Job Family: Clinical Appeals Nurse Travel Required: None Clearance Required: None What You Will Do: The Remote Clinical Denials/Appeals Nurse will be directly responsible for securing pre-service approvals, and reviewing pre/post service denials, medical necessity review and completing appeals and/or coordinating peer to peer reviews as appropriate. This position will perform all related job duties as assigned. Essential Job Functions: - Medical Necessity Reviews - Ensure documentation integrity - Construct warranted appeals - Coordinate pre-service authorization approvals Duties and Responsibilities: - Conduct comprehensive Denial Root-cause analysis. - Retrospective Medical Record reviews to assure complete and accurate physician/staff documentation is present to support medical necessity. - Collaboration with hospital Patient Access and Mid-Revenue Cycle - Utilize Evidence -based clinical guideline tool (Milliman ® or InterQual ®)) - Research and application of regulatory policies to support clinical appeal. - Telephonic communication with payors, provider, hospital staff and patient/family as necessary to bring the account into resolution. - Technical ability to multi-task on various systems, desktop and Microsoft applications while managing inbound calls. - Working knowledge of basic Coding Guidelines. - May be required to present oral presentations to client facility or Guidehouse staff and leadership - Attention to detail, strong organizational skills and self-motivated. - Ability to make decisions and assimilate multiple data sources or issues related to problem solving independently & accurately. - Ability to work under a timeline/deadline & provide clear & accurate update to project leader of assignment progress, hours worked & expected outcomes daily. - Familiarity with medical records assembly & clinical terminology, coding terminology additionally beneficial. - Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service. What You Will Need: - Current Registered Nursing License - Bachelor’s Degree (Relevant experience may be substituted for formal education or advanced degree) - 4+ years of clinical experience What Would Be Nice To Have: - Utilization Review experience a plus The annual salary range for this position is $68,000.00-$113,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include: - Medical, Rx, Dental & Vision Insurance - Personal and Family Sick Time & Company Paid Holidays - Position may be eligible for a discretionary variable incentive bonus - Parental Leave - 401(k) Retirement Plan - Basic Life & Supplemental Life - Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts - Short-Term & Long-Term Disability - Tuition Reimbursement, Personal Development & Learning Opportunities - Skills Development & Certifications - Employee Referral Program - Corporate Sponsored Events & Community Outreach - Emergency Back-Up Childcare Program About Guidehouse Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Owens & Minor is a global healthcare solutions company providing essential products, services and technology solutions that support care delivery in leading hospitals, health systems and research centers around the world. For over 140 years, Owens & Minor has delivered comfort and confidence behind the scenes, so healthcare stays at the forefront, helping to make each day better for the hospitals, healthcare partners, and communities we serve. Powered by more than 14,000 teammates worldwide, Owens & Minor exists because every day, everywhere, Life Takes Care™. Global Reach with a Local Touch - 140+ years serving healthcare - Over 14,000 teammates worldwide - Serving healthcare partners in 80 countries - Manufacturing facilities in the U.S., Honduras, Mexico, Thailand and Ireland - 40+ distribution centers - Portfolio of 300 propriety and branded product offerings - 1,000 branded medical product suppliers - 4,000 healthcare partners served Benefits - Comprehensive Healthcare Plan - Medical, dental, and vision plans start on day one of employment for full-time teammates. - Educational Assistance - We offer educational assistance to all eligible teammates enrolled in an approved, accredited collegiate program. - Employer-Paid Life Insurance and Disability - We offer employer-paid life insurance and disability coverage. - Voluntary Supplemental Programs – We offer additional options to secure your financial future including supplemental life, hospitalization, critical illness, and other insurance programs. - Support for your Growing Family – Adoption assistance, fertility benefits (in medical plan) and parental leave are available for teammates planning for a family. - Health Savings Account (HSA) and 401(k) - We offer these voluntary financial programs to help teammates prepare for their future, as well as other voluntary benefits. - Paid Leave - In addition to sick days and short-term leave, we offer holidays, vacation days, personal days, and additional types of leave – including parental leave. - Well-Being – Also included in our offering is a Teammate Assistance Program (TAP), Calm Health, Cancer Resources Services, and discount programs – all at no cost to you. Manages sales directly to