WellSky

Lead solution development from concept to launch, align with market needs, and collaborate with internal teams to deliver high-impact healthcare solutions. | 8-10 years in healthcare technology or life sciences, experience with product management, understanding of healthcare data standards, and stakeholder engagement skills. | The Director, Solution Management - Life Sciences will play a pivotal role in WellSky’s expansion into the life sciences market, serving as a strategic interface between external stakeholders and internal teams. Positioned at the intersection of clinical informatics, product innovation, and market growth, this role is primarily focused on engaging with clients, partners, and industry leaders to shape and deliver solutions that meet evolving market demands. The ideal candidate brings deep product development experience in healthcare or life sciences, a passion for data-driven innovation, and the agility to thrive in a fast-paced, entrepreneurial environment within an established enterprise. Key Responsibilities: Lead solution development from concept to launch, with a strong emphasis on external stakeholder alignment and market responsiveness. Translate market insights and client feedback into actionable product requirements and strategic roadmaps. Engage directly with clients and industry partners to understand needs, validate solutions, and build long-term relationships. Collaborate cross-functionally with engineering, analytics, and design teams to ensure delivery of high-impact, externally validated solutions. Define success metrics and monitor performance across externally-facing product initiatives. Align solution priorities with business goals and client commitments, ensuring market relevance and competitive differentiation. Mentor and guide product team members, fostering a culture of innovation, accountability, and client-centricity. Support go-to-market planning, including sales enablement, client engagement, and external communications. Serve as a subject matter expert on WellSky’s data assets and life sciences use cases, particularly in client-facing contexts. Stay informed on industry trends, regulations, and emerging technologies, and proactively incorporate them into solution strategy. Required Qualifications: Bachelor’s degree in a relevant field (e.g., life sciences, computer science, health informatics, business, or related discipline). 8–10 years of experience in healthcare technology, life sciences, or pharma, including product development or product management roles. Strong understanding of healthcare data (clinical, claims, EMR, RWD/RWE). Experience working with or building products for biopharma, CROs, or real-world evidence applications. Preferred Qualifications: Advanced degree (MBA, MPH, MS, or similar). Familiarity with healthcare interoperability standards (FHIR, HL7, APIs). Experience in agile product development methodologies. Job Expectations: Willing to travel up to 20% based on business needs Willing to work additional or irregular hours as needed Must work in accordance with applicable security policies and procedures to safeguard company and client information Must be able to sit and view a computer screen for extended periods of time WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.

Ensure compliance with healthcare regulations, analyze healthcare data, lead quality improvement initiatives, and prepare for audits. | Minimum 4-6 years of relevant healthcare experience, knowledge of CMS and NCQA standards, and experience leading quality projects. | This job is responsible for ensuring compliance with WellSky's Utilization Management and Quality Improvement Program by serving as a clinical expert on state and federal regulations. The scope of this job includes analyzing and presenting data to establish best practices across post-acute health care settings, including LTACHs, IRFs, SNFs, and Home Health facilities. We invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities: Facilitate activities related to performance measurement and outcomes, ensure the organization meets CMS, NCQA, and other regulatory standards, stay updated on relevant regulatory changes, and support their integration into practices. Generate and validate reports to monitor performance across health plan contracts, ensuring accuracy and alignment with requirements. Conduct regular audits of UM decisions, case documentation, turnaround times, and adherence to other CMS and NCQA requirements. Understand how the UM Program is driven by the NCQA UM standards to ensure UM Program meets all NCQA requirements for accreditation. Prepare and lead committee meetings on a monthly and quarterly basis, driven by NCQA requirements. Prepare detailed quality reports, identify and analyze trends, and present findings to leadership with actionable recommendations. Support implementing corrective action plans when scoring variances occur. Support quality improvement project initiatives. Prepare for regulatory, accreditation, and contractual audits, and contribute to the remediation and documentation of audit findings. Perform other job duties as assigned. Required Qualifications: At least 4-6 years relevant work experience. Experience leading quality improvement projects and committee work. Bachelor's Degree or equivalent work experience. Preferred Qualifications: Active, unrestricted license: RN, PT, OT or SLP, with a bachelor’s degree in a related field or a combination of education and experience that includes pertinent clinical experience and advanced working knowledge of CMS standards and guidelines. At minimum, 1-2 years of working knowledge of NCQA UM accreditation standards. Must be able to prioritize, plan and handle multiple tasks and demands simultaneously, with competing deadlines. Excellent in manipulating and sorting data for analytics and reporting. Prior experience owning client compliance SLAs and ensuring success in meeting SLA requirements. Job Expectations: Willing to work additional or irregular hours as needed. Must work in accordance with applicable security policies and procedures to safeguard company and client information. Must be able to sit and view a computer screen for extended periods of time. Travel approximately 10%. #LI-PG1 # Remote WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.

