Reveleer

Clinical Operations

• Assist Managers with clinical pends
• Assist with over-read feedback
• Assign manual assignments
• Assist with individual data entry production (MRR or OR1)
• Review reports daily for QA scores during the season(s) for abstractors, coders, and HPs
• Ensure collaboration among cross-functional teams for product release rollouts
• Perform additional duties as necessary to meet client obligations
• Interact with management and remote coding personnel
• Explain complex information

Clinical Operations Lead

Medical writer

• Facilitate improvement in the overall quality and completeness of Clinical Intelligence’s recapture and suspecting performance
• Review patient records to identify and validate Hierarchical Condition Category (HCC) diagnoses
• Query providers to ensure accurate and complete documentation supporting HCC and condition-related diagnoses
• Enhance RAF score accuracy and improve risk adjustment outcomes
• Apply medical terminology, disease process, treatment modality, diagnostic test, medication, and procedure knowledge to identify documentation gaps
• Validate recapture and suspect conditions based on clinical evidence
• Validate that documentation supports reported conditions
• Create queries reflecting best practice
• Formulate recommendations to improve clinical logic and workflows
• Maintain strict confidentiality of patient information in accordance with privacy regulations

Clinical Documentation Specialist – Outpatient

Artificial Intelligence

• Serve as the technical point of contact for receiving customer health-plan data in varied formats, including member, provider, clinic location, chart-retrieval detail, and claims data
• Ingest source data as-is into the SQL Server data warehouse while preserving raw data for traceability
• Build scalable, repeatable ingestion routines for varied data structures and file types
• Write and maintain SQL to transform raw source data into accurate, platform-ready outputs, including medical record retrieval load files
• Monitor pipelines for errors, anomalies, and data quality issues and remediate them before downstream impact
• Build and maintain data foundations supporting retrospective risk adjustment coding workflows
• Develop, test, and refine condition-suspecting algorithms for likely undocumented or under-documented diagnoses
• Partner with coding, clinical, and analytics teams to translate domain logic into production-grade data products
• Design and build semantic data structures that improve healthcare data accessibility for AI tools
• Refactor and clean a library of semantic analytics tables, migrate it into production, and establish automated scheduled refreshes
• Establish standards for promoting code from development to production and creating structured, reusable datasets
• Document data models, transformation logic, algorithms, and source-specific rules
• Partner with Data Management, analytics, and platform teams on production systems and handoffs
• Work with the VP of Data Strategy and cross-functional partners to improve raw-data-to-AI-ready-asset processes
• Report to the VP of Data Strategy

Data Integration Analyst, AI – Risk Adjustment

Operations

• Own the 24x7 operational health and reliability of CDM-managed production data services and workflows
• Serve as accountable leader and escalation owner for Sev-1 and Sev-2 production incidents
• Define SLAs/SLOs, escalation paths, on-call/coverage models, service-health measures, and operational performance expectations
• Drive service restoration, communication coordination, and corrective-action follow-through
• Own CDM incident and problem-management disciplines, including severity definitions, incident command, escalation, RCA, post-incident review, and corrective actions
• Track recurring failures and use MTTA, MTTR, availability, incident volume, and recurrence metrics to drive systemic improvement
• Provide technical leadership for production services operating in AWS and related enterprise environments
• Partner with Engineering on infrastructure-as-code using Terraform or comparable tooling, including repeatable configuration, deployment, and recovery
• Guide operational issues involving IAM, networking/connectivity, secure file transfer, storage, compute, logging, monitoring, and cloud dependencies
• Lead an automation-first strategy to eliminate repetitive manual work, fragile handoffs, and key-person dependencies
• Drive scripting, orchestration, automated validation, job recovery, exception handling, and self-healing patterns where appropriate
• Partner with Data Engineering on CI/CD, APIs, ETL/data pipelines, file movement, deployment/support patterns, and production automation
• Apply AI-assisted monitoring, troubleshooting, documentation, and workflow automation where appropriate
• Establish monitoring, logging, alerting, and operational dashboards that provide actionable visibility into production health
• Define production-readiness gates for workflows transitioning from implementation or engineering into Live Operations
• Require current runbooks, SOPs, recovery procedures, escalation paths, dependency maps, ownership, and cross-trained coverage before production handoff
• Define clear operating boundaries among Live Operations, Data Engineering, Data Management, Clinical Intelligence, Product, and IT
• Coordinate technical response across teams during production incidents and complex operational issues
• Build and lead a geographically distributed technical operations team with a culture of urgency, transparency, documentation, collaboration, and measurable improvement