end-users of the company’s specialty products, solutions, and services to achieve revenue, margin and sales targets within a defined territory or group of assigned customer accounts. Performs relationship management, develops sales strategy, and provides service support for assigned accounts. Ensures customer needs are acknowledged and addressed in a timely manner. The anticipated salary range for this position is $80-95k Base salary, plus an uncapped variable target of 70K, at plan. The actual compensation offered may vary based on job related factors such as experience, skills, education and location. RESPONSIBILITIES Customer Relationship Management - Serves as customers’ primary specialty products and services sales contact. - Manages the relationship with each account in an effort to ensure customer satisfaction through ongoing identification of customer needs and expectations. - Identifies, builds, and maintains customer and stakeholder relationships. Networks and manages customer relationships throughout the supply chain in support of assigned territory/accounts. - Continuously grows and maintains understanding of the hospital value analysis team and the relationships between manufacturers, distributors, Group Purchasing Organizations, and procedural supply chain. - Thoroughly learns and maintains current knowledge of the company’s specialty products, services, and competitors’ landscape. - Works with department administrators, clinicians, supply chain, and value analysis teams on all customer issues. - Logs sales activities into the Customer Relationship system. Sales Strategy Development - Orchestrates a strategic and tactical approach and selling plan to drive sales. - Forecasts, meets, and exceeds assigned sales quota through specialty product sales. - Provides accurate pipeline management and reporting and execute tactical sales plans. - Pursues business opportunities to ensure retention of existing revenue, while widening product usage and increasing customer penetration for the company’s products. - Manages contract & pricing negotiations, and performs contract management. - Provides quotes and supports all aspects of the bidding process. Maintains and corrects pricing for accuracy. - Handles sales positioning, analysis, and implementation with customers. Account Management - Grows and manages assigned specialty product accounts/territory efficiently and effectively. - Conducts sales presentations and product demonstrations. - Closes sales in accordance with sales policies and procedures. - Partners with internal teams to resolve customer service questions (AR research, large usage changes, etc.) or significant disruption issues requiring sales involvement. - Communicates shipping schedules with Distribution Center. - Performs additional duties as directed. EDUCATION & EXPERIENCE - 4 or more years of relevant sales experience (Business to Business Sales, Account Management, Healthcare Supply Chain, Healthcare Products, etc.) - Or any combination of relevant education and experience to meet the above requirements KNOWLEDGE, SKILLS, & ABILITIES - Very strong understanding of hospitals and how large hospital systems operate and/or the distribution industry and how warehouse/delivery operations function - Demonstrated functional knowledge of healthcare industry and the perioperative space - Demonstrated understanding of advanced selling techniques, including strategic selling, team selling and consultative/conceptual selling and sales performance metrics - Deep knowledge and understanding of CRM software and Account Management software systems (Salesforce) - General understanding of MS Office (particularly MS Excel) - Very strong financial management skills specifically in pricing, forecasting and developing cost justifications for product or service solutions - Demonstrated ability to profitably manage a portfolio of customer accounts as well as to significantly grow sales - Ability to create successful sales strategies for products, solutions and service offerings - Very strong leadership and people management skills with an ability to direct, coach and mentor all levels of teammates - Ability to deliver effective presentations to internal and external customers - Excellent communication and interpersonal skills with an aptitude for building strong client relationships - Excellent negotiation skills with an ability to influence most senior levels in an organization - Demonstrated ability to use critical-thinking, problem-solving, quick alternatives identification and effective decision-making skills in driving toward collective, successful customer solutions - Excellent project management, organizational and planning skills - Ability to handle multiple tasks simultaneously under pressured deadlines #LI-CS2 If you feel this opportunity could be the next step in your career, we encourage you to apply. This position will accept applications on an ongoing basis. Owens & Minor is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, sex, sexual orientation, genetic information, religion, disability, age, status as a veteran, or any other status prohibited by applicable national, federal, state or local law.

