Salary Range: $215,000 - $290,000 As Medical Director – Payment Integrity at EXL Health, you sit at the intersection of clinical practice, payor operations, and financial stewardship. You leverage your clinical expertise, managed care experience, and deep understanding of payer guidelines, regulatory requirements, and industry-standard policies to ensure claims are paid accurately, appropriately, and in full compliance with state, federal and plan-specific policies. In this role, every decision influences how healthcare dollars are safeguarded and allocated, making you a key clinical authority within EXL’s Payment Integrity team. You collaborate closely with senior leaders, analytics partners and Operations teams to connect clinical insight with business strategy. When coding changes, regulatory updates, or new data patterns emerge, you help interpret their clinical impact and shape how our payment integrity programs respond, contributing to the evolution of new concepts and solutions.

• Manage direct reports and maintain the hiring process for any internal (non-student) team members • Scale processes for reviewing clinical student applicants for potential employment • Hire clinical students based on the needs of current and future outreach programs. This can be hundreds at a time. • Guide students through the onboarding process, which entails multiple platforms. • Find ways to automate this • Management of the clinical education Learning Management System (LMS), which includes building, maintaining, selecting, scaling, and recording educational materials • Scale and maintain communication with students for any updates and changes to the programs they are performing within • Perform all compensation functions for all students including audits and payroll • Ensure our proprietary technologies are clinically relevant and safe • For our new Clinical Communication Training application, design new modules and join meetings with academic leadership from clinical programs • Be our thought leader on how this training can contribute towards students receiving school credit hours for completion of modules • Identify and implement improvements for our current care gap closure services, including workflows and call scripts • Identify new care gap closure opportunities with new and existing clients • Review documentation for errors. • Develop and scale plans to mitigate errors and improve the workforce’s documentation • Own the quality assurance process by managing individuals who perform the reviews and completing reviews yourself. • Assist in the development and ongoing optimization of new automated review tools. • Maintain and optimize student performance dashboards • Sustain a consistent process for coaching and addressing performance issues • Manage the internal ticketing system to manage any issues experienced on the Grove, our internal software for performing Care Gap Closure • Ensure students are compliant with data security standards (HITRUST, SOC2, and HIPAA) • Manage access control for internal systems for students • Maintain Mobile Device Management (MDM) platform to ensure settings meet the standards for HITRUST, SOC2, and HIPAA • Participate in the survey process of HITRUST, SOC2, and HIPAA • Work within Vanta to maintain relevant system compliance • Be a voice on social media, representing yourself as an expert • Work with marketing team to find speaking engagements at conferences, with a focus on themes like clinical education, quality, and more • Everyone sells here. You will be asked to join sales call and marketing meetings as needed.

Department: 10172 Advocate Aurora Health Corporate - WI Transitional Care Status: Part time Benefits Eligible: Yes Hours Per Week: 20 Schedule Details/Additional Information: This will be a 0.5 FTE weekend position. Hours are Saturdays and Sundays, 0800-1830. Fully remote, high- speed internet is a requirement. Occasional holiday must have a WI OR IL RN license. After hire will be required to hold WI and IL RN license. Pay Range $35.50 - $53.25 Major Responsibilities: - Identifies the needs of patients and families and coordinates internal and external community resources within the first month of hospital discharge to reduce post-hospitalization illness/disease. - Works closely with case manager to identify high risk patients. Creates a care plan to ensure patient has appropriate resources necessary to lower readmission rates. - Maintains caseload of patients following discharge to ensure patients receive appropriate home visits, are being seen by primary physicians and taking their medications as needed. - Facilitates communications between and negotiates with patient/family, physicians, nurses, dietary, rehab, homecare, social services and other disciplines that need to collaborate to provide care for the patient. - Identifies, evaluates and acts to resolve any potential barriers to delivery of care and a timely and appropriate discharge. May coordinate and document discharge plans of care. - Works closely with the medical staff, hospital departments and ancillary services in expediting care delivery and appropriate documentation to avoid delays in timely service provision. Validates care that is provided. - Collaborates as a partner with jointly assigned social worker to ensure safe and appropriate discharge planning. - Collaborates with physicians daily regarding patient care course. Makes suggestions in expediting care and modification to a tentative on a timely basis. Licensure, Registration, and/or Certification Required: - Registered Nurse license issued by the state in which the team member practices. Education Required: - Bachelor's Degree in Nursing. Experience Required: - Typically requires 2 years of experience in nursing in an acute care or community setting. Knowledge, Skills & Abilities Required: - Excellent written and verbal communication skills. - Strong organizational, analytical and problem solving skills. - Ability to educate clinical staff and the community. - Ability to work well with physicians and other healthcare professionals. - Ability to work in a team based multidisciplinary environment. Physical Requirements and Working Conditions: - May need to operate a motorized vehicle to facilitate home visits as appropriate. - Must be able to sit, stand and walk without restriction. - Must have the ability to move about in confined spaces, including bending, twisting, kneeling, squatting and occasionally reaching one or both arms overhead. - Must be able to concentrate on detailed information, tasks, and functions for prolonged periods of time. - Must be able to speak clearly and hear in order to communicate in person or via telephone. