Clinical Research Analyst RN Specialist
hace 2 semanas
UnitedHealth Group, a global leader in healthcare, empowers individuals to live healthier lives by connecting people with care, pharmacy benefits, data, and resources. As a Clinical Investigation Analyst RN, you will play a vital role in improving health outcomes by analyzing medical records and identifying opportunities for cost savings.
This position offers a dynamic work environment where you can utilize your clinical expertise to drive business growth while promoting a culture of diversity, inclusion, and innovation.
About the JobWe are seeking a skilled Clinical Investigation Analyst RN who will be responsible for reviewing medical records to ensure accurate billing practices. You will exercise judgment and decision-making skills to analyze complex payment decisions, adhering to state and government compliance guidelines and company policies.
Your key responsibilities will include:
- Investigating and reviewing claims to identify errors and waste, recommending providers for review and working with analytics to increase line of business savings.
- Identifying opportunities for clinical analytics and participating in projects necessary to achieve client objectives.
- Maintaining daily case review assignments with high accuracy and providing clinical explanations to providers.
You will also participate in provider/client/network meetings, provide education through written communication, and participate in additional projects as needed.
Required Skills and QualificationsTo succeed in this role, you will need:
- A valid, active, and unrestricted RN license.
- Intermediate Windows PC navigation proficiency and ability to navigate multiple systems.
- Professional proficiency in both English and Spanish.
Certified coder certifications such as AHIMA or AAPC are highly valued, but not required.
BenefitsAs a member of our team, you will enjoy:
- A competitive salary of $60,000 - $80,000 per year, based on location and experience.
- A comprehensive benefits package, including medical, dental, and vision insurance.
- Opportunities for career growth and professional development.
- A dynamic work environment that promotes diversity, inclusion, and innovation.
At UnitedHealth Group, we are committed to creating a healthier world by advancing health equity, improving health outcomes, and reducing costs. We believe in fostering a culture of diversity, inclusion, and innovation, and we strive to make a positive impact on the communities we serve.
-
Clinical Investigation Healthcare Specialist
hace 4 semanas
San Juan, San Juan, Puerto Rico UnitedHealth Group A tiempo completoCompany OverviewOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.Job DescriptionThe Clinical Investigation Healthcare Specialist will be responsible for reducing medical costs by identifying waste and error in provider billing practices. This role involves determining the accuracy of bills...
-
Healthcare Utilization Specialist
hace 3 semanas
San Juan, San Juan, Puerto Rico Elevance Health A tiempo completoAbout the RoleWe are seeking a skilled Healthcare Utilization Specialist to join our team at Elevance Health. This is an exciting opportunity for a motivated and detail-oriented individual to work in a dynamic environment.Job SummaryThe Healthcare Utilization Specialist will be responsible for conducting preauthorization reviews for diagnostic imaging...
-
Data Analyst Specialist
hace 3 semanas
San Juan, San Juan, Puerto Rico Popular A tiempo completoJob OverviewWe are seeking a highly skilled Data Analyst to join our team at Popular.Salary RangeThe estimated salary for this position is $80,000 - $110,000 per year, depending on experience.Key ResponsibilitiesFinancial Analysis: Obtain and analyze financial data to prepare projections and financial models. Summarize and report findings to support business...
-
Credit Analyst Specialist
hace 4 semanas
San Juan, San Juan, Puerto Rico Popular Bank A tiempo completoJob Description:This position is a key part of our Commercial Banking Center team, responsible for managing commercial loan applications and renewals. The Credit Analyst will work closely with the team to ensure compliance with regulations and underwriting according to bank policies.Key Responsibilities:Research and analyze financial information to assess...
-
Data Analyst
hace 3 semanas
San Juan, San Juan, Puerto Rico UnitedHealth Group A tiempo completoUnitedHealth Group is a global healthcare leader, dedicated to improving health outcomes for millions of people worldwide. Our team is committed to delivering innovative solutions that connect individuals with the care, resources, and benefits they need to thrive.The role of Data Analyst - Business Intelligence Specialist is crucial in driving this mission...
-
Clinical Care Coordinator
hace 1 mes
San Juan, San Juan, Puerto Rico Floral Long Term Care A tiempo completoJob Title:Clinical Care CoordinatorJob Summary:Fulfill a critical role in our team as a Clinical Care Coordinator at Floral Long Term Care. As a skilled Registered Nurse, you will oversee patient care, ensuring seamless interactions between healthcare professionals and residents.Responsibilities:Develop and maintain patient care plans, collaboratively with...
-
Clinical Reviewer and Coding Specialist
hace 2 semanas
San Juan, San Juan, Puerto Rico UnitedHealth Group A tiempo completoAbout the Role:We are seeking a highly skilled Clinical Reviewer and Coding Specialist to join our team at UnitedHealth Group. This is an exciting opportunity to work with a global organization that delivers care, aided by technology to help millions of people live healthier lives.Job Summary:The successful candidate will be responsible for conducting...
-
Data Analyst
hace 1 mes
San Juan, San Juan, Puerto Rico abarca health A tiempo completoAbout the RoleAbarca Health is seeking a skilled Data Analyst to join our team. As a Data Analyst, you will play a key role in driving business decisions by analyzing data and providing insights to stakeholders.Key ResponsibilitiesAnalyze data from healthcare claims to assess trend performance and identify potential operational and clinical...
