Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers Job Description The RCM Quality & Audit Specialist is responsible for ensuring the accuracy, efficiency, and compliance of the organization's revenue cycle processes. This role involves conducting audits, monitoring key performance indicators, identifying process improvements, and ensuring compliance with industry standards and regulations. his includes, but is not limited to claims, denial management, and functions for both onshore and offshore resources. The ideal candidate will have a strong background in medical billing, coding, and accounts receivable, with a focus on quality assurance and process auditing. Primary Job Duties: - Conduct quality reviews, audit revenue cycle claims and workflows against established standard operating procedures (SOPs) • Develop, collect, analyze, report and measure multiple quality improvement initiatives that supports RCM operational functions • Create and maintain quality measurements to track improvements in individual and team performance scores • Identify potential deficiencies in processes via analysis and trends • Create reports and deliver assessment/evaluation results to appropriate levels of leadership • Research and identify the “root cause analysis” in process improvement (eg. Ability to identify when a function/action was performed that is not included in the SOP or documentation available) and utilize audit findings to report trends and recommended training • Assist with establishing, updating and communicating new and existing procedures • Analyze and measure results of implemented policies and changes • Collaborate with various RCM Leaders and internal partners to ensure goals are being met • Serve as a SME on all RCM workflows that are being audited • Participate in special projects, audits and process improvements in support of quality assurance initiatives • Other duties, as assigned i.e. coordinate and serve as supplemental support to the National Training Team Qualifications • Associate’s or bachelor’s degree preferred • Experience with statistical analysis preferred • 3+ years experience in an auditing/QA role or equivalent RCM job related experience • 2+ years experience with athenaHeath and/or athenaOne • Advanced working knowledge of Google Suite: Sheets, Slides and Forms • Advanced Excel skills to include the ability to use formulas to analyze data, create graphs and pivot tables • Experience managing data located in multiple software systems • Experience documenting clearly defined processes, standard operating procedures and policies • Demonstrates effective written and verbal communication skills with the ability to self-edit • Must demonstrate strong interpersonal skills to interact positively and effectively • Ability to work in a very fast-paced and changing work environment • Must comply with HIPAA rules and regulations • Collaborative, customer-focused and able to create visible value • Ability to prioritize tasks, use sound judgment, and remain organized • Strong attention to detail and time management skills • Ability to accept constructive feedback and work towards self-improvement and professional growth The hourly range for this role is $24/hr to $26.45/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. - Department: Revenue Cycle

Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers Job Description The RCM Quality & Audit Specialist is responsible for ensuring the accuracy, efficiency, and compliance of the organization's revenue cycle processes. This role involves conducting audits, monitoring key performance indicators, identifying process improvements, and ensuring compliance with industry standards and regulations. his includes, but is not limited to claims, denial management, and functions for both onshore and offshore resources. The ideal candidate will have a strong background in medical billing, coding, and accounts receivable, with a focus on quality assurance and process auditing. Primary Job Duties: - Conduct quality reviews, audit revenue cycle claims and workflows against established standard operating procedures (SOPs) • Develop, collect, analyze, report and measure multiple quality improvement initiatives that supports RCM operational functions • Create and maintain quality measurements to track improvements in individual and team performance scores • Identify potential deficiencies in processes via analysis and trends • Create reports and deliver assessment/evaluation results to appropriate levels of leadership • Research and identify the “root cause analysis” in process improvement (eg. Ability to identify when a function/action was performed that is not included in the SOP or documentation available) and utilize audit findings to report trends and recommended training • Assist with establishing, updating and communicating new and existing procedures • Analyze and measure results of implemented policies and changes • Collaborate with various RCM Leaders and internal partners to ensure goals are being met • Serve as a SME on all RCM workflows that are being audited • Participate in special projects, audits and process improvements in support of quality assurance initiatives • Other duties, as assigned i.e. coordinate and serve as supplemental support to the National Training Team Qualifications - Associate’s or bachelor’s degree preferred - Experience with statistical analysis preferred - 3+ years experience in an auditing/QA role or equivalent RCM job related experience - 2+ years experience with athenaHeath and/or athenaOne - Advanced working knowledge of Google Suite: Sheets, Slides and Forms - Advanced Excel skills to include the ability to use formulas to analyze data, create graphs and - pivot tables - Experience managing data located in multiple software systems - Experience documenting clearly defined processes, standard operating procedures and policies - Demonstrates effective written and verbal communication skills with the ability to self-edit - Must demonstrate strong interpersonal skills to interact positively and effectively - Ability to work in a very fast-paced and changing work environment - Must comply with HIPAA rules and regulations - Collaborative, customer-focused and able to create visible value - Ability to prioritize tasks, use sound judgment, and remain organized - Strong attention to detail and time management skills - Ability to accept constructive feedback and work towards self-improvement and professional - growth The hourly range for this role is $24/hr to $26.45/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. - Department: Revenue Cycle

Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers Job Description The RCM Quality & Audit Specialist is responsible for ensuring the accuracy, efficiency, and compliance of the organization's revenue cycle processes. This role involves conducting audits, monitoring key performance indicators, identifying process improvements, and ensuring compliance with industry standards and regulations. his includes, but is not limited to claims, denial management, and functions for both onshore and offshore resources. The ideal candidate will have a strong background in medical billing, coding, and accounts receivable, with a focus on quality assurance and process auditing. Primary Job Duties: - Conduct quality reviews, audit revenue cycle claims and workflows against established standard operating procedures (SOPs) • Develop, collect, analyze, report and measure multiple quality improvement initiatives that supports RCM operational functions • Create and maintain quality measurements to track improvements in individual and team performance scores • Identify potential deficiencies in processes via analysis and trends • Create reports and deliver assessment/evaluation results to appropriate levels of leadership • Research and identify the “root cause analysis” in process improvement (eg. Ability to identify when a function/action was performed that is not included in the SOP or documentation available) and utilize audit findings to report trends and recommended training • Assist with establishing, updating and communicating new and existing procedures • Analyze and measure results of implemented policies and changes • Collaborate with various RCM Leaders and internal partners to ensure goals are being met • Serve as a SME on all RCM workflows that are being audited • Participate in special projects, audits and process improvements in support of quality assurance initiatives • Other duties, as assigned i.e. coordinate and serve as supplemental support to the National Training Team Qualifications - Associate’s or bachelor’s degree preferred - Experience with statistical analysis preferred - 3+ years experience in an auditing/QA role or equivalent RCM job related experience - 2+ years experience with athenaHeath and/or athenaOne - Advanced working knowledge of Google Suite: Sheets, Slides and Forms - Advanced Excel skills to include the ability to use formulas to analyze data, create graphs and - pivot tables - Experience managing data located in multiple software systems - Experience documenting clearly defined processes, standard operating procedures and policies - Demonstrates effective written and verbal communication skills with the ability to self-edit - Must demonstrate strong interpersonal skills to interact positively and effectively - Ability to work in a very fast-paced and changing work environment - Must comply with HIPAA rules and regulations - Collaborative, customer-focused and able to create visible value - Ability to prioritize tasks, use sound judgment, and remain organized - Strong attention to detail and time management skills - Ability to accept constructive feedback and work towards self-improvement and professional - growth The salary range for this role is $65,000,00 to $70,000,00 in base pay and exclusive of any bonus or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. - Department: Revenue Cycle

Join our growing organization in making a difference. We are seeking a Quality Nurse for our Onco360 Specialty Pharmacy in Houston, TX. This will be a Full-Time position, Monday to Friday from 8am to 4:30pm CST. Role can be worked remotely but it is required that you live within a commutable distance to our pharmacy located in Houston, TX. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. A career with us is more than just a job. It's an opportunity to connect and care for our patients, providers, communities and each other. We attract extraordinary people who have a strong desire to live our mission - to better the lives of those battling cancer and rare diseases. Compassion is more important than numbers. We value teamwork, respect, integrity, and passion. We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth. Starting salary from $80,000 annual and up We offer a variety of benefits including: - Medical; Dental; Vision - 401k with a match - Paid Time Off and Paid Holidays - Tuition Reimbursement - Company paid benefits – life; and short and long-term disability Quality Nurse Position Summary: The Quality Nurse works across the organization leveraging relationships with internal teams, patients, and providers to ensure the organization is providing quality patient care. The Quality Nurse provides expertise and participates in clinical and essential quality management activities within the Quality Department. Activities will include but are not limited to the quality audit process, medical record reviews, medical record documentation related to accreditation standards, and quality related events. When program opportunities or improvements are identified, provide escalation to the Director as appropriate. The Quality Nurse will work with the Director to provide recommendations, champion next steps, and obtain resolution as needed. Quality Nurse Major Responsibilities: - Performs medical record / chart audits and documents opportunities related to high quality, safe, and appropriate patient care. - Interacts telephonically with patients to counsel and assess when clinical intervention would be appropriate. - Demonstrates performance that improves the overall quality of care for our patients by thoroughly reviewing patient’s diagnosis, therapy line, adherence, co-morbidities, and information collected upon initial patient assessment leading to conducting and documenting the re-assessment. - Collaborate with the Director to develop auditing processes and training to ensure adherence to quality processes. - Tracks and trends quality results to inform continuous improvement opportunities. - Performs other tasks as assigned, maintains high attention to detail on all tasks and completes things in a timely, often independent, manner. - Works all projects that are assigned by the Director or Vice President of Pharmacy Operations. Quality Nurse Qualifications: Education/Learning Experience - Required - graduate from an accredited school with Bachelor of Science degree in Nursing Work Experience - Required: 2+ years in specialty pharmacy, quality process, patient care type of role Skills/Knowledge - Required: Caring clinical patient care, CPR+ knowledge, problem solving, patient education / intervention, and excellent communication skills (verbal and written). Self-starter who can work independently with little to no guidance. Licenses/Certifications - Required: Licensed Registered Nurse (RN) - License must be in good standing in the state of practice