Upward Health

Title: Medical Director Location: Hartford, Connecticut, United States Job Description: Company Overview: Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health! Job Title & Role Description: The Medical Director will partner with cross-functional teams and senior leaders to deliver innovative and high-quality care in the home and community for high-need, high-risk, high-utilizing patients. Job requires a leader with a proven track record of innovation, achievement of measurable goals, and exceptional clinical competencies. The candidate has a proactive role in the marketplace and with our patients: delivering care directly and providing clinical oversight to the members of our Interdisciplinary Care Team. The ideal candidate must be flexible and willing to work in a high growth, fast paced company where the scope of services and protocols will evolve. This is a dynamic environment requiring flexibility, dedication, and commitment to improve care for underserved populations. The role is primary remote, but residence in the state of interest is required. Approximately 20% of your time will be doing direct patient care. Skills Required: - Doctor of Medicine degree from a recognized medical school program - Must possess a current, unrestricted medical license in the State(s) of interest - Board Certified in Internal Medicine, Family Medicine or in related primary/specialty care - Minimum three years of experience practicing in a direct patient care environment - Previous medical leadership and teaching experience preferred - Expertise in of population-based medicine and quality improvement principles - Experience with managing patient with complex needs, included behavioral health and substance use diagnoses - Strong healthcare management acumen, including working knowledge of current U. S. payer and provider landscape - Must be able to positively interact with other clinicians, senior management, patients and their families, and all levels of medical and non-medical professionals - The high sense of urgency and can-do attitude required - Strong communication and problem-solving skills - will proactively and thoroughly communicate with other members of the team and seek input and guidance to solve tough problems - Technical acumen with EMR system (Athena experience a plus) Key Behaviors: Proactive Leadership: - Takes initiative in shaping clinical direction and driving the delivery of high-quality care, while motivating and leading interdisciplinary teams. Collaboration: - Works effectively across departments and with external stakeholders to ensure integrated, patient-centered care. Flexibility and Adaptability: - Able to navigate a rapidly evolving work environment, adjust strategies as needed, and embrace new methods of care delivery. Accountability: - Demonstrates ownership of both clinical outcomes and team performance, ensuring high-quality care for patients. Empathy: - Consistently demonstrates compassion and understanding toward patients and team members, recognizing the complexities of their needs. Effective Communicator: - Clearly articulates clinical goals, challenges, and changes to both technical and non-technical stakeholders, fostering transparency and collaboration. Patient-Centered Approach: - Prioritizes patient needs and ensures decisions are made with the goal of improving patient health and quality of life. Competencies: Clinical Expertise: - In-depth knowledge of medical practice, population health, and the application of medical principles to high-need patient populations. Leadership: - Proven ability to lead and manage clinical teams, providing oversight, mentorship, and direction to ensure optimal patient care. Problem-Solving and Critical Thinking: - Ability to analyze complex situations and develop effective, data-driven solutions to improve patient care and operational efficiency. Interdisciplinary Collaboration: - Expertise in working with cross-functional teams, fostering effective partnerships with diverse healthcare professionals to achieve the best patient outcomes. Healthcare System Knowledge: - Deep understanding of healthcare payer and provider systems, policies, and regulations to ensure effective service delivery. Quality Improvement: - Skilled in the application of quality improvement methods to continuously enhance care delivery processes and outcomes. Technology Proficiency: - Experience with EMR systems (Athena preferred) and the ability to leverage technology to improve care coordination and patient outcomes. Stakeholder Engagement: - Ability to interact with key stakeholders, including patients, families, senior management, and external partners, to align on goals and drive operational success. Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. NY pay range $250,000 - $250,000 USD Upward Health Benefits Upward Health Core Values Upward Health YouTube Channel.