Director, Live Operations

• Serve as the primary point of contact for a program's highest-volume AIDs and maintain direct relationships with provider office staff
• Monitor retrieval performance for large AIDs and proactively address barriers affecting chase completion
• Coordinate with provider offices on record request logistics, portal access, and recurring retrieval issues
• Distribute and rebalance daily chase assignments across the PSR team based on AID priority, chase age, and retrieval deadlines
• Monitor PSR workloads and adjust assignments to keep the queue moving and prevent aged chases from stalling
• Partner with the Retrieval Manager on weekly volume planning and flag capacity gaps
• Onboard and train new PSRs on chase workflows, AID ownership, pend code handling, and platform agent hand-offs
• Deliver ongoing coaching and refreshers on retrieval best practices, call quality, and documentation standards
• Maintain and update training materials and job aids
• Own first-line resolution of provider escalations related to retrieval outreach, record requests, or access issues
• Document escalation patterns and root causes and recommend workflow or script changes
• Escalate unresolved or systemic provider issues to the Retrieval Manager with a clear summary and recommended next step
• Track individual and team retrieval rate, pend rate, and productivity against program targets
• Provide day-to-day feedback and coaching to PSRs based on chase outcomes and call quality
• Flag underperformance or training gaps and support corrective action plans
• Ensure PSR adherence to standard retrieval processes, procedures, and documentation requirements
• Maintain accurate records on AID assignments, escalation status, and chase ownership
• Support process updates and standard operating procedure revisions

Retrieval Operations Lead

• Lead day-to-day execution of Reveleer’s retrieval program for a major customer launch covering approximately 500,000 chases beginning with the October 2026 go-live
• Own daily and weekly chase queue execution, monitoring retrieval rate, pend rate, and AID ownership across roughly one million annual chases
• Manage chase-to-AID assignments and adjust workflows as volume and provider mix change
• Resolve aged and at-risk chases and escalate systemic retrieval barriers
• Oversee performance of AI-enabled platform voice agents supporting retrieval outreach
• Monitor agent-to-human conversion and outcome metrics and identify tuning opportunities
• Maintain PSR staffing models and capacity forecasts based on volume, seasonality, and agent-enabled throughput
• Partner with the India retrieval team to align onshore and offshore capacity
• Serve as the day-to-day operational point of contact for the retrieval relationship
• Partner with Onboarding & Data Management on data quality and provider-matching issues
• Coordinate provider- and member-facing retrieval escalations with Customer Support
• Produce the Chase Status Underlying Report analysis and maintain retrieval, pend, and escalation tracking
• Build weekly and monthly scorecards for Reveleer and customer leadership
• Contribute performance narratives and data to quarterly business review materials
• Lead root-cause analysis of retrieval shortfalls, provider access issues, and agent performance gaps
• Establish escalation paths across Retrieval Services, Clinical Operations, and Engineering
• Drive corrective action plans to closure and confirm sustained improvement
• Identify opportunities to expand AI agent-enabled retrieval to additional chase types or provider segments
• Document and refine standard operating procedures for the blended agent and PSR retrieval model
• Share launch lessons learned with peers supporting other RISK, HEDIS, and IVA programs

Manager – Retrieval Operations

Product Manager

• Own the roadmap and day-to-day product management for EHR and Data Engineering pods
• Lead and participate in agile ceremonies
• Lead new product development for EHR integrations and data ingestion capabilities
• Manage relationships with EHR and other integration vendors
• Develop expertise in Reveleer data and industry standards
• Translate analytical insight into scalable product and operational solutions
• Define requirements, workflows, and data specifications from ingestion to insight
• Own business logic and specifications
• Analyze large datasets to identify patterns, diagnose issues, and validate outputs
• Develop data-spec templates and standards for data ingestion
• Triage and solve data-quality issues
• Support data-quality KPIs, monitoring, and self-service tooling
• Partner with Product, Engineering, and Implementation teams on documentation, frameworks, and repeatable processes
• Coordinate stakeholders, manage timelines, and drive projects from problem definition through execution
• Investigate and diagnose EHR integration and data ingestion issues
• Recommend solutions where applicable

Senior Product Manager, EHR – Data

Data Scientist

• Build machine learning models in classification and information extraction
• Analyze rich and complex healthcare data to build and improve existing features and models
• Implement new solutions to improve the performance of existing models
• Work with engineering teams to implement ML models into production and build ML pipelines
• Bring cutting-edge ML and NLP technologies into existing models
• Explore LLM solutions for AI models