Top Clinical Outcomes Executive jobs in Iowa

Top Clinical Outcomes Executive designs studies that evaluate clinical outcomes data and uses the results of these studies to develop clinical process improvement initiatives. Defines performance metrics to review program effectiveness, balancing clinical and financial concerns. Being a Top Clinical Outcomes Executive evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Requires a bachelor's/master's degree, current RN license. Additionally, Top Clinical Outcomes Executive typically reports to top management. The Top Clinical Outcomes Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. To be a Top Clinical Outcomes Executive typically requires 8+ years of managerial experience. (Copyright 2024 Salary.com)

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Operations & Clinical Claims Specialist
  • OUTCOMES OPERATING INC
  • Des Moines, IA OTHER
  • Job Details

    Job Location:    W Des Moines Office - West Des Moines, IA
    Salary Range:    Undisclosed

    Description

    JOB SUMMARY

    The Operations and Clinical Claims Specialist is responsible for supporting the Revenue Cycle Management (RCM) operations, onboarding of client programs and process improvement while collaborating on strategic projects.

    ESSENTIAL DUTIES & RESPONSIBILITIES

    Revenue Cycle Management - Clinical Claims

    • Support all aspects of revenue cycle management (RCM) pertaining to pharmacy services provided as a medical benefit (claim posting and submission, payment posting and claim reconciliation, denials management, repot generation).
    • Understands and can speak to billing and reimbursement protocols, set forth by HIPAA and other government compliance authorities with whom pharmacy clients are contracted.
      Responsible for special program implementation requiring pharmacy clinical billing.

    Operational Analysis and Process Implementation

    • Analyze organizational processes and data as required.
    • Identify areas for process improvement to improve quality, productivity, and efficiency.
    • Implement process improvements based on the defined requirements and objectives.
    • Synthesize data and feedback from users, clients, management, and data reporting tools to deliver progress reports, and enhancement evaluations
    • Assist with ad-hoc projects as required.

    Subject matter expert on all product offerings

    • Acquire a high-level competency in full offering of Company’s software products or services.
    • Possess advanced knowledge and understanding of healthcare industry and all assigned products.

    Qualifications


    KNOWLEDGE & REQUIREMENTS

    What is expected of you and others at this level

    • Applies comprehensive knowledge and a thorough understanding of concepts, principles, and technical capabilities to perform varied tasks and projects
    • May contribute to the development of policies and procedures
    • Develops technical solutions to a wide range of difficult problems
    • Completes work; independently receives general guidance on new projects
    • Work reviewed for purpose of meeting objectives

    Preferred Qualifications

    • Minimum of 2 years’ experience in revenue cycle management within a healthcare clinic or hospital
    • Minimum of 2 years’ experience with practice management and electronic medical records (EMR) application integrations, or training
    • Minimum of 2 years’ experience with EDI clearinghouses such as Availity or CHANGE Healthcare, and direct EDI connection to payers
    • Thorough understanding of EDI concepts, role of clearinghouse and ANSI 837P and 835 formats
    • Minimum of 2 years’ experience with provider credentialing either direct with payer or CAQH
    • Project management experience preferred

    EDUCATION & EXPERIENCE REQUIREMENTS

    • Minimum years of work experience: 2 years in healthcare industry preferably in revenue cycle management
    • Minimum level of education or education/experience: Bachelors Degree or equivalent experience

    PHYSICAL REQUIREMENTS

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

    • Frequent sitting in stationary position at a desk
    • Occasional standing, walking, stooping, kneeling, squatting, and climbing stairs
    • Occasional twisting of body
    • Occasional reaching by extending hands and arms in any direction
    • Occasional lifting, pulling, or pushing
  • 1 Month Ago

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Contracts Manager
  • Outcomes Operating Inc
  • Des Moines, IA FULL_TIME
  • JOB SUMMARY (added Nov 2023) Contract Manager is responsible for coordinating administration of customer and vendor contract terms and conditions across multiple areas to maximize contract value; resp...
  • 20 Days Ago