About the Temp Clinical Product Lead at Headspace: Headspace is seeking an experienced Temp Clinical Product Lead to serve as a key liaison between Product and Clinical leadership and provide senior-level clinical product partnership across high-priority product domains. This role will embed directly within product squads across core clinical experience areas—including but not limited to Measurement-Based Care, Provider & Care Hub experience, and AI safety initiatives. This is a US-based, remote Temp role that runs for about 6 months with an expected schedule of 40 hours per week. What you will do: - Clinical Product Partnership - Work directly with product teams to translate clinical requirements into product strategy, requirements, and execution plans - Ensure clinical integrity, safety, and evidence alignment in product design and decision-making - Provide structured input into PRDs, experimentation design, and go-to-market considerations - Identify clinical risks and mitigation strategies early in the product lifecycle - Serve as connective tissue between Product, Care Delivery, and Clinical Leadership. Ensure feedback loops between frontline care teams and product teams - Drive alignment on clinical standards, guardrails, and scope - Facilitate cross-functional decision-making where clinical risk or ambiguity exists - AI Safety - Review AI-enabled experiences for clinical appropriateness and safety considerations - Support iteration of escalation pathways, and risk governance - Contribute to evidence planning and execution where relevant What you will bring: Required Skills: - Advanced clinical degree (e.g., PhD, PsyD, LCSW, LMFT, LPC, MD, or equivalent) - 5+ years of clinical experience, preferably in behavioral health or digital care delivery - 3+ years partnering directly with product teams in a health tech environment - Strong familiarity with measurement-based care and clinical assessment frameworks, provider workflow optimization, digital mental health safety standards - Demonstrated ability to operate autonomously in ambiguous, fast-moving environments - Strong systems thinking and structured decision-making capability Preferred Skills: - Experience supporting AI-enabled or automated care experiences preferred About Headspace Headspace exists to provide every person access to lifelong mental health support. We combine evidence-based content, clinical care, and innovative technology to help millions of members around the world get support that’s effective, personalized, and truly accessible whenever and wherever they need it. At Headspace, our values aren’t just what we believe, they’re how we work, grow, and make an impact together. We live them daily: Make the Mission Matter, Iterate to Great, Own the Outcome, and Connect with Courage. These values shape our decisions, guide our collaborations, and define our culture. They’re our shared commitment to building a more connected, human-centered team—one that’s redefining how mental health care supports people today and for generations to come. Why You’ll Love Working Here: - A mission that matters—with impact you can see and feel - A culture that’s collaborative, inclusive, and grounded in our values - The chance to shape what mental health care looks like next - Competitive pay and benefits that support your whole self How we feel about Diversity, Equity, Inclusion and Belonging: Headspace is committed to bringing together humans from different backgrounds and perspectives, providing employees with a safe and welcoming work environment free of discrimination and harassment. We strive to create a diverse & inclusive environment where everyone can thrive, feel a sense of belonging, and do impactful work together. As an equal opportunity employer, we prohibit any unlawful discrimination against a job applicant on the basis of their race, color, religion, gender, gender identity, gender expression, sexual orientation, national origin, family or parental status, disability*, age, veteran status, or any other status protected by the laws or regulations in the locations where we operate. We respect the laws enforced by the EEOC and are dedicated to going above and beyond in fostering diversity across our workplace. *Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Headspace. Please inform our Talent Acquisition team by filling out this form if you need any assistance completing any forms or to otherwise participate in the application or interview process. Headspace participates in the E-Verify Program. Privacy Statement All member records are protected according to our Privacy Policy. Further, while employees of Headspace (formerly Ginger) cannot access Headspace products/services, they will be offered benefits according to the company's benefit plan. To ensure we are adhering to best practice and ethical guidelines in the field of mental health, we take care to avoid dual relationships. A dual relationship occurs when a mental health care provider has a second, significantly different relationship