Conduct patient assessments, coordinate care, and collaborate with healthcare providers to ensure optimal outcomes. | Requires a Bachelor's degree, RN licensure in specific states, and 2-4 years of relevant clinical experience, especially in emergency departments. | The Clinical Operations Nurse is responsible for completing telephonic patient evaluations and assessments for WellSky's various payer programs. We invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities Cultivate and maintain professional relationships with clients, patients, and stakeholders by providing sensitive and respectful care in line with diversity standards and human dignity. Conduct assessments with patients and providers to identify most appropriate level of care setting, identify potential gaps in care, and coordinate with stakeholders to provide resources to promote best possible outcomes and reduce readmissions. Coordinate and educate program expectations with providers, payers, and members to ensure appropriate referrals and optimized clinical outcomes. Advocate for patient needs through effective communication and service coordination and promote patient self-management and wellness by empowering patients and families to make informed choices and build supportive care systems. Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care and seamless care transitions. Responsible for making outreaches to emergency departments to provide care coordination and safe transitions for patients. Maintain accurate documentation, stay current on healthcare regulations and practices, and participate in team meetings and orientation activities to promote collaboration and continuous improvement. Perform other job duties as assigned. Required qualifications Bachelor’s degree or equivalent work experience. At least 2-4 years of relevant work experience. RN Licensure in New York and/or Oklahoma and/or Compact. At least 2 years’ experience in emergency departments. Preferred qualifications Experience in acute/ACO/post-acute care facility care coordination, discharge planning, social services, disease management, population health, home health, and/or post-acute care facilities. Job Expectations Willing to travel up to 30% based on business needs. Willing to work additional or irregular hours as needed/evening hours/holidays. Must work in accordance with applicable security policies and procedures to safeguard company and client information. Must be able to sit and view a computer screen for extended periods of time. #LI-PG1 #LI-Remote WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.

Manage project schedules, lead meetings, assign tasks, identify risks, and maintain communication between clients and internal teams to ensure successful software implementations. | Bachelor’s degree or equivalent experience, 4-6 years relevant project management experience, willingness to travel up to 25%, and ability to work irregular hours as needed. | The Implementation Project Manager is responsible for overall project management and support of client software implementation projects. The scope of this job includes managing overall project schedule by partnering with resource owners and executive sponsors to ensure activities are carried out in accordance with established goals and budgets. We invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities Create and oversee project schedules based on scope and resources, manage daily operations, and make revisions as needed to keep projects on track and within budget. Assign tasks, provide project updates and reports, identify potential risks, and lead project planning and status meetings. Develop an understanding of each client’s business and objectives to enhance project execution and identify future sales opportunities. Facilitate both project management and executive steering committee meetings to ensure alignment between client and WellSky teams. Create relationships with the client project manager and project sponsor to facilitate effective and timely communication. Leverage existing methods and procedures to facilitate consistent and repeatable results across the project team. Perform other job duties as assigned. Required qualifications Bachelor’s degree or equivalent work experience At least 4-6 years of relevant work experience Job Expectations Willing to travel up to 25% based on business needs Willing to work additional or irregular hours as needed Must work in accordance with applicable security policies and procedures to safeguard company and client information Must be able to sit and view a computer screen for extended periods of time #LI-OF1 #LI-Remote WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.

Ensure compliance with CMS and NCQA standards through performance measurement, audits, data analysis, and quality improvement initiatives in healthcare settings. | 4-6 years healthcare quality management experience, preferably clinical background (RN, OT, PT), proficiency with CMS/NCQA audits, strong communication and data skills. | Description: • Facilitate activities related to performance measurement and outcomes, ensure the organization meets CMS, NCQA, and other regulatory standards, stay updated on relevant regulatory changes, and support their integration into practices. • Comply with state, federal, and organizational standards by assisting in the development and enforcement of policies aligned with Utilization Management and Quality Improvement Program requirements. • Guide the implementation of internal audit protocols in compliance with CMS regulations and NCQA standards, and contribute to the consistency of clinical documentation and decision-making processes. • Analyze data to identify trends and areas for improvement, and execute defined projects aimed at enhancing care quality across various lines of business. • Generate and validate reports to monitor performance and compliance across health plan contracts, ensuring accuracy and alignment with requirements. • Prepare for regulatory, accreditation, and contractual audits, and contribute to the remediation and documentation of audit findings. • Perform other job duties as assigned Requirements: • Bachelor's Degree or equivalent work experience • At least 4-6 years of relevant experience in healthcare quality management and post-acute care utilization management • Preferred: Registered Nurse, Occupational Therapist, or Physical Therapist with a bachelor’s degree in a related field, or a combination of education and experience that includes pertinent clinical experience and an understanding of CMS standards and guidelines • Experience with CMS and/or NCQA audits • Ability to manage multiple competing priorities and tasks effectively • Strong written, oral, and interpersonal communication skills • Demonstrated ability to collaborate with external vendors and clients • Proficiency in manipulating and sorting data for analytics and reporting • Excellent analytical and data interpretation skills • Experience in case management in a healthcare setting • Applicants for U.S.-based positions must be legally authorized to work in the United States • Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates Benefits: • Excellent medical, dental, and vision benefits • Mental health benefits through TelaDoc • Prescription drug coverage • Generous paid time off, plus 13 paid holidays • Paid parental leave • 100% vested 401(K) retirement plans • Educational assistance up to $2500 per year

