Job Family: Clinical Appeals Nurse Travel Required: None Clearance Required: None What You Will Do: - Conduct pre‑ and post‑service medical necessity reviews for inpatient, observation, and outpatient hospital encounters using evidence‑based criteria such as InterQual and Milliman Care Guidelines. - Perform retrospective medical record reviews to validate completeness and accuracy of physician and clinical documentation supporting level of care and services rendered. - Identify denial root causes and determine appeal viability based on payer policies, regulatory guidance, and clinical standards. - Prepare, submit, and track clinical appeals, including written appeals. - Collaborate with Patient Access, Case Management, Utilization Management, Coding, and Mid‑Revenue Cycle teams to resolve denials and prevent recurrence. - Research and apply payer‑specific policies, CMS regulations, and contractual language to support appeal arguments. - Track and report denial and appeal outcomes, identify trends, and provide recommendations for process improvement and staff education. - Maintain accurate documentation of all review activities in hospital and payer systems in accordance with compliance standards. What You Will Need: - Current unrestricted Registered Nurse license in the state you reside. - Requires a University Degree and minimum 4-6 years of prior relevant experience in acute care clinical experience in hospital setting (Relevant experience may be substituted for formal education or advanced degree) - Prior experience in clinical denials, utilization review, case management, or appeals required - Experience with InterQual and/or Milliman Care Guidelines, and electronic medical record systems. What Would Be Nice To Have: - Bachelor of Science in Nursing - Master’s degree in nursing - Compact State RN License - Experience with inpatient level‑of‑care denials, DRG downgrades, and CMS payer rules. - Strong knowledge of hospital revenue cycle workflows, medical necessity review, and payer regulations. - Excellent analytical, organizational, and written communication skills with the ability to independently manage multiple cases. #LI-DNI 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.

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 115,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: - Career development with an international company where you can grow the career you dream of. - Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. - An excellent retirement savings plan with a high employer contribution · Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. - A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. - A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity This position is a field-based position based in Phoenix, AZ in the Cardiac Rhythm Management division. As a global leader in Cardiac Rhythm Technologies, we focus on innovative technologies that can improve the way doctors treat people with heart arrhythmias or irregular heartbeats. What You’ll Work On Under general direction, the CRM Product Support Specialist provides comprehensive engineering, sales, educational, and technical support. This role responds to field inquiries from physicians, healthcare professionals, patients, and field sales staff regarding CRM (Cardiac Rhythm Management) products. Key Responsibilities: - Clinical Interface: Acts as a clinical interface between the medical community and the business. - Relationship Building: Demonstrates the ability to build and sustain credible business relationships with customers and shares product expertise accordingly. - Comprehensive Support: Provides engineering, sales, education, and clinical support in response to field inquiries on an as-needed basis. Demonstrates a thorough command of all CRM products, related product and technical knowledge, trends, and players. - Training and Education: Develops, leads, and/or facilitates training sessions and other programs on CRM products for healthcare professionals. - Sales Support: Provides additional back-up support to CRM Sales Representatives. Required Qualifications - Bachelor’s degree in Bio-Medical Engineering, related field or equivalent healthcare experience. - A minimum of 0-2 years of related experience or a program certification from an accredited cardiac training program. - Must have the capability to obtain certification in CRM products - Demonstrated knowledge of cardiology, electro-physiology, or cardiac electro-physiology procedures. - Familiarity with cath lab and operating room procedures and protocol - Demonstrate advanced knowledge of cardiac pacing systems. - Must apply engineering skills and abilities to interpret and solve complex clinical problems - Must possess strong written and verbal communication skills, along with excellent interpersonal, presentation, analytical, and organizational abilities. Additionally, must be able to meet deadlines effectively. - Must be detail-oriented and capable of working independently - Must be able to collaborate effectively with engineers, technical specialists, vendors, and customers to achieve assigned goals. Additionally, must be capable of managing multiple assignments simultaneously and efficiently. - Must have extensive personal computer skills, including experience with Microsoft Office or equivalent software, for tasks such as graphics, word processing, databases, and authoring programs, to develop presentation materials. Apply Now Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: www.abbottbenefits.com Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity. Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews. The base pay for this position is $55,300.00 – $110,700.00In specific locations, the pay range may vary from the range posted. JOB FAMILY: Support Services DIVISION: CRM Cardiac Rhythm Management LOCATION: United States of America : Remote ADDITIONAL LOCATIONS: WORK SHIFT: Standard TRAVEL: Yes, 50 % of the Time MEDICAL SURVEILLANCE: Not Applicable SIGNIFICANT WORK ACTIVITIES: Continuous standing for prolonged periods (more than 2 consecutive hours in an 8 hour day), Continuous walking for prolonged periods (more than 2 hours at a time in an 8 hour day), Driving a personal auto or company car or truck, or a powered piece of material handling equipment Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans. EEO is the Law link - English: http://webstorage.abbott.com/common/External/EEO_English.pdf EEO is the Law link - Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf

When our values align, there's no limit to what we can achieve. At Parexel, we all share the same goal - to improve the world's health. From clinical trials to regulatory, consulting, and market access, every clinical development solution we provide is underpinned by something special - a deep conviction in what we do. Each of us, no matter what we do at Parexel, contributes to the development of a therapy that ultimately will benefit a patient. We take our work personally, we do it with empathy and we're committed to making a difference. At Parexel, we are a leading Clinical Research Organization (CRO) specializing in delivering life‑changing medicines to patients. We are seeking a Clinical Research Associate (CRA) to join our team. As a CRA, you’ll be joining a fast‑paced, driven environment that’s helping to make a life‑changing difference to patients by ensuring high‑quality clinical trial execution, building strong site partnerships, and maintaining compliance across all phases of a study. Through the collaboration and diversity of our teams, CRAs are provided with multiple opportunities to excel and discover where their skills can take them. Who We’re Looking For - Detail‑oriented and a strong problem solver - Highly communicative, collaborative, and adaptable - Motivated, accountable, and able to work independently - Positive, professional, and comfortable supporting virtual and in‑person teams What You’ll Do - Monitor clinical trial sites through on‑site and remote visits - Build and maintain strong relationships with investigators and site staff - Collaborate with cross‑functional teams to meet project timelines - Manage site‑level study documentation, systems updates, and visit reports - Implement corrective actions when needed to maintain study integrity - Ensure sites are always audit- and inspection-ready Additional Details - Home‑based role; only candidates residing in Mexico City are eligible - Must be fluent in English and Spanish - Bachelor’s degree in life sciences, pharmacy, nursing, or related field is required - A minimum of 1 year of CRA experience required - Must be able to travel and hold a valid driver’s license Why Join Us - Be part of groundbreaking projects pushing the boundaries of clinical research - Work in a collaborative and inclusive environment that values your expertise - Unlock career growth and professional development opportunities - Enjoy work‑life balance and flexible working arrangements If this job doesn’t sound like your next step, but you know someone who’d be a perfect fit, feel free to share this opportunity with them! At Parexel, we embrace flexibility and understand the importance of balancing your career with your personal life. Come join us where learning is constant and you’re exposed to a world of experiences and open doors.

About Us We are developing potentially best in class therapies for patients living with severe autoimmune diseases. Our lead antibody, claseprubart (DNTH103), is purposefully engineered with extended half-life, improved potency, and high selectivity for only the active C1s complement protein that drives disease pathology – enabling less frequent and more convenient self-administered subcutaneous injections. Our second clinical candidate, DNTH212 is a first and potentially best in class, bifunctional inhibitor that targets clinically validated and complementary disease modifying mechanisms, Type 1 IFN suppression and B cell modulation – enabling potential for improved clinical outcomes and patient friendly convenient, self-administered subcutaneous injections. To learn more, please visit www.dianthustx.com and follow us on LinkedIn. About the Role We are building our Clinical team and need two Senior Clinical Trail Associates who are open to owning end-to-end processes. You will report directly to the respective Senior Director, Clinical Development Operations global leads. As the Senior Clinical Trial Associate (Sr. CTA)/ Sr. Associate, you will play a crucial role in the Clinical Development Operations (CDO) department to support the planning, execution, and management of clinical trials in accordance with regulatory requirements and industry best practices. In this role, you will collaborate with cross functional study teams, clinical Research Organizations (CROs), and other external vendors to ensure the successful delivery of clinical study activities. You must have experience supporting global clinical study teams in order to be successful. Experience in rare diseases is ideal, however not required. We are looking for someone who can grow with our organization and will continue to support your ongoing development. We are building a culture of individuals who hold our core principles at the center of our operations, with the goal to elevate the care of our patients’ lives. We are open to you working remotely. Key Responsibilities - Provides support to assigned clinical studies, taking on various responsibilities to support project and study deliverables. - Coordinates, attends and may lead study team meetings; ensures appropriate meeting scheduling and documentation, including creation, distribution and filing of meeting agendas and minutes. - Maintains and generates applicable study trackers and documents (for example: action-decision log, storyboard, patient enrollment and IRB approvals). - Monitors clinical trial insurance and license agreements across studies and work with vendors to ensure current agreements. - Supports the development and review of study documents, including study manuals. - Maintains knowledge and acts as team super-user or subject matter expert for study-related systems and processes. - Manages deliverables and navigates changing priorities. - Supports the clinical team with coordination and preparation for investigator meetings, PI calls, conferences as well as internal clinical meetings. - Supports management of the Trial Master File according to Sponsor Oversight plan to ensure accuracy and completeness. - Assists with study budget oversight, including invoice tracking, reconciliation and collaboration with cross-functional teams and vendors. - Participates in vendor selection and management meetings (e.g., CROs, IVRS, Central Labs, etc). Experience - BA/BS degree or equivalent, relevant work experience. - Minimum of 5 years’ experience working on clinical studies in pharmaceutical, biotech, or CRO setting preferred. Prior CTA experience required. - Excellent interpersonal and communication skills with ability to work collaboratively across functional teams. - Strong organizational and time management skills, and strong attention to detail. - Knowledge of global regulatory and compliance requirements for clinical research. - Experience with essential documentation for Trial Master Files required. - Knowledge of drug development, clinical operation processes, medical terminology, and procedures according to FDA GCP/ICH regulatory guidelines. - Excellence with MS Office products Word, Excel, SharePoint, PowerPoint. - Experience working with clinical trial systems (CTMS, IRT, EDC) preferred.