Title: Utilization Review Specialist Location: Tuscaloosa United States Job Description: About Company: We're officially a Great Place To Work! We've always believed that supporting our team is just as important as supporting our patients. Now, we're proud to share that we've earned Great Place To Work Certification - based entirely on feedback from our own employees. This certification reflects the culture we've worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership. At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being. Our benefits include: - Medical Coverage - Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits. - Expanded Coverage - Options for domestic partners and a wider network of in-network providers. - Mental Health Support - Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching. - Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more. - Student Loan Repayment - Available for nurses and therapists. - Retirement Benefits - 401(k) plan through Voya to help employees plan for the future. - Generous PTO - A robust paid time off policy to support work-life balance. - Voluntary Benefits for Part-Time Employees - Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of patient records, treatment plans, and clinical data to determine the appropriateness of care and resource utilization. The specialist collaborates closely with healthcare providers, insurance companies, and case managers to facilitate timely approvals and optimize patient outcomes. By applying clinical knowledge and regulatory guidelines, the role helps control healthcare costs while maintaining high-quality patient care. Ultimately, the Utilization Review Specialist contributes to the integrity and sustainability of healthcare delivery systems across the United States. Minimum Qualifications: - Bachelor's degree in a healthcare or related field. - At least 2 years of experience in utilization review, case management, or clinical healthcare roles. - Strong knowledge of medical terminology, clinical procedures, and healthcare regulations. - Familiarity with insurance authorization processes and healthcare reimbursement models. - Excellent analytical, communication, and organizational skills. Preferred Qualifications: - Experience with electronic health records (EHR) systems and utilization management software. - Certification in Utilization Review (e.g., Certified Professional in Utilization Review or Certified Case Manager). - Prior experience working with managed care organizations or insurance companies. - Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines. Responsibilities: - Review and analyze medical records, treatment plans, and clinical documentation to assess the necessity and appropriateness of healthcare services. - Coordinate with healthcare providers, insurance representatives, and case managers to obtain additional information and clarify treatment details. - Make informed decisions regarding authorization, continuation, modification, or denial of services based on clinical guidelines and regulatory requirements. - Maintain accurate and detailed records of utilization review activities, decisions, and communications in compliance with organizational policies and legal standards. - Stay current with evolving healthcare regulations, payer policies, and clinical best practices to ensure consistent and compliant review processes. Skills: The Utilization Review Specialist applies clinical expertise and analytical skills daily to evaluate patient care plans against established medical criteria and payer policies. Effective communication skills are essential for collaborating with multidisciplinary teams, including physicians, nurses, and insurance representatives, to gather necessary information and explain review decisions. Organizational skills enable the specialist to manage multiple cases simultaneously while maintaining detailed documentation and meeting deadlines. Proficiency with healthcare IT systems supports efficient data retrieval and documentation of utilization review activities. Continuous learning and adaptability are important to stay updated on regulatory changes and evolving clinical standards, ensuring compliance and optimal patient care.

