Adaptive Innovations

hybrid • USA • lead • Не указана

About Us -------- **We are fixing US healthcare by building an AI-native physical care platform, starting with home health.** Home health is a $140B industry with less than $10B in EBITDA — 40% of revenue is spent on pure administrative waste. We automate this work with AI, creating a fundamentally different cost structure compared to incumbents. This lets us rapidly take market share by serving the 30% of patients who go untreated today. **By reshaping the cost structure of this industry, we unlock its growth.** We've built one of the best AI teams in the world (from Character AI, Scale, Palantir, Citadel, Jane Street) and paired them with a team of healthcare veterans to build a new type of healthcare company: one that delivers care at the speed of an AI company. Our physical care platform already operates with 30pp higher gross margins than traditional home health providers. With our AI advantage, we pay nurses more, remove their admin burden, and unlock the scale economics that have been missing from this fragmented industry. If we served this entire $140B market, instead of $10B in EBITDA, we'd drive $60B. We're starting with home health, then expanding to all delivered care. Our mission is _"any care, any where"_. **Fundamentally, our incentives are aligned with America. Every dollar in revenue we make is two dollars taken out of the healthcare system. If we succeed, so does US healthcare.** What You’ll Do -------------- Lead a team responsible for the work that makes home health claims ready to bill. You’ll manage day-to-day execution across orders management, pre-bill audit, and related medical records and contract therapy workflows—and partner with our R&D team to build better processes and technology. **Lead the team** * Manage, coach, and support onshore and offshore team members and team leads. Set clear priorities, monitor workload and performance, and provide timely feedback and training. * Stay close to daily workflows, respond to questions, and resolve or escalate operational and clinical issues with the appropriate partners. * Develop and maintain SOPs, quality controls, and escalation paths that help the team work accurately and consistently. **Own orders and billing readiness** * Oversee the pursuit of outstanding physician orders and plans of care, prioritizing aged items and orders that are holding claims while maintaining compliance follow-up for other orders. * Help the team verify physician information and preferred delivery methods, confirm receipt, follow up on missing signatures, and ensure returned orders are recorded accurately in HCHB. * Manage the pre-bill audit and held-claim workflow. Ensure claims are reviewed against applicable requirements and that holds are documented, assigned, followed up, and cleared only when requirements are met. * Coordinate with clinical, quality, medical records, contract therapy, billing, and other teams to resolve issues such as missing documentation, unverified visits, unsigned orders, and face-to-face or OASIS exceptions. * Oversee related documentation workflows, including timely handling of contract therapy notes and medical records requests, and escalate exceptions to the appropriate owner. **Improve the operating model** * Use workflow boards and dashboards to monitor unsigned orders, held claims, aging, team productivity, and unbilled revenue; prioritize work and surface recurring bottlenecks. * Partner with R&D, product, and engineering to map workflows, define requirements and guardrails, test new tools and automations, and improve the experience for the team. * Translate frontline feedback and performance data into practical process improvements, updated SOPs, and training. Basic Qualifications -------------------- * Strong experience in home health revenue cycle or revenue operations, including the documentation and workflows required before claims can be billed. * Experience managing and developing operational teams, including setting priorities, coaching performance, and addressing escalations. * Working knowledge of physician orders management and pre-bill audit or held-claim resolution. * Familiarity with Homecare Homebase (HCHB) and its home health workflows. * Ability to use operational data and work queues to identify bottlenecks, track performance, and drive follow-through. * Experience improving and documenting operational processes across teams. * Ability to work effectively with clinical, quality, billing, and other partners and communicate clearly about complex issues. Preferred Qualifications ------------------------ * Experience leading distributed teams across onshore and offshore locations. * Experience working with product, engineering, or technical teams to design or implement operational tools or automation. * Familiarity with physician signature workflows, contract therapy documentation, and home health medical records processes. * Experience with PDGM, Medicare and Medicare Advantage billing-readiness workflows, or payer-specific documentation requirements. What We Offer ------------- * Competitive salary * Comprehensive health insurance, dental, and commuter benefits * 401(k) retirement plan with employer contribution * Opportunity for growth in a fast-growing company * Collaborative team valuing innovation and problem-solving