U.S. Renal Care

Role Description The State and Local Tax Director is responsible for owning and leading all aspects of the Company's State and Local Tax function, including: - State income/franchise tax and indirect tax compliance - ASC 740 state tax provision support - Planning and controversy management This role serves as a key technical expert and strategic advisor on multistate tax matters, including: - Nexus - Apportionment - Sourcing - State footprint strategy The State and Local Tax Director partners cross-functionally with Accounting, Finance, Legal, Operations, and IT to ensure tax implications are identified and addressed, manages external advisors, drives process and technology improvements, and supports broader business initiatives. Essential Duties and Responsibilities - Own and lead the Company's SALT function, including governance, compliance and financial reporting calendars, controls, and documentation standards across all jurisdictions. - Serve as the primary internal advisor on all SALT and indirect tax matters, providing practical guidance to leadership on SALT risks, opportunities, and business impact. - Provide strategic input on the Company's state tax footprint, entity structure, operational changes, and business initiatives. - Partner cross-functionally with Accounting, Finance, Legal, Operations, IT, and senior management to ensure SALT implications are identified, evaluated, and properly addressed. - Support business teams in understanding SALT impacts of operational and strategic decisions. - Develop and maintain strong relationships with external tax advisors, auditors, and other key stakeholders. - Manage, mentor, train, and develop team members supporting SALT workstreams, including performance oversight, technical review, skill development, and knowledge sharing. - Direct and manage the preparation and review of multistate, multi-entity corporate income and franchise tax returns, extensions, and estimated payments, refund claims, and related filings. - Manage a combination of outsourced and in-house SALT compliance processes. - Review quarterly estimated tax payment calculations and extension payment calculations. - Direct and manage partnership tax compliance processes. - Provide a high degree of service to physician partners through annual K-1 tax reporting. - Review and approve state filing positions, including apportionment, nexus, sourcing, and state modifications. - Lead SALT planning initiatives. - Direct and manage state cash tax forecasting, budgeting, and income tax projection models. - Prepare and maintain defensible documentation supporting SALT positions. - Support the preparation and review of state tax items for quarterly and year-end income tax provisions. - Review and analyze state provision-to-return true-up adjustments. - Support the use of OneSource OTP and related tax technology. - Drive process improvements, automation, and standardization across SALT compliance. - Enhance data quality, workflow efficiency, documentation practices, controls, and review processes. - Manage and optimize the use of tax systems and external provider processes. - Lead tax process enhancements. - Lead and manage state and local tax audits, notices, inquiries, and controversy matters. - Identify, quantify, and mitigate SALT exposure risks. - Manage voluntary disclosures, amended filings, refund claims, and other risk mitigation initiatives. - Coordinate SALT-related documentation requests and inquiries from external auditors. - Oversee outsourced indirect tax compliance. - Establish and maintain controls over taxability determinations. - Monitor indirect tax processes and identify opportunities to improve compliance. - Provide SALT support for tax planning, M&A transactions, due diligence, structuring, and post-acquisition integration. - Identify and evaluate state credits and incentives opportunities. - Assess SALT implications of business initiatives, expansions, restructurings, and operational changes. - Prepare technical analysis, documentation, and recommendations. - Monitor, interpret, and communicate state legislative and regulatory developments. - Conduct technical research and analysis of complex SALT matters. - Prepare technical memoranda and other documentation supporting SALT positions. - Communicate developments, risks, opportunities, and recommendations to Tax leadership. Qualifications - Bachelor's degree in accounting, tax, finance, or related field. - CPA and/or Master's in Tax strongly preferred. - 12 to 15+ years of progressive tax experience, including recent corporate tax department experience. - Strong technical knowledge of state income and franchise tax. - Proven ability to operate effectively in a remote work environment. - Prior experience managing complex SALT compliance processes. - Prior experience with ASC 740. - Strong tax technical research, writing, documentation, and analytical skills. - Strong understanding of complex corporate and partnership income tax principles. - Experience managing state and local tax audits, controversy matters, and tax authority inquiries. - Experience overseeing indirect tax matters preferred. - Ability to identify, assess, and communicate SALT risks and opportunities. - Thorough knowledge of corporate accounting and finance practices. - Experience managing external tax advisors and co-sourced service providers. - Knowledge of corporate internal control requirements under SOX Section 404 preferred. - Excellent communication, problem solving, and critical thinking skills. - Ability to prioritize and manage multiple assignments, deadlines, and stakeholders. - Strong leadership, project management, and team development skills. - Strong emphasis on advanced Excel skills. - Experience with OneSource OTP, Alteryx, D365, BNA, and/or similar tax/accounting systems preferred.