We’re here for one reason and one reason only – to cure cancer. Every moment is dedicated to developing treatments and every action moves us one step closer to our goal. We’ve made incredible scientific breakthroughs and our pioneering personalized CAR T-cell therapies have changed the paradigm. But we're not finished yet. Join Kite, as we make even bigger advances in cancer therapies, and help shape where our business and medical science goes next. We believe every employee deserves a great leader. People Leaders are the cornerstone to the employee experience at Gilead and Kite. As a people leader now or in the future, you are the key driver in evolving our culture and creating an environment where every employee feels included, developed and empowered to fulfil their aspirations. Join Kite and help create more tomorrows. Job Description The Senior Associate, Regulatory Writing will be responsible for writing and/or editing clinical documents for INDs, BLAs, MAAs, and associated regulatory submissions. This is an individual contributor role. Roles and Responsibilities (including, but not limited to): - Serve as medical writing contributor or lead for clinical trial-related regulatory documents - Write/edit/review content of clinical trial-associated documents for new and ongoing programs - Work with cross-functional teams to ensure production of high-quality written documents - Perform literature searches as needed and summarize data for incorporation into documents - Adhere to company Style Guide, templates, and SOPs for document development - Commit to company timelines for all assigned documents Requirements: - Bachelor’s degree required; advanced degree in life sciences preferred - BA/BS and 6+ years of relevant experience (less with advanced degree) - Strong scientific background in cellular immunology or related field, or oncology, is a plus - Experience with generating text from data or literature - Experience with clinical trial-related report documents is a plus - Demonstrated advanced writing skills with strong command of English language and grammar - Proficiency with MS Office Suite, EndNote, and MS Word templates - Strong oral and written communication skills - Efficient, organized, and able to handle short timelines in a fast-paced environment - Ability to work both independently and collaboratively - Ability to identify issues, ask questions, and propose solutions The salary range for this position is: $115,260.00 - $149,160.00. Kite considers a variety of factors when determining base compensation, including experience, qualifications, and geographic location. These considerations mean actual compensation will vary. This position may also be eligible for a discretionary annual bonus, discretionary stock-based long-term incentives (eligibility may vary based on role), paid time off, and a benefits package. Benefits include company-sponsored medical, dental, vision, and life insurance plans*. For additional benefits information, visit: https://www.gilead.com/careers/compensation-benefits-and-wellbeing * Eligible employees may participate in benefit plans, subject to the terms and conditions of the applicable plans. Kite is a biopharmaceutical company engaged in the development of innovative cancer immunotherapies with a goal of providing rapid, long-term durable response and eliminating the burden of chronic care. The company is focused on chimeric antigen receptor (CAR) and T cell receptor (TCR) engineered cell therapies designed to empower the immune system's ability to recognize and kill tumors. Kite is based in Santa Monica, CA. For more information on Kite, please visit www.kitepharma.com. Sign up to follow @KitePharma on Twitter at www.twitter.com/kitepharma. For jobs in the United States: Kite Pharma is committed to providing equal employment opportunities to all employees and applicants for employment, and is dedicated to fostering an inclusive work environment comprised of diverse perspectives, backgrounds, and experiences. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin, sex, age, sexual orientation, physical or mental disability, genetic information or characteristic, gender identity and expression, veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact ApplicantAccommodations@gilead.com for assistance. For more information about equal employment opportunity protections, please view the 'Know Your Rights' poster. NOTICE: EMPLOYEE POLYGRAPH PROTECTION ACT YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT Kite Pharma will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, (c) consistent with the legal duty to furnish information; or (d) otherwise protected by law. Our environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team. Kite Pharma provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion. For Current Kite Pharma Employees and Contractors: Please apply via the Internal Career Opportunities portal in Workday.