-
Healthcare Professional
hace 7 días
San Juan, San Juan, Puerto Rico Protalents A tiempo completoAt Protalents, we value diversity and inclusion. As a patron committed to equal employment opportunities and affirmative action for women, minorities, veterans, and individuals with disabilities, we strive to create an environment that fosters growth and success.We are seeking a skilled Healthcare Professional - Clinical Care Specialist to join our team....
-
Financial Analyst
hace 5 días
San Juan, San Juan, Puerto Rico Busy Season Staffing Solutions A tiempo completoJob DescriptionWe are seeking a skilled Financial Analyst - Accounting and Reporting Specialist to join our team at Busy Season Staffing Solutions.Job Responsibilities:Prepare accurate financial statements, including balance sheets and income statements, in accordance with accounting principles and company guidelines.Analyze data using Microsoft Excel,...
-
Clinical Specialist
hace 1 mes
San Juan, San Juan, Puerto Rico Medtronic A tiempo completoCareers that Change LivesAt Medtronic, we're committed to bringing innovative medical technologies to patients around the world. As a Clinical Specialist, you'll play a critical role in delivering exceptional customer service and support to our customers.In this position, you'll work closely with our sales and customer service teams to provide technical,...
-
Senior Financial Analyst
hace 3 semanas
San Juan, San Juan, Puerto Rico First BanCorp A tiempo completoAbout UsAt FirstBank PR, we strive to be a trusted advisor to our clients and are committed to delivering exceptional customer service. Our team of over 3,100 employees in Puerto Rico, the Virgin Islands, and Florida share a passion for excellent customer service and continuously work to exceed client expectations.We are seeking an experienced Senior...
-
Clinical Specialist
hace 1 mes
San Juan, San Juan, Puerto Rico Medtronic A tiempo completoCareers that Change LivesAt Medtronic, we're committed to bringing innovative solutions to the healthcare industry. As a Clinical Specialist, you'll play a vital role in providing technical support to our customers, ensuring they receive the best possible outcomes and service.A Day in the LifeResponsibilities may include:Conducting on-site education and...
-
Financial Analyst
hace 2 semanas
San Juan, San Juan, Puerto Rico Firma de Reclutamiento en PR A tiempo completoWe are seeking a highly skilled Financial Analyst to join our team as an Investment Reporting Specialist. This role involves collaborating with various departments to prepare accurate and timely financial reports, ensuring compliance with regulatory requirements.Key Responsibilities:Investment Reporting: Prepare detailed investment reports for monthly...
-
Senior Financial Analyst
hace 1 mes
San Juan, San Juan, Puerto Rico Popular A tiempo completoAbout the Role:The Senior Financial Analyst will be responsible for obtaining and analyzing financial data, preparing projections and financial models, and summarizing and reporting findings. This role will also involve executing administrative tasks related to a credit portfolio and assisting in the preparation of credit approval memos.Key...
-
Data Insights Analyst
hace 3 semanas
San Juan, San Juan, Puerto Rico abarca health A tiempo completoCompany OverviewAbarca Health is a leading healthcare technology company that is revolutionizing the pharmacy benefits industry with its innovative solutions.We are seeking a highly skilled Data Insights Analyst to join our team and contribute to our mission of transforming healthcare.Salary: $85,000 - $110,000 per year, depending on experienceJob...
-
Clinical Nurse Reviewer
hace 1 mes
San Juan, San Juan, Puerto Rico Elevance Health A tiempo completoJob SummaryCarelon Global Solutions, a managed service delivery organization, is seeking a Clinical Nurse Reviewer to join their team. As a key member of the Elevance Health family of companies, this role will play a critical part in providing information technology and business operations services for health plans.Key ResponsibilitiesConduct...
-
Executive Support Specialist
hace 2 semanas
San Juan, San Juan, Puerto Rico Black Dragon Capital A tiempo completoJob DescriptionWe are seeking a highly skilled and experienced Executive Support Specialist to join our team at Black Dragon Capital. This is a hybrid role that requires 24/7 availability, even though it often won't be needed.About the CompanyBlack Dragon Capital is a minority-controlled, growth-driven private equity fund created by technology operating...
-
Lead Financial Analyst Specialist
hace 2 días
San Juan, San Juan, Puerto Rico Busy Season Staffing Solutions A tiempo completoAbout the RoleWe are seeking a highly skilled Lead Financial Analyst to join our team at Busy Season Staffing Solutions. As a key member of our team, you will be responsible for overseeing and managing the monthly accounting closing process to ensure timely and accurate financial reporting.
-
Senior Financial Analyst
hace 3 semanas
San Juan, San Juan, Puerto Rico Buscojobs Puerto Rico A tiempo completoJob OverviewWe are seeking a skilled Senior Financial Analyst to join our team at Buscojobs Puerto Rico. This role is responsible for collecting, analyzing, and reporting credit risk information to internal and external stakeholders.About the RoleThe ideal candidate will have at least four years of experience in credit risk, financial analysis, portfolio...