Role Description The Payment Poster performs general accounting related tasks in accordance with US Renal Care, reimbursement policies and procedures. - Posts and allocates all payments per explanation of benefits to patient accounts for commercial, contract, and government payers. - Posts adjustments as on the approved list and per explanation of benefits. - Ensures there are no variances in batches posted and all reports turned in prior to day end process. - Ensures all posted lockbox batches are scanned and indexed daily to the appropriate patient accounts. - Reconciles EFT (Electronic Funds Transfers) and posts appropriate payments and allocation. - Identifies and reconciles Unapplied account balances where necessary. - Posts all denials received with appropriate reason codes. - Performs other duties as assigned. Qualifications - High School diploma or GED required. - At least two years of experience in a health/medical billing and collection office. - Ability to use copier, fax machine, printer, calculator, and multi-line telephone. - Must be proficient with computers with an understanding of medical billing software. - Extensive knowledge of medical terminology as well as knowledge of government and private insurer rules and regulations. - Advanced knowledge of CPT, ICD-9, and HCPCS coding as well as in-depth knowledge of medical billing requirements. - Working knowledge of Microsoft Outlook, Word, and Excel. - Ability to utilize the internet, specifically Medicare and Medicaid websites. - Maintain confidentiality in regards to HIPAA rules and regulations, as well as private company matters.

Role Description The Cloud Engineer II is responsible for designing, implementing, and supporting Microsoft Azure cloud solutions across the enterprise. This role requires solid hands-on experience with Azure infrastructure, scripting/automation, identity integrations, and cloud governance. Working closely with architecture, security, and operations teams, this position helps ensure our cloud platforms are scalable, secure, and reliable. As a mid-level cloud engineering role, the Cloud Engineer II works independently on moderately complex cloud initiatives and collaborates with senior engineers or architects on large-scale or high-complexity solutions. This role may also provide guidance to Cloud Engineer I team members as needed. - Deploy, configure and optimize Azure infrastructure components including VNets, NSGs, Azure Firewall, Application Gateway, VPN/ExpressRoute, and load balancers. - Implement and support Azure compute services (VMs, VMSS, App Services, AKS). - Contribute to the design, configuration, and implementation of Azure storage, backup, and disaster recovery solutions under direction of senior cloud engineers or architects. - Build and maintain Infrastructure‑as‑Code (IaC) using Terraform, Bicep, or ARM templates. - Develop CI/CD pipelines using Azure DevOps or GitHub Actions. - Automate operational tasks using PowerShell, Python, or Azure CLI. - Implement Azure security best practices, including RBAC, managed identities, Key Vault, policies, and blueprints. - Ensure adherence to governance frameworks regarding tagging, naming conventions, and resource organization. - Implement and maintain monitoring and logging using Azure Monitor, Log Analytics, and Application Insights. - Support identity integrations with Azure AD including conditional access, PIM, and B2C/B2B scenarios. - Troubleshoot cloud infrastructure issues across network, compute, storage, and identity layers. - Monitor, analyze and optimize Azure cost, performance, and capacity. - Maintain technical documentation including diagrams, runbooks, and configuration standards. - Collaborate with cross-functional teams on cloud initiatives and operational improvements. - Stay current with emerging Azure services, cloud engineering best practices, and industry trends. Qualifications - Bachelor's degree preferred; degree in computer science, information systems, engineering, or related field preferred. - Three plus (3+) years' experience with multi location healthcare preferred; other relevant experience will be considered; previous dialysis experience a strong plus. - Proficient with all Microsoft Office products, including Outlook and Word. - Working knowledge of VMWare ESXi. - 3+ years of hands‑on experience with Microsoft Azure platforms. - Experience with automation scripting (PowerShell, Python, Azure CLI). - Strong understanding of Azure networking, identity, compute, and governance. - Experience with IaC tools (Terraform, Bicep, ARM). - Experience supporting hybrid environments and on-prem connectivity. - Strong troubleshooting and analytical skills. - Ability to collaborate across teams and lead technical initiatives. - Self‑driven, curious, and comfortable working in a fast‑moving environment. Requirements - Preferred certifications: - AZ‑104: Azure Administrator - AZ‑305: Azure Solutions Architect - AZ‑500: Azure Security Engineer

