
Virtix Health
Remote Jobs
Innovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
11 Jobs
SQL Database Developer, AWS RDS
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Design, develop, and maintain SQL Server databases hosted on AWS RDS, ensuring reliability, availability, and data integrity. • Perform query and index performance tuning — analyze execution plans, identify bottlenecks, and implement optimizations to support production workloads. • Conduct load testing to simulate high-traffic scenarios, interpret results, and drive schema or configuration improvements. • Collaborate with application developers to review and improve database-facing code, stored procedures, functions, and views. • Develop and maintain data models, schema designs, and documentation following best practices for normalization and scalability. • Build and maintain ETL/ELT pipelines and data transformation workflows using Python or similar tooling. • Participate in CI/CD pipelines for database change management, including scripted migrations and version-controlled deployments. • Ensure all data practices comply with HIPAA regulations and internal data governance standards for handling PHI/PII. • Monitor database health, capacity, and performance metrics; proactively address issues before they impact end users. • Contribute to peer code reviews and help establish database development standards across the team
Manager, Payer Strategy – Success
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Execute a comprehensive strategic account plan showing current state, target future state with timeline and an underlying plan to drive adoption and outcomes leading to renewals, expansion and advocacy for each customer • Prepare and lead regular, recurring meetings, to include quarterly business and executive business reviews, demonstrating an understanding of the customer’s goals and effectively communicating the value delivered from Virtix Health’s products and services • Execute adoption plans to increase utilization and engagement of Virtix Health's products and services • Proactively identify risks to the customer achieving their stated goals and demonstrate influence in driving outcomes, both internally and externally • Successfully manage renewal and growth opportunities with each customer, and identify expansion opportunities • Build and foster senior-level relationships with the customer’s leadership and decision makers to solidify our partnership and commitment to the customer business • Partner with customer stakeholders to understand their goals, provide guidance and recommendations to help them achieve desired outcomes • Successfully identify and drive expansion opportunities with assigned customers across Virtix Health's complete portfolio of products and solutions • Develop and maintain in-depth product knowledge and expertise regarding all Virtix Health’s products, services, and delivery processes, with emphasis on risk adjustment and clinical quality offerings used by Virtix Health’s customers • Maintain compliance with Virtix Health's policies, procedures and mission statement • Adhere to all confidentiality and HIPAA requirements as outlined within Virtix Health’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position
HCC Coding Specialist
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Review, analyze and code patient medical records based on client specific guidelines for the project. • Follow ICD-10-CM Coding Guidelines and interpret coding guidelines for accurate code assignment. • Follow Risk Adjustment Data Abstraction Rules. • Follow client/project specific guidelines. • Will be required to maintain a quality score of 95% or higher. • Will be required to maintain an ongoing productivity level based on project requirements. • Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.
HCC Coding Specialist – Full Time
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models • Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements
HCC Coding Specialist – Part Time
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. • Follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements.
Senior QA Engineer
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Develop test strategies for new system functionality. • Introduce and support use of automation tools and frameworks as needed for successful delivery. • Collaborate with Product Management and Engineering teams, in an Agile/SCRUM environment, to develop a comprehensive set of tests. • Implement automated tests for both functional testing (new functionality) and regression testing (existing functionality). • Assist with manual and exploratory testing as needed for successful delivery. • Analyze failed tests, produce reports, and manage defects using the defect tracking tool. • Diagnose failures and gather comprehensive information to assist in defect resolution. • Align conduct with the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program. • Comply with all internal policies and procedures. • Actively participate in Company provided training and education.
Director, Provider Risk Adjustment
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Serve as the primary escalation point and strategic lead for assigned clients. • Oversee the successful implementation of new clients, including resource planning, onboarding, process mapping, and EMR/project education. • Maintain overall accountability for contracted deliverables such as coding quality, adherence to project guidelines, data analysis and reporting, and production standards. • Lead regular client meetings and updates, ensuring transparency and alignment with expectations.
HCC Coding Quality Specialist – Auditor
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• HCC Coding Quality Specialist Team Members will be responsible for reviewing the accuracy of our HCC coded records, specifically those that map to HCCs and RxHCCs. • Auditors will support their findings utilizing Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. • Ensure that the codes captured are supported by the documentation within the record and are properly coded following Medicare guidelines, ICD-10-CM guidelines as well as client specific guidelines for the project. • Support your findings in a way the coder can easily identify and learn from the error. • Have strong and professional communication skills. • Be a resource for HCC coding team members by having a deep understanding of the project and coding guidelines. • Follow Risk Adjustment Data Abstraction Rules. • Assist with the creation of PowerPoints presentations for training purposes. • Will be required to maintain a quality score of 95% or higher. • Will be required to maintain an ongoing productivity level based on project requirements.
Communication Center Representative
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Serve as the primary point of contact for providers, facilities, and internal partners seeking support with WISeR workflows. • Deliver timely, professional, and empathetic customer service. • Assist with prior authorization requests, case status inquiries, documentation intake, and portal navigation. • Respond to inbound inquiries via phone, email, portal, and fax regarding WISeR cases and prior authorization requests. • Provide clear, courteous updates on case status, next steps, and estimated turnaround times. • Educate customers on submission options to help prevent delays in patient care. • De‑escalate concerns professionally and route issues appropriately when needed. • Review incoming requests for completeness and accuracy. • Assist with documentation intake and routing to the appropriate WISeR queue. • Identify submission issues and communicate corrective guidance. • Document all customer interactions accurately in internal systems. • Collaborate with WISeR clinical, admin, and management teams to support timely case resolution. • Track follow‑ups and ensure customers receive consistent and accurate information. • Adhere to HIPAA and data privacy requirements when handling sensitive information. • Support maintenance of knowledge base articles and customer guidance materials.
Senior Data Scientist – Value-Based Car
Virtix HealthInnovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS
• Support risk adjustment and quality initiatives for Value-Based Care programs across Medicare Advantage, ACA health plans, and Medicaid • Build and maintain risk-adjustment analytic modeling (HCC suspecting, recapture models, RAF forecasting) • Apply NLP and GenAI to medical records and clinical notes to extract structured clinical evidence • Develop LLM-assisted and agentic workflows to support medical record coding review, evidence summarization, and improved productivity and accuracy • Perform forecasting and scenario analysis tied to operational capacity and financial impact • Monitor model performance, bias, drift, and documentation sufficiency • Ensure analytics are explainable, auditable, and compliant • Partner closely with Product, Engineering, Coding, Clinical, Compliance, and Operations teams • Translate analytics into actionable signals embedded in payer workflows
1more opportunities are still waiting for you.Log in now and take your next shot before someone else does.