"Ce message est publié en prévision d'un rôle futur." French Job Description Niveau d'emploi : Biostatisticien principal FSP pour le secteur pharmaceutique RWE Localisation : Travail à domicile aux États-Unis ou au Canada Pourquoi DSSS ? Data Sciences Staffing Solutions, DSSS, est une unité au sein d'IQVIA qui fournit à nos sponsors des ressources entièrement intégrées via un partenariat de fournisseur de services fonctionnels (FSP). Cela signifie que vous bénéficiez de tous les avantages de travailler pour un CRO mondial leader du secteur tout en collaborant directement avec des équipes de sponsors interfonctionnelles expertes. Les clients sponsors comprennent des sociétés pharmaceutiques et biotechnologiques de classe mondiale qui vous offrent des opportunités uniques d’influencer l’avenir de la médecine et de faire progresser les thérapies sur le marché. Résumé du poste : Le biostatisticien principal est chargé de fournir un soutien statistique à la nouvelle recherche clinique. Avantages supplémentaires : - Possibilités de travail à distance à domicile - Équilibre travail/vie personnelle ainsi que des horaires flexibles. - Collaborer avec des équipes de statistiques et de recherche motivées et performantes - Formation technique et programme de développement sur mesure - Opportunités de recherche qui correspondent à vos compétences uniques - Un parcours professionnel prometteur - Stabilité d'emploi : engagements à long terme et opportunités de redéploiement - Concentrez-vous sur la mise sur le marché de nouveaux traitements plutôt que sur les budgets de projet et les modifications d'ordres. - Expérience avec les soumissions réglementaires. - Environnement engageant et dynamique. - Bon équilibre travail-vie personnelle. Responsabilités du poste : Accès et collecte des données : - Identifiez et accédez à diverses sources RWD, telles que les dossiers de santé électroniques (DSE), les bases de données de réclamations, les registres de patients et d'autres référentiels de données du monde réel. - Collaborer avec les fournisseurs de données et les organisations de soins de santé pour garantir la qualité, la conformité et l'accessibilité des données. - Développer des pipelines de collecte de données robustes en utilisant des techniques de programmation avancées pour soutenir les objectifs de l'étude. - Analyse des données et modélisation statistique : - Concevoir et exécuter des analyses statistiques de RWD pour générer RWE à des fins cliniques, réglementaires et commerciales. - Appliquer des méthodes statistiques avancées, notamment l'appariement des scores de propension, l'analyse de survie, la modélisation de régression et l'apprentissage automatique, pour obtenir des informations significatives. - Tirer parti de solides compétences en programmation pour développer, valider et optimiser des modèles analytiques et des scripts pour des ensembles de données RWD complexes. - Mener des recherches comparatives sur l'efficacité, des études sur les résultats en matière de santé et des analyses pharmacoéconomiques, en abordant des problèmes tels que les confusions, les biais et les données manquantes. Conception de l’étude et développement de protocoles : - Collaborer avec des équipes interfonctionnelles pour concevoir des études RWE, y compris des études de cohorte rétrospectives, des études cas-témoins et des essais pragmatiques. - Contribuer aux protocoles d'étude, aux plans d'analyse statistique (SAP) et aux rapports techniques, en garantissant que les éléments de programmation sont clairement définis. - Veiller à ce que les études soient conformes aux normes réglementaires (par exemple, FDA, EMA) pour les soumissions RWE. Rapports et communications : - Préparer des rapports, des manuscrits et des présentations de haute qualité résumant les conclusions de RWE pour les parties prenantes internes, les autorités réglementaires et les publications évaluées par des pairs. - Utiliser vos compétences en programmation pour créer des outils de reporting automatisés et des visualisations de données dynamiques pour un public non technique. - Fournir des recommandations stratégiques basées sur RWE pour soutenir le développement de médicaments, l'accès au marché et la gestion du cycle de vie. Conformité et assurance qualité : - Démontrer une solide compréhension et assurer le respect des directives réglementaires (par exemple, FDA 21st Century Cures Act, cadre EMA RWE) et des normes de l'industrie (par exemple, ISPOR, ISPE), telles qu'applicables aux statistiques. - Mettre en œuvre les meilleures pratiques en matière d'intégrité, de reproductibilité et de transparence des données grâce à un code bien documenté et efficace. - Effectuer le contrôle de qualité et la validation des résultats statistiques et de