Role Description We are looking for a Junior Front End Developer responsible for building and enhancing our in-house applications using R and .NET Core, including anything from back-end services to their Front End Interfaces. Your primary responsibilities will include: - Translate application user stories and use cases into functional application modules. - Design, build, and maintain efficient, reusable, and reliable C# and TypeScript. - Ensure the best possible performance, quality, and responsiveness of applications. - Identify bottlenecks and bugs, and devise solutions to these problems. - Develop new tools/modules which improve productivity of Clinicians, thus improving quality of patient care. - Enhance various analytics software components enabling better revenue collection. - Stay plugged into emerging technologies/industry trends and apply them in providing efficient operational software solutions. - Enhance our current iOS and Android applications, used by our field personnel and physicians, to include new functionalities improving patient care. - Data Modeling to ensure solutions cover various Business and Operation scenarios. - Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization. - Regular and reliable attendance is required for the job. Qualifications - Experience with C# and React with a good understanding of its ecosystems. - Familiarity with the .NET framework. - Strong understanding of object-oriented programming. - Skill for writing reusable libraries. - Familiar with various design and architectural patterns (E.g. Agile, Waterfall). - Familiarity with relational databases like Oracle, Microsoft SQL Server, or MySQL. - Knack for writing clean, readable code. - Understanding fundamental design principles behind a scalable application. - Creating database schemas that represent and support business processes. - Implementing automated testing platforms and unit tests. - Proficient understanding of code versioning tools (CVS, VSS, or TFS). - Ability to create tasks and logs in JIRA. - EMR and Claims Knowledge a plus but not mandatory. - Should be analytical and have good problem-solving skills.

Role Description - Provides administrative and clerical support for the Business Development team as well as other teams supporting business growth initiatives and strategies. - Works collaboratively with key support personnel within the organization to meet company objectives, goals, and projects as needed/directed. - Resolves day-to-day administrative and operational challenges utilizing critical thinking skills and independent decision-making as appropriate to the role. - Coordinates and maintains meetings, calendars, schedules, conferences, training sessions, special events, travel, invoicing, and expense reports as directed. - Maintains strict confidentiality of departmental records, sensitive information related to the company, patient information and employee information. - Prepares and assists with creating presentations, charts, graphs, statistical reports, budget tracking/analysis, research and gathering of data, and other special projects as requested. - Provides follow up and feedback, both written and verbally, regarding project findings and activities to key stakeholders. - Drafts, generates, and coordinates routine correspondence; production (formatting/copying) and dissemination of documents such as presentations, handouts, training materials, and reports. - Establishes, maintains, and updates files, databases, records and other documents. - Responds courteously and professionally to internal and external customers via phone calls, office visits, correspondence etc. - Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization. - Participate in team concepts and promote a team effort; perform duties in accordance with company policies and procedures. - Regular and reliable attendance is required for the job. Qualifications - To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. - Associate degree or equivalent work experience. Bachelor's degree preferred. - Three (3) plus years of experience in administrative support role; prior experience with supporting senior leadership is a plus. - Ability to thrive in fast-paced, deadline driven work environment. - Strong organizational and time management skills. - Excellent customer service skills and ability to communicate effectively, both verbally and in writing. - Must have proficient computer skills, including Microsoft Office (Word, Excel, Power Point and Outlook); proficiency in USRC applications required within 90 days of hire.

