Machinify
Manager, Complex Clinical Review
Remote - US · Mid
Sponsorship not specified$115k-$130kDetected 2 days ago
Project ManagementJiraExcelAuditingPerformance ManagementLeadershipCommunicationProblem SolvingMicrosoft OfficeInternal Audit
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odds of building a lasting career here
57Sponsors, lottery-bound
Cap-exempt (no lottery)0
Sponsors this role90
Entry-level history0
PERM / green-card track0
Lottery odds (Level III)83
Fits your clock70
Sponsors, but it's cap-subject — you still face the weighted lottery (~45% per draw at Level III). Good if you win; have a cap-exempt backup on your list.
Lottery odds assume a STEM candidate.
Personalize to your clock →Employer immigration record
from this employer's Department of Labor filings
Files H-1B transfers
17 transfer filings in the last year, covering 17 workers. Median labor-condition decision: 7 days. An employer that already files transfers is one that can take over an existing H-1B.
Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.
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About the role
- Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country.
- Machinify is an employment at will employer.
- In accordance with applicable state laws, we do not inquire about salary history during the recruitment process.
Responsibilities
- Analyze and track internal business requirements and processes through document and workflow analysis.
- Perform requirements gathering to problem solve for any process-related issues that require attention from development.
- Manage team member's current assignments and collaborate across teams/departments for timeliness to ensure all internal and external SLAs are met.
- Develop and coordinate training materials, quality assurance process, and dispute response workflows for the team.
- Support internal operations to keep the team abreast of any organizational or client policy changes.
- Performs audit quality assurance reviews to supplement QA team activity as necessary based upon business need or special projects.
Requirements
- 3+ years' experience performing clinical audits of itemized bills.
- 3+ years' diverse nursing experience providing direct care in an inpatient or outpatient setting.
- Experience managing multiple projects in a team environment.
- Ability to prioritize and multitask.
- Must be a strong effective communicator, both orally and in writing, with an energetic, charismatic and approachable style.
- Proven experience in managing high performing dynamic teams.
- Ability to work in a diverse and fast paced environment.
- Strong working knowledge of Windows office systems including full Microsoft Suite and Teams.
- Experience with various forms of software and experience engaging development teams.
- will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee's geographic location.
- Required Skills/Qualifications:
- 3+ years relevant supervisory or leadership experience in similar business environment, preferred. Experience managing remote staff is a plus.
- Proven experience with healthcare industry software products and process development.
- Possess a broad and comprehensive understanding of audit standards, policies and regulations, applies a broad and comprehensive knowledge in areas including, medical chart reviews.
- Strong project management and interpersonal skills, makes sound decisions, exhibiting initiative and intuitive thinking.
- Consulted often by others for advice and opinions and recognized as a leadership role model.
- Strong interpersonal skills for interfacing with all levels of internal and external audit teams and management.
Nice to have
- Current, unrestricted nursing license in good standing is required - certified coding certification is a plus.
- 3+ years relevant supervisory or leadership experience in similar business environment, preferred.
Compensation
- In accordance with applicable state laws, we do not inquire about salary history during the recruitment process.
- $115,000 - $130,000 USD.
- The salary range is for Base Salary.
- Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee's geographic location.
- Pay range: $115,000 - $130,000 USD.
Benefits
- Full Medical/Dental/Vision for employees & their families
- Flexible and trusting environment where you'll feel empowered to do your best work
- Competitive salary, equity, 401(k) including employer match
- We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
Company info
- What We Offer - Work from anywhere in the US!
- We are proud to be an equal opportunity workplace.
- If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know.
Visa & Work Authorization
- al employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status
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This listing is sourced directly from Machinify's careers page and normalized into a canonical job model.