programmation. Qualifications - Doctorat en statistiques, biostatistiques ou dans un domaine connexe avec plus de 5 ans d'expérience dans l'industrie. - Expertise avérée dans les études RWD/RWE, avec une expérience pratique de l'analyse des DSE, des données de réclamation, des registres ou d'autres sources de données du monde réel. - Expérience avec différentes conceptions d'études, l'élaboration de protocoles et la rédaction de plans d'analyse statistique - Expérience démontrée en matière de soutien aux soumissions réglementaires (par exemple, FDA, EMA) en utilisant RWE. - Excellentes compétences en résolution de problèmes et en pensée critique. - Solides capacités de communication et de collaboration pour travailler avec des équipes interfonctionnelles et des partenaires externes. - Capacité à gérer plusieurs projets et à respecter les délais dans un environnement en évolution rapide. - Expérience en modélisation statistique de données cliniques et en inférence statistique - Solides compétences en programmation : maîtrise avancée des langages de programmation statistique tels que R, Python ou SAS pour la manipulation de données, l'analyse statistique et l'automatisation. - Expérience avec l'interrogation de bases de données (par exemple, SQL) et la gestion d'ensembles de données volumineux et complexes. - Familiarité avec les outils de visualisation de données (par exemple, Tableau, Power BI ou R Shiny) pour créer des présentations percutantes des résultats de RWE. - Connaissance des systèmes de contrôle de version (par exemple, Git) et des pratiques de recherche reproductibles. - Maîtrise de l'application de méthodologies statistiques pour le RWD, y compris les méthodes de score de propension, l'analyse de données longitudinales et les techniques d'inférence causale. - Basé sur un fuseau horaire aux États-Unis ou en Europe (UTC-8 à UTC+2) pour faciliter la collaboration en temps réel - Compréhension de ICH GCP, ICH E9 et connaissance générale des pratiques et normes de l'industrie. - Expérience avec CDISC, y compris SDTM, ADAM, CDASH. Expérience souhaitée : Aucune autre compétence spécialisée n’est applicable. Remarque - Nous avons des rôles de statisticien principal dans tous les domaines du FSP - Phase précoce et Phase tardive, alignés sur diverses études thérapeutiques. "This is posted in anticipation of a future role" English Job Description- Job Level: FSP Principal Biostatistician for Pharmaceutical RWE Location: Home-based in US/Canada Why DSSS? Data Sciences Staffing Solutions, DSSS, is a unit within IQVIA that provides our sponsors with fully embedded resources through a Functional Service Provider (FSP) partnership. This means you get all the benefits of working for an industry leading global CRO while collaborating directly with expert cross-functional sponsor teams. Sponsor clients include world class pharmaceutical and biotech companies offering you unique opportunities to influence the future of medicine and advance therapies to market. Job Summary: The Principal Biostatistician is responsible for providing statistical support for novel clinical research. Additional Benefits: - Home-based remote working opportunities - Work/life balance as well as flexible schedules. - Collaborating with motivated, high-performance, statistical and research teams - Technical training and tailored development curriculum - Research opportunities that match your unique skillset - Promising career trajectory - Job stability: long-term engagements and re-deployment opportunities - Focus on bringing new therapies to market rather than project budgets and change orders. - Experience with regulatory submissions. - Engaging, fast-paced environment. - Good work-life balance. Job Responsibilities: Data Access and Collection: - Identify and access diverse RWD sources, such as electronic health records (EHRs), claims databases, patient registries, and other real-world data repositories. - Collaborate with data vendors and healthcare organizations to ensure data quality, compliance, and accessibility. - Develop robust data collection pipelines using advanced programming techniques to support study objectives. Data Analysis and Statistical Modeling: - Design and execute statistical analyses of RWD to generate RWE for clinical, regulatory, and commercial purposes. - Apply advanced statistical methods, including propensity score matching, survival analysis, regression modeling, and machine learning, to derive meaningful insights. - Leverage strong programming skills to develop, validate, and optimize analytical models and scripts for complex RWD datasets. - Conduct comparative effectiveness research, health outcomes studies, and pharmacoeconomic analyses, addressing issues like confounding, bias, and missing data. Study Design and