Role Description The Director of VBC Market Operations serves as an operational leader accountable for driving the day-to-day performance of US Renal Care's value-based care programs. The Director builds and manages relationships with nephrologists, nephrology practice staff, and dialysis clinic teams. They collaborate internally with clinical, analytics, and other leaders to develop and drive strategies that deliver improved outcomes and reduced costs. The Director must be able to work effectively and collaboratively across all key internal and external stakeholders and thrive in ambiguous, fast-paced start-up environments. - Develop a deep understanding of key requirements of value-based care programs within USRC. - Identify, develop, and manage key performance metrics to measure performance of providers related to their value-based contracts. - Collaborate with US Renal Care Clinical, Finance, Analytics, and other leaders to develop initiatives that improve clinical and financial outcomes, and lead implementation of those with physician practices and dialysis clinics. - Collaborate with provider group physicians and their practice staff to develop and implement operational and clinical process improvements to help providers achieve higher performance in value-based care programs. - Own the financial, clinical, and quality performance of practices within the market. - Work collaboratively with analytics, technology, and care teams to design and document new processes, workflows, and tools. - Effectively work in a matrixed organizational structure in which you lead with influence, collaborating across various internal and external teams to achieve success in value-based care programs. - Be comfortable effectively navigating ambiguity to create new approaches and solutions with internal and external partners. - Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization. - Participate in team concepts and promote a team effort; perform duties in accordance with company policies and procedures. - Regular and reliable attendance is required for the job. Qualifications - Bachelor's degree required, master's degree in related field (e.g., MBA, MPH, MHA) preferred. - Minimum of eight years of experience in health care preferred. - Management consulting and/or process improvement backgrounds preferred. - Experience in a start-up environment preferred. - Experience with value-based care programs preferred. - Experience managing physician relationships required. - Advanced Excel and PowerPoint skills required. - Travel required up to 50% of the time, with periods of more and less travel. - Ideal candidate lives in close proximity to one of the following airports: Denver, Salt Lake City, Seattle-Tacoma.

Role Description The Director of Clinical Research reports to the VP of Clinical Research and is responsible for oversight of the day-to-day operations of research physician/clinical site partners who conduct multiple FDA regulated clinical trials. Responsibility also includes management of Clinical Research Coordinators (CRC) and upholding U.S. Renal Care's research practices and policies. - Manages the operational and logistical tasks of clinical research to ensure efficient execution of trials within established budgets and timelines. - Ensures all activities are in compliance with the appropriate regulations (Good Clinical Practice (GCP), Food and Drug Administration (FDA) Federal Code of Regulations, all applicable state and local agencies). - Assists in the coordination of efforts of internal and external resources (industry partners, clinical research organizations) to ensure efficient trial selection, patient recruitment, and trial plan. - Assists with the recruitment of new industry partners, research opportunities, and access to novel therapies. - Promotes growth of USRC's research footprint by identifying and pursuing future nephrology research investigator physicians and practices in both the CKD and dialysis space. - Maintains productive and effective current physician research collaborations. - Collaborates with applicable internal teams to deliver efficient clinical research integration into USRC facilities and a seamless transition for new nephrology practices interested in clinical trials. - Assists with the maintenance of the Clinical Trials Management System, including oversight of patient stipend payments. - Assists field coordinators with all aspects of sponsor relations (on-site visits such as site initiations and written requests for information). - Develops and maintains professional relationships with industry partners, contract research organizations (CROs), research investigator physicians, and USRC clinical and business operations divisions. - Fosters a patient-care culture that emphasizes patient safety and quality in all activities. - Positively represents USRC at sponsor investigator meetings, national conferences, and in the field environment (clinical research sites). - Collaborates with VP of Clinical Research to develop a quality assurance program and ensure metrics are upheld by USRC research investigator physicians and practices. - Conducts site GCP audits to ensure program requirements are met. - Maintains a working knowledge of current clinical research practice standards and regulatory requirements. - Recruits, trains, develops, and supervises clinical research department personnel as well as assists with training and onboarding of new research investigator physicians. - Ensures appropriate licensures and certifications are in place. - Maintains effective personnel management and employee relations, including evaluating the performance of CRC personnel. - Approves and submits all hours worked and counsels and disciplines staff as needed. - Upholds management goals of the corporation by leading staff in team concepts and promoting teamwork. - Effectively communicates expectations; accepts accountability and holds others accountable for performance. - Regular and reliable attendance is required. Qualifications - Eight (8) plus years of experience in clinical research. - A four-year college degree preferred. An equivalent combination of work experience and education will be considered in lieu of a degree. - Clinical Research Coordinator Program (CCRP) Certification or similar required. - Nephrology experience preferred. - Knowledge of kidney care and/or End-Stage Renal Disease (ESRD) or similar field is a plus. - Work experience within a dialysis organization or in direct patient care is a plus. - Extensive knowledge of FDA regulations, IRB requirements, and Good Clinical Practice. - Excellent interpersonal and communication skills, both verbally and in writing. - Intermediate computer skills, including Microsoft Office (Word, Excel, PowerPoint, Outlook, and web-based tools) required; proficiency in USRC applications required within 90 days of hire.

