Full-Time
Clinical Reviewer
Confirmed live in the last 24 hours
AI-driven personalized healthcare solutions
Junior, Mid, Senior
Remote in USA
- Bachelor's degree in a healthcare, informatics or analytics-related discipline
- Proficiency in Python programming language
- Deep experience with healthcare data analysis in payment integrity, medical appropriateness, utilization management and/or special investigation
- Strong analytical and problem-solving skills, well-organized, capable of performing background research and with thorough attention to detail
- Excellent communication and interpersonal skills with ability to work independently and as part of a team
- Knowledge of healthcare practices, coding, claims and utilization processing workflows
- Conduct data analysis and evaluate healthcare records for inappropriate utilization and/or reimbursement
- Work with other healthcare professionals to identify potential cases of fraud, waste, abuse and errors
- Conduct thorough investigations of healthcare records and transactions
- Develop and implement strategies to improve payment integrity, utilization management and claims processing
- Develop reports and presentations on cases for management and other stakeholders
- Stay current with healthcare regulations and policies
Health at Scale offers hyper-personalized healthcare solutions leveraging proprietary artificial intelligence and machine learning technologies to optimize care delivery for individuals, including precision health benefits, personalized provider navigation, proactive risk prediction, and fraud detection. These technologies are deployed at scale in real operational settings, driving better health outcomes and affordability for customers, including major payers.
Company Stage
Series A
Total Funding
$16M
Headquarters
San Jose, California
Founded
2015
6 month growth
↓ -3%1 year growth
↓ -6%2 year growth
↑ 38%Benefits
Competitive salary
Stock options
Health benefits
401k, generous time-off
Meals and snacks
Team outings
Parental leave