Role Description This position provides clinical oversight and quality review of: - Appeal submissions prepared by review partners for escalation to the CMS Independent Review Entity (IRE) on behalf of UHC Payment Integrity - Review partner oversight of Facility DRG audits for coding and clinical accuracy and consistency - Review partner oversight of Home Health, Skilled Nursing claims audits - Oversight of cost outlier audits The role ensures that clinical arguments are accurate, complete, and defensible, with medical record evidence, coding validation, and policy references clearly articulated and aligned with CMS standards. Responsibilities include: - Reviewing vendor-prepared appeal determinations for clinical validity, clarity, structure, and consistency - Identifying gaps or risk areas prior to submission - Collaborating with internal stakeholders to mitigate regulatory and STAR rating risk - Supporting continuous quality improvement by monitoring IRE outcomes, identifying trends, and driving corrective actions across review partners This position reports to the Chief Medical Officer (CMO) for Payment Integrity. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Qualifications - Current, unrestricted Registered Nurse (RN) license - Certified Professional Coder (CPC) or equivalent nationally recognized coding certification - 4+ years of experience performing clinical denial review, appeal preparation, or denial rebuttal writing on behalf of a payer - 1+ years of experience with Inpatient facility DRG coding, auditing, or clinical validation review - Demonstrated expertise applying CMS regulations, coverage determinations, clinical validation principles, and coding standards (ICD 10 CM/PCS, Official Coding Guidelines) - Advanced proficiency with EMR systems, Microsoft Office tools, and AI/ML to support clinical review, documentation, and reporting Requirements - Demonstrated responsibility for appeal quality and regulatory defensibility - Triage complex cases requiring CMO involvement and review outcomes of escalated clinical determinations - Render nurse or analyst level determinations for administrative aspects of appeals based on clinical documentation, policy interpretation, and coding guidance - Perform second level clinical quality review of cases overturned by the CMS Independent Review Entity (IRE) - Monitor IRE outcomes and appeal trends to support continuous clinical quality improvement - Collaborate with Payment Integrity, Appeals & Grievances, vendors, and internal stakeholders - Demonstrate solid clinical judgment and written communication skills Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) Company Description At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone—of every race, gender, sexuality, age, location and income—deserves the opportunity to live their healthiest life. We are committed to mitigating our impact on the environment and enabling equitable care that addresses health disparities and improves health outcomes.

• Develop and execute the commercial training strategy aligned with business priorities • Design and maintain onboarding, continuing education, certification, and new product training programs • Create engaging learning content, including instructor-led materials, eLearning, videos, job aids, presentations, and sales enablement resources • Deliver training through a blend of classroom, virtual, and self-paced learning formats • Develop training focused on Justrite Safety Group's value proposition, go-to-market strategy, product portfolio, STUD-E, and commercial capabilities • Create sales enablement tools that reinforce learning and support effective customer engagement • Manage the company's learning management system and learning technologies • Measure training effectiveness through learner feedback, completion metrics, and business results, and continuously improve programs based on insights • Partner across Product Management, Marketing, Sales, and other business functions to identify learning needs and support product launches and commercial initiatives

