Volunteer: Creative design for newsletters and posters
Alignment Health
Physician Reviewer, Appeals Anywhere in the U.S.
Alignment Health • via RemoteFront
$1.98L–$2.97L a year
Full–time
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Job description
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Appeals Physician Reviewer plays a critical role in the healthcare review process by conducting clinical reviews of appeals and grievances submitted by providers and members. This position ensures that medical necessity decisions align with current clinical guidelines, regulatory requirements, and plan benefits. The physician reviewer provides objective, evidence-based determinations and collaborates with internal teams to support fair and timely resolution of appeals.
Job Responsibilities:
• Review clinical documentation and case records for appeals and grievances involving denied services for Medicare populations.
• Apply evidence-based guidelines, clinical judgment, and medical policy to assess medical necessity and appropriateness of care.
• Render determinations in accordance with applicable regulations (e.g., CMS, NCQA, URAC), contractual obligations, and clinical best practices.
• Provide clear, concise, and well-supported written rationales for all decisions and benefit interpretations.
• Participate in peer-to-peer discussions with attending providers, when appropriate.
• Ensure timely review and resolution of cases in accordance with organizational and regulatory timelines.
• Collaborate with medical directors, case managers, and legal/compliance teams as needed.
• Maintain strict confidentiality of all patient and proprietary information.
• Stay current with clinical guidelines, medical advancements, and regulatory changes.
Job Requirements:
Experience:
Required:
• 3-5 years of clinical practice experience.
• Strong knowledge of medical necessity criteria (e.g., MCG, InterQual), CMS guidelines, and health plan operations.
Preferred: Experience in utilization management, appeals, peer review, or managed care
Education and Licensure
Required:
• MD or DO with an active, unrestricted medical license in CA, AZ, NV, TX and/or NC.
• Board certification in a clinical specialty Internal Medicine or Family Medicine preferred
Preferred: Multistate licensure or compact state license
Specialized Skills
Required:
• Excellent written and verbal communication skills.
• Basic computer skills, typing, word processing, presentation and internet researching skills.
• Ability to work independently and manage multiple appeals reviews under tight deadlines.
Preferred:
• Familiarity with healthcare regulations especially Medicare.
• Proficiency with electronic health record (EHR) systems and clinical review software.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $198,219.00 - $297,329.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or ****** orientation.
• DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.
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Youth Alliance for Leadership and Development in Africa
Volunteer: Creative design for newsletters and posters
Youth Alliance for Leadership and Development in Africa • Richmond, VA, United States • via LinkedIn
6 days ago
No Degree Mentioned
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Job highlights
Identified by Google from the original job post
Qualifications
Some FUN, ENGAGING and COLOURFUL posters YALDA US has an opening for Graphics Designer Volunteer reporting directly to the YALDA US President and team
FUN, ENGAGING and COLOURFUL posters are on an ad-hoc basis
Responsibilities
Design of YALDA newsletters (4 of them) - first one in March 2025, the second one in July 2025, the third one in September 2025, and the fourth one in December 2025, etc
By networking with professionals, mentors and each other, members will increase their capacity to take on positive leadership roles in their universities, countries and on the continent
Job description
This is a volunteer opportunity provided by Taproot Foundation, a nonprofit creating social change through pro bono connections.
YALDA is looking for a creative designer, who loves color and making designs that attract the youth generation. We have some very simple design needs that need to be completed on a rolling basis: - Design of YALDA newsletters (4 of them) - first one in July 2022, second one in September 2022, third one October 2022, and fourth one in January 2023, etc. - Some FUN, ENGAGING and COLOURFUL posters YALDA US has an opening for Graphics Designer Volunteer reporting directly to the YALDA US President and team. Do you have a strong passion for the development of Africa? Do you have innovative ideas on how the youth can contribute to Africa’s development? Do you want to positively impact the lives of bright and talented young people to make the most of their lives on the African continent? Do you love to network and meet people from all over the world? Then this position is for you! YALDA is a networking organization that is truly Africa branded: "By Africans, For Africa!" YALDA is a non-profit international organization that was established by upper-level and graduate Harvard University students to create a resourceful networking database for those with a strong interest in Africa. The network is centered around YALDA branches, primarily at African universities, and serves to increase the capacity of youth in Africa for developing positive leadership skills and to espouse an honest work ethic. YALDA US works on researching opportunities in Africa, fundraising activities, working with branches, maintaining relationships with the UN, and compliance with regulations as a 501(c)(3). CContent for all 4 projects has been completed, we just need the design. Design of YALDA newsletters (4 of them) - first one in March 2025, the second one in July 2025, the third one in September 2025, and the fourth one in December 2025, etc. FUN, ENGAGING and COLOURFUL posters are on an ad-hoc basis. YALDA is ready to share all the content for the newsletter and key messages volunteer can draw on including all our branding elements such as our logo, colour palette etc.
Youth Alliance for Leadership and Development in Africa Mission: YALDA provides a forum for youth on the African continent and those abroad with a commitment to the welfare of Africa. By networking with professionals, mentors and each other, members will increase their capacity to take on positive leadership roles in their universities, countries and on the continent. Through YALDA, members will implement th