Role Description A Clinical Information Systems Specialist is responsible for training and developing US Renal Care's software applications. - Participates in development of testing plans and testing scenarios within EMR system. - Subject matter expert on Clinical Information System(s) and Portal Systems. - Provide User Support and end-user training on Clinical Information System for Physician and Clinical Care Team for ongoing education / new users per US Renal Care policy and procedures. - Provide pre and post Application Implementation support. - Liaison to Clinical Information System(s) vendors. - Work closely with other departments within USRC in development / improve processes. - Effective Communication to end users about upgrades and version controls including presenting to large groups. - Able to listen effectively to end users to resolve outstanding issues. - Ability to prioritize workload and make good judgment calls according to the severity of the requests. - Develop and Maintain Training Material as needed. - Actively promotes GUEST customer service standards; develops effective relationships at all levels of the organization. - Participates in team concepts and promotes a team effort; performs duties in accordance with company policies and procedures. - Regular and reliable attendance is required for the job. Qualifications - Minimum of 2 years of Clinical Information System software support experience. - Outstanding telephone skills and customer service skills are required. - Ability to work in an organized manner, quickly, and efficiently in a fast-paced environment. - Excellent communication and interpersonal skills with Management and Users. - Travel required up to 50%. - Ability to work independently without supervision. - Advanced analytical skills required; Excel.

Role Description The Senior Manager, Strategy & Analytics plays a critical role in supporting and accelerating growth opportunities across the organization. This position is responsible for analyzing data, identifying process inefficiencies, and delivering actionable insights that help the Business Development team to increase overall effectiveness. The role partners closely with cross-functional stakeholders to monitor performance, track key metrics, and lead efforts that enhance the quality, speed, and consistency of growth opportunities. The position requires strong analytical skills, cross-functional collaboration, and the ability to manage multiple projects in a dynamic, remote environment. Essential Duties and Responsibilities - Conduct detailed analysis of internal and external growth data to identify trends and opportunities to accelerate growth for the Business Development team. - Provide regular insights and reporting to support operational improvements and process optimization efforts led by the Business Development team. - Develop and maintain performance dashboards that track admissions KPIs, SLA compliance, and team productivity metrics. - Automate and maintain the quarterly Business Development bonus tracker based on evolving performance goals and eligibility criteria. - Collaborate with IT and analytics teams to ensure data integrity, and to maintain and update data lake tables supporting growth reporting. - Lead efforts to streamline manual reporting processes in collaboration with cross-functional stakeholders. - Perform ad hoc analyses and generate reports to support strategic initiatives, pilot programs, and executive inquiries. - Track and support operational pilots aimed at reengineering aspects of the Business Development workflow; monitor results and communicate outcomes. - Maintain up-to-date hospital and referring physician lists within the referral management platform, performing quarterly audits and updates. - Analyze and identify hospital referral trends to uncover opportunities for outreach and engagement aimed at increasing referral volumes and expanding market share. - Other projects assigned based on business needs. Qualifications - Bachelor's degree in business, healthcare, marketing, analytics, or related quantitative discipline required. - At least 6 years of related experience in at least one of the following disciplines: Strategy, Business Development, or Market Research. - Experience in data analysis, modeling, and project management required. - Data Visualization Tools: Skilled in Power BI and/or Tableau for creating dynamic dashboards, performance tracking, and executive-level reporting. - Data Analysis: Strong working knowledge of SQL and Excel for querying, cleaning, and analyzing large datasets to uncover trends and inform strategic decisions. - Referral Management Systems: Experience managing and maintaining data integrity within referral tracking platforms, including routine updates of physician and hospital databases. - Collaboration Platforms: Comfortable working within shared environments such as SharePoint, monday.com, and Teams to coordinate cross-functional initiatives. - Ability to effectively articulate data and metrics to stakeholders, business partners, and leadership. - Excellent customer service skills and ability to communicate effectively, both verbally and in writing.