Role Description Reporting to the Medical Science Liaison - Therapeutics, the Medical Science Liaison (MSL) is a field-based Medical Affairs professional who serves as the external scientific face of Revance to Healthcare Professionals. The MSL will primarily work within an assigned territory, which includes California, the Pacific Northwest, Mountain West, and Midwest. The MSL develops and maintains professional relationships with external stakeholders (e.g., Thought Leaders and other Healthcare Professionals) to support their scientific and data needs. The MSL facilitates information exchange, education, and research activities for physicians and ancillary healthcare professionals regarding current and future therapies in development or commercialized by Revance. - Serves as subject matter expert and provides fair-balanced, objective, scientific information and appropriate product education. - Complies with all policies, regulations, and guidelines to ensure the safe and effective use of Revance products upon commercialization. - Responsible for leading and executing field-based medical and scientific initiatives that support Revance Therapeutics pipeline products. - Works closely with internal Revance personnel to ensure the scientific and technical needs of Medical Affairs and Clinical Development colleagues are identified and met. - Maintains monthly expenses to assigned budget parameters. - Responsible for accurate and timely documentation of activities. - Conducts all field scientific support activities under the direction of Medical Affairs leadership and in accordance with current regulatory and healthcare compliance guidelines. Qualifications - PhD, MD, PharmD, DO or other recognized doctorate level education. Requirements - Minimum of 3 years MSL experience (5 years preferred); preferably with expertise in neuromodulators (botulinum toxin/neurotoxins/movement disorders) and/or other relevant specialties. - Minimum of 5 years post professional degree, practice, or relevant transferrable experience (e.g., clinical practice, academic research, regulatory/scientific). - Experience, desire, and initiative to deliver superior services to internal and external stakeholders. - Knowledge of customer segments and market dynamics within Movement disorders. - Highly-developed interpersonal skills and demonstrated ability to develop and maintain credible medical/scientific relationships with TLs in Neurology and Physiatry. - Capability to work independently or in a cross-functional team structure and to adjust effectively to work within new structures, processes, requirements, or cultures. - Working knowledge of drug development, regulatory approval processes, clinical trial methodologies, and guidelines. - Knowledge of PhRMA, OIG, and other regulatory guidelines relating to compliant medical and scientific communications. Benefits - $160,000-$190,000 annual base salary and annual performance bonus. - Flexible PTO, holidays, and parental leave. - Generous healthcare benefits, HSA match, 401k match, employer paid life and disability insurance, pet insurance, wellness discounts, and much more! Company Description Revance is a global company developing, producing, and distributing industry-leading, differentiated products across aesthetics, skincare, and therapeutics. Revance drives innovation beyond convention to offer treatment options for individuals across generations. The Company’s vision is to redefine excellence in aesthetics, skincare, and therapeutics through science-powered innovation, with an unwavering commitment to its providers, patients, and consumers. - Revance’s award-winning products are the result of robust research and development, driven by renowned scientists. - Revance is advancing treatments for movement disorders with DAXXIFY® (daxibotulinumtoxinA-lanm) for injection, the first and only peptide-formulated botulinum toxin. - This differentiated formulation is designed to deliver consistent clinical outcomes and sustained symptom control – addressing a significant unmet need in cervical dystonia.

Role Description Caring Senior Service is seeking a strategic, growth-minded General Manager of Caring Anywhere to lead one of our most innovative business units. This role is ideal for a results-driven leader who is passionate about business growth, operational excellence, customer experience, sales leadership, and market development. The General Manager will be responsible for: - Leading the overall growth, profitability, market incubation, virtual care delivery, and operational success of Caring Anywhere. - Driving revenue in non-protected territories while building the client base, referral network, caregiver pool, infrastructure, and market presence needed to support future franchise success. Qualifications - Proven leadership experience in business operations, sales, healthcare services, home care, senior care, franchise operations, or related field. - Strong understanding of revenue growth, profitability, client acquisition, and performance management. - Experience leading teams, developing talent, and creating accountability systems. - Ability to build referral relationships and support market expansion strategies. - Strong communication, planning, analytical, and problem-solving skills. - Comfortable working with CRM systems, reports, dashboards, KPIs, and business intelligence tools. - Ability to collaborate across departments and with executive leadership. - Entrepreneurial mindset with the ability to lead in a growing and evolving business unit. Requirements - Develop and execute annual and long-range growth strategies for Caring Anywhere. - Drive sustainable revenue growth, profitability, and operating efficiency. - Identify and develop strategic markets with future franchise potential. - Build market incubation plans, market readiness scorecards, and transition-ready market strategies. - Recruit, onboard, coach, and develop Home Care Consultants. - Lead internal sales operations and improve inquiry-to-admission conversion performance. - Strengthen referral development, territory expansion, and healthcare/community partnerships. - Oversee service delivery operations, client retention, customer experience, and utilization. - Improve scalability through technology, automation, CRM utilization, dashboards, and reporting. - Build a high-performing, accountable team focused on growth, innovation, and results. Benefits - Earn an annual salary based on experience, with additional performance-based bonus opportunities tied to growth, profitability, market development, and key business outcomes. - Lead a high-impact growth initiative. - Shape the future of Caring Anywhere. - Build new markets and referral partnerships. - Develop sales and operational teams. - Improve access to care for seniors across the country. - Work with a mission-driven organization committed to helping seniors stay at home.