Protocol Development: - Collaborate with cross-functional teams to design RWE studies, including retrospective cohort studies, case-control studies, and pragmatic trials. - Contribute to study protocols, statistical analysis plans (SAPs), and technical reports, ensuring programming components are clearly defined. - Ensure studies align with regulatory standards (e.g., FDA, EMA) for RWE submissions. Reporting and Communication: - Prepare high-quality reports, manuscripts, and presentations summarizing RWE findings for internal stakeholders, regulatory authorities, and peer-reviewed publications. - Use programming skills to create automated reporting tools and dynamic data visualizations for non-technical audiences. - Provide strategic recommendations based on RWE to support drug development, market access, and lifecycle management. Compliance and Quality Assurance: - Demonstrate strong understanding of and Ensure compliance with regulatory guidelines (e.g., FDA 21st Century Cures Act, EMA RWE framework) and industry standards (e.g., ISPOR, ISPE), as applicable to statistics. - Implement best practices for data integrity, reproducibility, and transparency through well-documented and efficient code. - Perform quality control and validation of statistical and programming outputs Qualifications - PhD in Statistics, Biostatistics, or related field with 5+ years industry experience. - Proven expertise in RWD/RWE studies, with hands-on experience analyzing EHRs, claims data, registries, or other real-world data sources. - Experience with different study designs, protocol development, and statistical analysis plan writing - Demonstrated track record of supporting regulatory submissions (e.g., FDA, EMA) using RWE. - Excellent problem-solving and critical-thinking skills. - Strong communication and collaboration abilities to work with cross-functional teams and external partners. - Ability to manage multiple projects and meet deadlines in a fast-paced environment. - Experience with statistical modelling of clinical data and statistical inference - Strong Programming Skills: Advanced proficiency in statistical programming languages such as R, Python, or SAS for data manipulation, statistical analysis, and automation. - Experience with database querying (e.g., SQL) and managing large, complex datasets. - Familiarity with data visualization tools (e.g., Tableau, Power BI, or R Shiny) to create impactful presentations of RWE findings. - Knowledge of version control systems (e.g., Git) and reproducible research practices. - Proficiency in applying statistical methodologies for RWD, including propensity score methods, longitudinal data analysis, and causal inference techniques. - Based in a time zone within the United States or Europe (UTC-8 to UTC+2) to facilitate real-time collaboration - Understanding of ICH GCP, ICH E9 plus general knowledge of industry practices and standards. - Experience with CDISC, including SDTM, ADAM, CDASH. Desired Experience: - No further specialized skills are applicable. Note--We have Principal Statistician roles across all areas of FSP- Early Phase, Late Phase aligning to various Therapeutic studies. #LI-Remote #LI-NITINMAHAJAN IQVIA est un fournisseur mondial de premier plan de services de recherche clinique, d'informations commerciales et de renseignements sur les soins de santé pour les secteurs des sciences de la vie et de la santé. IQVIA se consacre à accélérer le développement et la commercialisation de traitements médicaux innovants pour aider à améliorer les résultats des patients et la santé de la population dans le monde entier. Pour en savoir plus, visitez https://jobs.iqvia.com IQVIA est fière d’être un employeur souscrivant au principe de l’égalité d’accès à l’emploi. Tous les candidats qualifiés seront pris en considération pour un emploi sans égard à la race, la couleur, la religion, le sexe, l’orientation sexuelle, l’identité de genre, l’origine nationale, le handicap, l’âge, l’état matrimonial ou tout autre statut protégé par la loi applicable. Des mesures d’adaptation pour les candidats handicapés sont disponibles sur demande dans tous les aspects du processus de recrutement. Si vous avez un handicap qui nécessite une mesure d’adaptation, nous vous encourageons à contacter notre équipe d’acquisition de talents au workday_recruiting@iqvia.com, afin qu’IQVIA puisse soutenir votre participation au processus de recrutement. IQVIA s’engage à faire preuve d’intégrité dans son processus de recrutement et applique une politique de tolérance zéro en matière de fraude des candidats. Toutes les informations et toutes les qualifications soumises dans votre candidature doivent être véridiques et complètes. Toute fausse déclaration, présentation trompeuse ou omission importante au cours