Role Description The Vice President of Technical Services provides enterprise-level leadership and strategic direction for technical services across the organization. This role is accountable for defining strategy, setting performance expectations, and ensuring alignment between technical services, clinical priorities, and organizational growth objectives. This role is ultimately responsible for ensuring dialysis equipment, water systems, and facility infrastructure are safe, reliable, and compliant with all regulatory and company standards. The VP focuses on long-term planning, innovation, and enterprise performance--driving standardization, scalability, and continuous improvement while building leadership capability across the technical organization. Key Responsibilities - Strategic Leadership & Growth - Lead the execution of technical services strategy in alignment with organizational priorities - Oversee technical operations to achieve financial, operational, and growth objectives - Support expansion efforts including de novo clinics, acquisitions, and facility relocations - Evaluate and implement new technologies, products, and treatment modalities - Develop and manage capital planning, including asset lifecycle and replacement strategies - Drive continuous improvement initiatives to enhance efficiency, reduce downtime, and optimize equipment performance - Operational Excellence & Outcomes - Ensure all equipment and water systems meet company policy, manufacturer specifications, AAMI standards, and regulatory requirements - Establish and monitor key performance indicators related to quality, safety, and operational performance - Identify and improve business processes to enhance clinical and financial outcomes - Standardize and scale preventative maintenance programs and technical practices - Prioritize patient safety at all times - Regulatory & Compliance Leadership - Maintain expertise in federal, state, and local regulatory requirements and industry standards - Ensure all programs (chronic, acute, and home) maintain compliance and certification readiness - Lead audit preparedness, corrective action planning, and regulatory response efforts - Support implementation and adoption of systems (e.g., electronic documentation and tracking tools) - Partner in enterprise emergency preparedness and disaster response planning - Technical Infrastructure & Innovation - Oversee the performance and reliability of water treatment systems, dialysis equipment, and facility systems - Provide technical expertise for clinic design, equipment selection, and infrastructure planning - Champion innovation and advancement of technical programs, tools, and technologies - Ensure alignment of technical services with evolving clinical practices and treatment models - Partnerships & Enterprise Collaboration - Collaborate with clinical, operations, and corporate leaders to support organizational initiatives - Communicate technical performance, risks, and priorities across the organization - Build and maintain strong relationships with vendors, contractors, and external partners - Support cost management strategies and enterprise-wide initiatives - Promote a culture of service excellence and accountability - Effectively collaborate with operations, construction team, clinical services, and other stakeholders to maintain a safe and appropriate physical plant - Team Leadership & Development - Lead, develop, and support Technical Directors and regional technical leaders - Establish career pathways and development opportunities for technical team members - Partner with Human Resources on recruitment, performance management, and succession planning - Foster a culture of accountability, engagement, and continuous learning - Set clear expectations and hold leaders accountable for performance outcomes Qualifications - Required - Bachelor's degree in biomedical technology, business, or related field (or equivalent combination of education and experience) - Minimum of 5+ years of technical leadership experience in a multi-site healthcare environment - Deep knowledge of dialysis equipment, water systems, and regulatory standards - Proven ability to lead large, geographically dispersed teams - Preferred Skills - Strong strategic thinking and execution capabilities - Financial and operational acumen, including capital planning and cost management - Excellent leadership, coaching, and organizational development skills - Effective communication and stakeholder management skills - Advanced problem-solving and analytical capabilities Requirements - Oversight of Technical Directors and regional technical teams - Accountability for technical services performance, strategy, and budgets across the organization Work Environment & Physical Requirements - Frequent travel, including overnight travel (up to ~60%) - Exposure to clinical environments, chemicals, and biohazards - Moderate noise levels in clinical and office environments - Ability to perform physical activities as required in technical and facility settings