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Contracts Manager
  • OUTCOMES OPERATING INC
  • Des Moines, IA OTHER
  • Job Details Job Location: W Des Moines Office - West Des Moines, IA Salary Range: Undisclosed DescriptionJOB SUMMARY (added Nov 2023) Contract Manager is responsible for coordinating administration of...
  • 27 Days Ago

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Senior Network Enablement Specialist
  • OUTCOMES OPERATING INC
  • Des Moines, IA OTHER
  • Job Details Job Location: W Des Moines Office - West Des Moines, IA Salary Range: Undisclosed DescriptionQualifications
  • 1 Month Ago

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Sr. Sales Executive - Healthcare (Digital Transformation)
  • Hispanic Technology Executive Council
  • Des Moines, IA FULL_TIME
  • We are: Accenture Song accelerates growth for our clients across industries through sustained focus on improving customer acquisition, conversion, and retention for business-to-business and business-t...
  • 4 Days Ago

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Sr. Sales Executive - Public Services (Digital Transformation)
  • Hispanic Technology Executive Council
  • Des Moines, IA FULL_TIME
  • We are: Accenture Song accelerates growth for our clients across industries through sustained focus on improving customer acquisition, conversion, and retention for business-to-business and business-t...
  • 4 Days Ago

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Sales Executive- Employee Benefits
  • AssuredPartners, Inc.
  • Cranford, NJ
  • Please note that the duties below can vary based on the workflow of your local office. Prospect: involves using our Sale...
  • 3/28/2024 12:00:00 AM

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Sales Executive - Employee Benefits
  • Brown & Brown, Inc.
  • Irvine, CA
  • Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best...
  • 3/28/2024 12:00:00 AM

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Sales Executive- Employee Benefits
  • AssuredPartners
  • Deerfield Beach, FL
  • Overview: Love what you do but not where you do it? As a Sales Executive at AssuredPartners, you will use your existing ...
  • 3/28/2024 12:00:00 AM

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Sales Executive- Employee Benefits
  • Assured Partners
  • Houston, TX
  • Overview Love what you do but not where you do it? As a Sales Executive at AssuredPartners, you will use your existing s...
  • 3/28/2024 12:00:00 AM

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Sales Executive, Employee Benefits
  • Keenan
  • Greater Los Angeles, CA
  • Keenan has an exciting career opportunity as a Sales Executive that will be tasked with the generation of new business i...
  • 3/27/2024 12:00:00 AM

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Sales Executive- Employee Benefits
  • Assured Partners
  • Deerfield Beach, FL
  • Overview Love what you do but not where you do it? As a Sales Executive at AssuredPartners, you will use your existing s...
  • 3/25/2024 12:00:00 AM

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Account Executive-Employee Benefits
  • National Financial Partners Corp.
  • Palm Beach Gardens, FL
  • Who We Are NFP is a seven-time Best Places to Work award winner in Business Insurance who has also earned the 5-Star Div...
  • 3/25/2024 12:00:00 AM

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Sales Executive- Employee Benefits
  • AssuredPartners, Inc.
  • Deerfield Beach, FL
  • The Sales Executive is a new Producer or a Producer that does not have a book of business. In this role, the Sales Execu...
  • 3/25/2024 12:00:00 AM

Iowa (/ˈaɪəwə/ (listen)) is a state in the Midwestern United States, bordered by the Mississippi River to the east and the Missouri River and Big Sioux River to the west. It is bordered by six states; Wisconsin to the northeast, Illinois to the east, Missouri to the south, Nebraska to the west, South Dakota to the northwest and Minnesota to the north. In colonial times, Iowa was a part of French Louisiana and Spanish Louisiana; its state flag is patterned after the flag of France. After the Louisiana Purchase, people laid the foundation for an agriculture-based economy in the heart of the Corn...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Top Clinical Outcomes Executive jobs
$160,621 to $268,601