du processus de recrutement entraînera la disqualification immédiate de votre candidature, ou la cessation d’emploi si elle est découverte ultérieurement, conformément aux lois applicables. Nous apprécions votre honnêteté et votre professionnalisme. Veuillez noter qu'il est possible que nous utilisions l'intelligence artificielle (IA) dans le traitement de votre candidature. Cependant, nous utilisons l'IA uniquement pour aider notre équipe de recrutement à sélectionner ou à évaluer les candidatures, et non pas pour remplacer la prise des décisions par les membres de notre équipe. IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, marital status, or any other status protected by applicable law. Accommodations for applicants with disabilities are available in all aspects of the recruitment process upon request. If you have a disability that requires an accommodation, we encourage you to contact our Talent Acquisition Team at: workday_recruiting@iqvia.com, so that IQVIA can support your participation in the recruitment process. IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism. Please note that we may use artificial intelligence (AI) in the processing of your application. However, we only use AI to assist our recruitment team with the screening or assessment of candidacies, and not as a substitute for human decision-making. La fourchette salariale de base potentielle pour ce poste, annualisée, est de $116,300.00 - $235,400.00. Le salaire de base réel offert peut varier selon plusieurs facteurs, notamment les qualifications liées à l’emploi telles que les connaissances, les compétences, la formation et l’expérience; l’emplacement; et/ou l’horaire (temps plein ou temps partiel). Selon le poste offert, des régimes d’incitation, des primes et/ou d’autres formes de rémunération peuvent être proposés, en plus d’une gamme d’avantages sociaux liés à la santé, au bien-être et/ou d’autres bénéfices. The potential base pay range for this role, when annualized, is $116,300.00 - $235,400.00. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and wellness and/or other benefits.

Role Description The Outpatient Clinical Documentation Integrity (CDI) Specialist supports accurate, complete, and compliant provider documentation in ambulatory settings. This role focuses on chronic condition capture, risk adjustment accuracy, quality reporting, and provider education to ensure documentation reflects the true clinical complexity of the patient population. Essential Duties and Responsibilities - Review outpatient encounters (pre visit, concurrent, and/or post visit) to assess documentation accuracy and completeness. - Identify opportunities for improved documentation related to: - Chronic conditions and disease specificity - Risk adjustment (e.g., HCCs) - Quality measures and medical necessity - Provide compliant documentation clarification via query and feedback to providers through approved communication channels. - Support accurate problem list management and ongoing condition validation. - Collaborate with coding, quality, compliance, and revenue cycle teams as needed. - Track and report CDI interventions, trends, and outcomes. - Participate in provider education and training initiatives. - Stay current on outpatient coding, risk adjustment, and regulatory guidance. Compliance & Regulatory Oversight - Ensure compliance with CMS, payer, and organizational documentation and billing requirements. - Identify potential compliance risks, including but not limited to overcoding, undercoding, and missing and/or unsupported diagnoses. - Apply knowledge of HCCs, risk adjustment, quality measures, and outpatient reimbursement methodologies as applicable. Qualifications - An active coding credential required such as - RHIA, RHIT, CPC, COC, CCS-O, CCS, CDEO, CCDS, CDIP or CCDS-O. - 3+ years of outpatient coding, risk adjustment, outpatient CDI. - Strong understanding of: - ICD‑10‑CM outpatient coding - Risk adjustment models (e.g., Medicare Advantage HCCs) - Outpatient E/M documentation requirements - Experience working in an ambulatory EHR (Epic, Cerner, or similar). Skills & Competencies - Strong clinical and analytical judgment. - Professional communication style. - Excellent written documentation skills. - Comfortable working independently in a fast-paced environment. - Proficient in Microsoft Office Applications. Physical Demands - Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. - Regular eye-hand coordination and manual dexterity is required to operate office equipment. - The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. - At times, Team Members are subject to sitting for prolonged periods. - Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. - Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.