Manage compliance with healthcare quality and utilization management programs by analyzing data, ensuring regulatory adherence, and supporting audits across post-acute care settings. | Requires 4-6 years healthcare quality management experience, preferably clinical licensure (RN, OT, PT), knowledge of CMS and NCQA standards, and strong data and communication skills. | The Clinical Quality Program Manager is responsible for ensuring compliance with WellSky's Utilization Management and Quality Improvement Program by serving as a clinical expert on state and federal regulations. The scope of this job includes analyzing and presenting data to establish best practices across post-acute health care settings, including LTACHs, IRFs, SNFs, and Home Health facilities. We invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities: Facilitate activities related to performance measurement and outcomes, ensure the organization meets CMS, NCQA, and other regulatory standards, stay updated on relevant regulatory changes, and support their integration into practices. Comply with state, federal, and organizational standards by assisting in the development and enforcement of policies aligned with Utilization Management and Quality Improvement Program requirements. Guide the implementation of internal audit protocols in compliance with CMS regulations and NCQA standards, and contribute to the consistency of clinical documentation and decision-making processes. Analyze data to identify trends and areas for improvement, and execute defined projects aimed at enhancing care quality across various lines of business. Generate and validate reports to monitor performance and compliance across health plan contracts, ensuring accuracy and alignment with requirements. Prepare for regulatory, accreditation, and contractual audits, and contribute to the remediation and documentation of audit findings. Perform other job duties as assigned Required Qualifications: Bachelor's Degree or equivalent work experience. At least 4-6 years of relevant experience in healthcare quality management and post-acute care utilization management. Preferred Qualifications: Registered Nurse, Occupational Therapist, or Physical Therapist with a bachelor’s degree in a related field, or a combination of education and experience that includes pertinent clinical experience and an understanding of CMS standards and guidelines. Experience with CMS and/or NCQA audits. Ability to manage multiple competing priorities and tasks effectively. Strong written, oral, and interpersonal communication skills. Demonstrated ability to collaborate with external vendors and clients. Proficiency in manipulating and sorting data for analytics and reporting. Excellent analytical and data interpretation skills. Experience in case management in a healthcare setting. Job Expectations: Willing to work additional or irregular hours as needed Must work in accordance with applicable security policies and procedures to safeguard company and client information Must be able to sit and view a computer screen for extended periods of time #LI-OF1 #LI-Remote WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.

Oversee and manage a team of clinical operations staff ensuring efficient and accurate completion of tasks related to utilization review and care coordination. | Bachelor's degree, 4-6 years clinical nursing or therapy experience, active RN license, knowledge of utilization management tools, and ability to manage clinical teams. | The Sr. Team Lead, Clinical Operations is responsible for overseeing the team responsible for coordinating and delivering care to patients as part of payer programs authorized by their health insurance provider. The scope of this job includes providing operational and management oversight a team of clinicians and other members of the clinical team but does not include providing clinical oversight to staff. This position oversees a team of Utilization Review Clinicians who are responsible for timely review of request for post-acute services based on established clinical guidelines and/or coverage benefits limitations to determine appropriateness of requested services. Alongside their team, the Sr. Team Lead, Clinical Operations will develop relationships with physicians, healthcare service providers, and internal and external clients to help improve health outcomes for enrollees. They will apply clinical knowledge to work with facilities and providers for care coordination and comply with all standard operating procedures, as well as departmental and organizational policies. They will access and consult with peer clinical reviewers, Medical Directors, and/or delegated clinical reviewers to help ensure medically appropriate, quality, and cost-effective care throughout the medical management process. The ideal candidate will possess a passion for coaching and mentoring others, as well as working knowledge and aptitude of the Microsoft suite of applications (e.g., Office, Excel), clinical decision support tools and operational software. We invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities: Oversee daily operations of clinical operation support staff and ensure tasks are completed efficiently and accurately. Identify and address operational challenges and escalate more complex issues to management as needed. Support the development and implementation of work plans, assign tasks, and ensure alignment with program objectives. Manage larger, more-complex and growing or expanded clinical programs. Provide enhanced training and mentorship to team members by fostering skill development and professional growth. Collaborate with managers on recruitment, onboarding, and performance feedback for team members. Analyze team performance data and recommend process improvements to enhance quality, efficiency, and service outcomes. Perform other job duties as assigned. Required Qualifications: Bachelor's Degree or equivalent work experience 4-6 years of clinical nursing or therapy experience Active RN license Preferred Qualifications: 1-2 years' experience in utilization review, case management and/or managed care regulations Experience with MCG (Milliman Care Guidelines), InterQual or other clinical decision support tools, especially in utilization management and prior authorization processes General understanding of managed care guidelines and impact on services Job Expectations: Able to pass federal and state required background checks and drug screen Willing to travel up to 30% based on business needs. Willing to work additional or irregular hours as needed. Must work in accordance with applicable security policies and procedures to safeguard company and client information. Must be able to sit and view a computer screen for extended periods of time. WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.