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training - Premium pay such as shift, on call, and more based on a teammate's job - Incentive pay for select positions - Opportunity for annual increases based on performance Benefits and more - Paid Time Off programs - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability - Flexible Spending Accounts for eligible health care and dependent care expenses - Family benefits such as adoption assistance and paid parental leave - Defined contribution retirement plans with employer match and other financial wellness programs - Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Thriveworks is currently seeking Psychiatric Mental Health Nurse Practitioners in Louisiana. ***Clinicians need to be licensed and living in the state in which they will be practicing.*** Compensation: This is a Fee for Service (W2) position, the range for this position is $61,000-$89,000 per year based on 15-20 clinical hours per week. To maintain safety and best practices for our clinicians and patients via telemedicine, Thriveworks does not push or incentivize the use of stimulant medications; instead, we offer them as an option based on the client’s specific symptoms and diagnosis, with prescribing decisions left to the discretion of the clinician. We do not currently treat substance use disorders, and make every effort to refer out to an in-person provider when symptoms arise that are too severe to be treated via telemedicine only. Thriveworks Nurse Practitioners are expected to provide care to a diverse population of clients with mental health conditions such as depression, anxiety, ADHD, and more. They work with a broad range of age groups, primarily adults and adolescents, with a future focus on expanding care across the lifespan. Qualifications: - Licensed Psychiatric Mental Health Nurse Practitioner - Board Certification required - Master's in Nursing with active prescriptive authority required in the state - Understanding of AdvancedMD (AMD) EMR is a plus - Three years of experience is a plus; 1 year of psychiatry practice is required - Licensed Psychiatric Mental Health Nurse Practitioners need to be licensed and live in the state in which they will be practicing - Part-time requires 15 - 20 hours of availability per week - All clinicians are required to complete an in-house training on our ADHD treatment standards, guidelines, and approach, followed by a brief exam. While all new hires are enrolled in the ADHD Clinic and expected to accept and treat ADHD clients, there are no quotas for the number of clients or prescriptions. What We Need: - Make Psychiatric assessments and evaluations of clients in an ongoing telemedicine capacity - Willingness to treat 14 years old and up - Prescribe medication to reduce mental health symptoms, as needed - Create and collaborate with clients on care plans - Complete and/or administer appropriate paperwork and assessment tools for clients - Adhere to Thriveworks' Clinical Practice Guidelines - Consult with Regional Clinic Directors and staff on clients, programs, and services at the various sites What We Give: We are dedicated to taking great care of our employees and empowering them to succeed. This enables them to focus on providing excellent care to our clients. We offer the following benefits: - Fully Remote - Remote Medical Assistants - Guaranteed, bi-weekly pay (no need to wait on reimbursement) - 401K with 3% employer match - Paid orientation and annual pay increases - Flexible scheduling (Sessions are available from 7 am–10 pm, 7 days/week) - Paid orientation, Paid Credentialing, Paid Malpractice Coverage, In-house professional development, including case consultation groups - Annual pay increases and Bonus Opportunities - Schedule Flexibility with No Show Protection and No required on-call - Amazing team culture and clinical support Who we are - about Thriveworks: Thriveworks is a trusted mental health provider with 340+ locations and a nationwide hybrid care model. We serve over 175,000 clients annually through more than 1.7 million sessions, and these numbers continue to grow. As a clinician-founded and clinician-led organization, we offer the tools, support, and community you need to build a fulfilling, long-term career. A career at Thriveworks isn’t just about finding a job that pays the bills. It’s about helping others, joining a community, and learning to thrive both personally and professionally. We believe that the success of our employees is just as important as the success of our organization; they go hand in hand. So, what do you say? Are you interested in joining our team? Apply today. #LI-Remote #LI-MS1 Interested in joining Team Thriveworks? We're thrilled to meet you! With Job scams becoming more and more frequent, here's how to know you're speaking with a real member of our team: - Our recruiters and other team members will only email you from thriveworks@myworkday.com or an @thriveworks.com email address. - Our recruiters and other team members may also contact you via text or phone to schedule an interview. - A google meets interview invitation will be sent via email and will only come from an @thriveworks.com email address. - Our interviews will take place over Google Meet (not Microsoft Teams, Zoom, or any other platform). - We will never ask you to purchase or send us equipment. If you see a scam related to Thriveworks, please report it to infosec@thriveworks.com. You can contact employment@thriveworks.com with any questions or concerns. Thriveworks is an Equal Opportunity Employer. Our people are our most valuable assets. We embrace and encourage differences in age, color, disability, ethnicity, gender identity or expression, national origin, physical and mental ability, race, religion, sexual orientation, veteran status, and other characteristics that make our employees unique. We encourage and welcome diverse candidates to apply for any position you are qualified for to bring your unique perspective to our team. By clicking Apply, you acknowledge that Thriveworks may contact you regarding your application.