Role Description This role will be responsible for providing top-notch billing services while ensuring accuracy and efficiency in managing medical claims. This individual would report to the Revenue Cycle Manager. There will be a strong focus on reviewing data to develop insights on key gaps and trends, along with communication with colleagues and external stakeholders. We are looking for a detail-oriented and highly organized colleague who can manage multiple priorities and has the flexibility to wear multiple hats at our high-growth company. We want someone who will thrive in a fast-paced environment with a willingness to learn and grow. Additionally, we seek an excellent team player who delivers great service to colleagues. Our providers and other staff are based all over the United States, so we are looking for someone who can communicate effectively – verbally and in writing – with colleagues around the country. Key Responsibilities - Prepare and submit billing data and medical claims to insurance companies, ensuring accurate coding. - Ensure the patient’s medical information is accurate and up to date. - Prepare bills, invoices, and document amounts due for medical procedures and services. - Post payments to the system, review Electronic Remittance Advice (ERA) for accuracy, and alert the AR follow-up team of any denials. - Report trends in denied claims or payment discrepancies to management. - Communicate with colleagues and health plan staff to address issues and concerns, such as troubleshooting denials, takebacks, and underpayments. Issue Analysis and Resolution - Analyze Electronic Remittance Advice (ERA) to resolve billing issues. - Use critical thinking and problem-solving skills to address patient inquiries. - Provide clear explanations of insurance claims and escalate complex issues as needed. Work Queue Reviews - Review Open Work queue in Athena to ensure accounts are appropriately worked in conjunction with the billing cycle. - Review Correspondence Open Task Work queue for proper assignment and follow-up. - Review and manage Hold Bill/Alert Open Work queue for incomplete registrations. Qualifications - 2 years of experience in medical billing or a similar role. - Solid understanding of billing software and electronic medical records (EMR); experience with Athena is a plus. - Ability to multitask and manage time effectively in a fast-paced environment. - Knowledge of ICD-10, CPT, and HCPCS codes. - Associate degree or high school diploma. Preferred Qualifications - Experience with Athena or similar medical billing platforms. - Experience with Salesforce. - Proven experience in customer service, preferably in healthcare or financial settings. - Proficient in Microsoft Office, especially Excel. Knowledge, Skills & Abilities - Self-starter, with high energy but also flexibility to shift directions quickly as the business requires it. - Strong analytical and problem-solving skills. - Ability to effectively multitask across many different tasks to ensure high-priority tasks are completed on time. - Ability to work independently and in a highly virtual environment, with colleagues all over the country. - Strong interpersonal skills to build relationships at multiple levels inside the company and with external vendors or clients. - Open and accepting of suggestions, feedback, and new ideas. - Excellent written and oral communication skills. - Strong work ethic and a willingness to adhere to deadlines. Benefits - Upward Health Benefits - Upward Health Core Values - Upward Health YouTube Channel

Title: Patient Access Representative Location: Remote Job Description: Company Overview: Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health! Job Title & Role Description: The Patient Access Representative is an essential member of the Centralized Operations Team. This remote role is responsible for managing a large volume of inbound and outbound calls in a timely manner, addressing patient inquiries, needs, and concerns while ensuring patient satisfaction. The role includes appointment scheduling, call triaging, and outbound follow-up calls to patients for rescheduling and reminders. The ideal candidate will have experience in a call center and medical appointment scheduling within a fast-paced environment, with a strong focus on providing excellent customer service. Skills Required: - High school diploma or GED required - Prior experience in a customer support/call center role - Prior experience with health insurance and medical terminology preferred - Familiarity with CRM and EMR systems - Strong phone and verbal communication skills, including active listening - Attention to detail to ensure accurate documentation and scheduling - Technologically savvy, with the ability to adapt to various digital systems - Ability to work independently in a virtual environment and as part of a team - Cultural competency, able to work with diverse groups of community members - Multilingual capabilities preferred, but not required Key Behaviors: Customer-Centered Focus: - Always prioritizes patient satisfaction by providing timely, accurate information and addressing patient needs with empathy and professionalism. Adaptability & Flexibility: - Demonstrates the ability to adjust to evolving work demands and shifting priorities in a dynamic healthcare environment. Urgency & Efficiency: - Responds quickly and efficiently to a high volume of calls, scheduling appointments and resolving issues promptly. Effective Communication: - Utilizes clear, concise, and empathetic communication when speaking with patients, ensuring they fully understand the information and are supported throughout their care journey. Detail-Oriented: - Ensures all patient information is accurately documented and all processes are followed to meet regulatory and operational requirements. Problem-Solving: - Identifies and resolves issues that may arise during patient interactions, ensuring a seamless experience for the patient and the healthcare team. Collaboration & Teamwork: - Works effectively within a multidisciplinary team, collaborating with colleagues and leaders to ensure efficient and effective care delivery. Competencies: Call Center & Patient Communication: - Ability to manage large volumes of calls while maintaining a high level of customer satisfaction and resolving inquiries promptly. Scheduling & Appointment Management: - Expertise in scheduling and rescheduling appointments for patients, ensuring that all appointments are accurately documented and confirmed. Technology Proficiency: Proficient in navigating and using CRM and EMR systems for patient scheduling, documentation, and follow-up management. Time Management & Multitasking: - Able to manage multiple tasks, such as answering calls, documenting patient information, and handling follow-up tasks, while maintaining accuracy and meeting deadlines. Cultural Competency & Empathy: - Ability to engage effectively with diverse patient populations, providing culturally sensitive care and support. Data Entry & Documentation: - Ability to accurately input and manage patient data, ensuring all necessary follow-up and actions are tracked in the system. Professionalism & Confidentiality: - Demonstrates respect for patient privacy, maintaining confidentiality in all interactions and adhering to company policies and procedures. Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.

Coordinate care transitions to prevent hospital readmissions by collaborating with PCPs, hospitalists, and SNF providers. Refer patients appropriately for behavioral health and specialty services.