evaluate quality-of-care metrics across multiple PCP clinics - Ensure adherence to evidence-based clinical guidelines and best practices - Identify gaps in care and develop action plans to improve patient outcomes - Support initiatives related to population health, preventive care, and chronic disease management - Promote patient safety standards and risk mitigation strategies Compliance & Regulatory Oversight - Ensure clinic compliance with federal, state, and local regulations - Review and update clinical policies, procedures, and protocols to align with regulatory standards - Track and report quality and compliance data to leadership Operational Oversight - Partner with clinic leadership to standardize workflows and clinical processes across states - Conduct chart audits and clinical documentation reviews to ensure accuracy and completeness of the Medical Assistant - Identify operational inefficiencies and recommend process improvements - Manage all quality checklists, reporting, and logs for quality assurance Education & Staff Support - Provide clinical education and coaching to nursing and clinical staff - Create and manage clinical competencies - Support onboarding and ongoing training related to quality standards and workflows - Serve as a clinical resource for questions related to policies, procedures, and best practices Data Analysis & Reporting - Analyze quality metrics, patient outcomes, and performance data - Prepare reports and dashboards for leadership review - Use data to drive continuous quality improvement initiatives Collaboration & Communication - Collaborate with physicians, advanced practice providers, clinic managers, and administrative teams - Participate in quality committees and leadership meetings - Communicate findings, recommendations, and action plans clearly and effectively Other job duties are assigned Qualifications Required - Active Registered Nurse (RN) license (multi-state compact license preferred) - Minimum of 3–5 years of clinical nursing experience, preferably in primary care or ambulatory care - Experience with quality improvement, clinical audits, or compliance activities - Strong knowledge of clinical guidelines, quality measures, and regulatory standards - Excellent organizational, analytical, and communication skills - Ability to manage responsibilities across multiple clinic locations Preferred - Bachelor of Science in Nursing (BSN) - Familiarity with CMS quality programs, HEDIS, or value-based care models - Experience working with electronic health records (EHRs) Work Environment - Primarily remote or hybrid, with periodic travel to clinic sites as needed - Collaborative, fast-paced healthcare environment focused on continuous improvement Physical & Travel Requirements - Ability to travel to clinical locations across multiple states as required - Ability to sit, stand, and work at a computer for extended periods Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances. The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment. *The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).

• Configure, test, and deploy updates and enhancements across Workday modules including Core HCM, Benefits, Time & Absence, Talent, and Payroll. • Serve as a primary point of contact for Workday support, troubleshooting, and issue resolution. • Maintain data integrity through audits, reporting, system monitoring, and ongoing maintenance activities. • Develop custom reports, dashboards, and calculated fields to support operational and business needs. • Partner with HR, Payroll, Operations, and IT to gather requirements and implement scalable Workday solutions and process improvements.