Role Description The Sr. Clinical Consultant - Payment Integrity position is responsible for determining medical appropriateness of inpatient and outpatient services following evaluation of medical documentation, and published CMS, Coding and other industry criteria. This position will provide direction and guidance to Medical Coding Analysts, as well as cross-functional team members within Payment Integrity and Claims. Responsible for communication with medical professionals and written education material to support improved documentation and correct coding in future. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Investigate, review, and provide clinical and/or coding expertise in review of post-service, pre-payment or post-payment claims. - Conduct extensive audits on a project basis and generate response letters for review by medical director(s). - Monitor action plans as a result of the audit and track/document the whole process. - Perform comprehensive research and identify billing abnormalities, questionable billing practices, and/or irregularities. - Investigate, research, and analyze claims data applying knowledge of medical or pharmacy policy. - Work with Payment Integrity Analytics to determine audit sample and if a statistical extrapolation is possible. - Conduct audits of provider records and claims submissions to ensure appropriateness of billing practices. - Identify and document fraudulent or erroneous activity during an audit. - Determine actual overpayment that may have occurred and generate written notice to providers on audit findings. - Participate in case review and medical determination conference/consults. - Conduct reviews for medical necessity and determination of correct coding. - Facilitate improvement in overall quality, completeness, and accuracy of medical record documentation. - Coordinate education related to compliance, coding, and clinical documentation for payment integrity issues. - Act as a consultant to claims coding professionals when additional information or documentation is needed. - Take ownership of the total work process and provide constructive information to minimize problems. - Detect and identify aberrant behavior for providers and facilities. - Identify updated clinical analytics opportunities and participate in projects as necessary. - Maintain and manage case review assignments. - Ensure issues are identified, tracked, reported, and resolved. - Develop relevant training programs, policies, and procedures for claims and benefit staff. - Review and edit requirements, specifications, business processes, and recommendations related to proposed solutions. - Work directly with management teams on quality results, trending analysis, and needed process improvement. - Escalate issues to project team and management for support and/or guidance. - Keep abreast of current Medicare guidelines and Regulations and compliance standards. - Modify the system specifications as changes in regulation occur. - Perform other duties as assigned. Qualifications - Bachelor’s Degree in Nursing required (Associate’s Degree or Nursing Diploma from accredited nursing school with 2 or more years of additional experience may be substituted in lieu of a bachelor’s degree) and current RN license in good standing. - 4+ years of ICD-9, ICD10 coding experience and medical review of Medicare claims and medical documentation. - 4+ years associated business experience with Medicare policies and regulations. - Solid knowledge of the Medicare policies, CMS NCDs, LCDs, and Articles. Preferred Qualifications - CPC certification from the American Academy of Professional Coders. - 5+ years in a Medicare Insurance environment. - Experience working as a medical review nurse and coder with strong analytical and research skills. - Experience in working in a MAC or RAC with medical review and payment integrity functions. - Experience working with process improvement teams and streamlining processes. - Experience with Encoder Pro. - Proven excellent written and verbal communication skills. - Proven ability to solve process problems crossing multiple functional areas and business units. - Proven solid problem-solving skills; the ability to analyze problems, draw relevant conclusions, and devise and implement an appropriate plan of action. - Proven good business acumen, especially as it relates to Medicare. - MS Office Suite, moderate to advanced EXCEL and PowerPoint skills. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

Role Description We are seeking an experienced Aprimo Consultant to support the design, implementation, and maintenance of Aprimo workflows and Digital Asset Management (DAM) solutions. - Create and manage workflows including DCT, checklists, role assignments, attachments, DAM assets, notifications, mappings, and attribute updates - Configure work requests, navigation settings, users, groups, roles, encoded titles, business rules, extended attributes, and system types - Perform DAM configuration including field management, classifications, and rule creation - Support production environments using tools such as ServiceNow and Remedy - Execute production deployments and migrate content from development to production - Conduct testing activities and develop technical and test case documentation - Develop and maintain default scripts and validation scripts - Implement workflow improvements and automate manual processes - Support Aprimo customizations and integrations with other systems Qualifications - Hands-on experience with Aprimo DAM and workflow configuration (4+ years of experience) - Strong knowledge of system administration, testing, and deployment processes - Familiarity with IT support tools and process automation - Good problem-solving and documentation skills

Role Description I have an opportunity for a NetSuite OpenAir Functional Consultant (REMOTE) and I am looking for a candidate who can join immediately. If you are interested, please reply with your updated resume or refer someone. - Position: NetSuite OpenAir Functional Consultant - Location: Remote with client travel (expenses will be covered) - Duration: 6 weeks to start with possibility of extension beyond 6 weeks - Visa: Green Card / US Citizen Qualifications - Very senior candidate - Experience of migrating Oracle PPM into NetSuite OpenAir Requirements - NetSuite OpenAir Functional Consultant experience Benefits - Expenses for client travel will be covered Company Description NAVTECH INC - Address: 1600 Golf Road, Suite 1200, Rolling Meadows, IL 60008 - Phone: (224) 348-1340 - Email: Alex@navtechusa.com - Website: www.Navtechusa.com - E-Verified Company

Role Description Join a team that shares your calling. At MultiCare, you’re more than just a job title — you’re part of a team built on trust that cares for each other, our patients, and our communities. Belonging here means living our mission and values every day. If your purpose and passions align with ours, you’ll find a place to grow, do meaningful work, and build a career you love in a community that feels like home. - FTE: 1.0 - Shift: Days - Schedule: Exempt - Design, build, and maintain Workday reports, dashboards, and calculated fields to support business needs. - Develop and optimize automations within Workday to streamline processes and improve data accuracy. - Rebuild and maintain Workday Adaptive Planning sheets. - Create advanced analytics and data visualizations using Workday Prism. - Experience with Power BI and Workday Orchestrations preferred. Qualifications - Bachelor of Arts in Business Administration, Computer Science, Mathematics or related field; Master’s degree preferred. - Minimum five (5) years’ experience in an analytical role. - Experience with data analysis, data visualization, forecasting, and modeling. - Experience with SQL, or similar language preferred. - Experience in Workforce Planning, Workforce Management, People Analytics, or working with HR/organizational people data systems preferred. - One (1) year of experience in Workday Adaptive. - Consideration may be given to internal candidates not meeting the minimum qualifications. Benefits - Rooted in the local community, partnering with patients, families, and neighbors across the Pacific Northwest for more than 140 years. - Competitive tuition assistance, award-winning residencies, fellowships, and career development to invest in you. - Generous PTO, Code Lavender, and Employee Assistance Programs to help you maintain balance and feel cared for in your work and life. - Respect, integrity, kindness, and collaboration guide how we care for patients, communities, and each other. - Resource Groups and outreach programs help ensure every team member feels safe, seen, heard, and valued. - Work and live where natural beauty, adventure, and strong community connections are part of everyday life. Pay and Benefit Expectations We provide a comprehensive benefits package, including competitive salary, medical, dental and retirement benefits, and paid time off. As required by various pay transparency laws, we share a competitive range of compensation for candidates hired into each position. The pay scale is $127,171.20 - $175,614.40 USD. However, pay is influenced by factors specific to applicants, including but not limited to: skill set, level of experience, and certification(s) and/or education. If this position is associated with a union contract, pay will be reflective of the appropriate step on the pay scale to which the applicant’s years of experience align.