with their client in addition to the traditional client-therapist relationship—including, for example, a managerial relationship. As such, Headspace requests that individuals who have received coaching or clinical services at Headspace wait until their care with Headspace is complete before applying for a position. If someone with a Headspace account is hired for a position, please note their account will be deactivated and they will not be able to use Headspace services for the duration of their employment. Further, if Headspace cannot find a role that fails to resolve an ethical issue associated with a dual relationship, Headspace may need to take steps to ensure ethical obligations are being adhered to, including a delayed start date or a potential leave of absence. Such steps would be taken to protect both the former member, as well as any relevant individuals from their care team, from impairment, risk of exploitation, or harm. For how how we will use the personal information you provide as part of the application process, please see: https://www.headspace.com/applicant-notice

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are currently seeking a talented Supervisor to lead a Care Management / Care Coach team. This role is responsible for overseeing a team of RNs or non‑licensed Care Coaches and ensuring high‑quality care, service excellence, and operational performance. The ideal candidate will demonstrate strong clinical understanding (if RN), leadership capability, coaching skills, and the ability to effectively manage daily operations. Key Responsibilities - Operational Leadership - Oversee day‑to‑day team operations, including attendance management, call queue oversight, and adherence to client expectations. - Ensure compliance with floor management policies and service level agreements (SLAs). - Verify system and equipment connectivity prior to shift start and escalate issues to WFM, IT, or the Operations Manager as needed. - Provide real-time support to associates by answering questions and assisting with technical or process-related issues. - Ensure huddles, coaching sessions, and workflow routines are carried out consistently and on schedule. - Ensure team adherence to shift schedules, breaks, and offline activities. - Performance Management - Monitor daily quality and productivity metrics using available reports, dashboards, and databases. - Complete daily Team Leader checklists and submit weekly to the appropriate leader. - Conduct weekly performance coaching with signed coaching logs; provide additional counseling when required. - Complete regular one-on-one feedback sessions, including developmental coaching and disciplinary conversations. - Develop and maintain Individual Development Plans (IDPs) for assigned associates. - Identify high‑potential team members and assign projects or tasks to support development. - Ensure timely coaching and corrective action for non-compliance errors. - Conduct yearly performance appraisals for all assigned team members. - Communication & Alignment - Cascade process updates, product knowledge, policy changes, and client updates in a timely manner. - Meet with the team at least weekly to share updates, address concerns, and promote best practices. - Participate in calibrations and alignment sessions with Quality, Training, and other support groups. - Escalate operational issues to the Operations Manager or Shift Manager as needed. - Associate Support & Engagement - Address and help resolve HR‑related concerns promptly and professionally. - Promote positive team morale by planning team engagement and bonding activities. - Investigate potential conduct violations in alignment with internal policies and recommend appropriate disciplinary actions. - Administrative Responsibilities - Submit all required reports, including: - Weekly Coaching Logs - Weekly Huddle Agendas - Weekly & Monthly Team Performance Reviews - Yearly Performance Appraisals - Generate associate attendance records via Global ESS and ensure schedule updates reflect approved changes. - Execute process-related tasks within required turnaround times. Qualifications - Active U.S. Registered Nurse (USRN) license Requirements - Active USRN with a minimum of 2 years of post‑education clinical experience - Preferably 2–3 years of customer service or healthcare operations experience - Strong communication and interpersonal skills - Proficiency with MS Office and other computer applications Skills & Competencies - Ability to deliver timely, accurate coaching based on performance, behavior, and compliance. - Strong understanding of operational processes, internal workflows, and client requirements. - Ability to manage, motivate, and develop a team in a fast‑paced environment. - Strong analytical abilities to interpret reports and identify trends. - Ability to enforce policy adherence and conduct investigations when required. - High level of professionalism, reliability, and organizational skill. Location Work@Home USA, United States of America