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Healthhelp Jobs (NOW HIRING)

Sr Nurse Clin Education

Houston, TX · Remote

$80K - $95K/yr

... HealthHelp policies and clinical processes • Reviews monthly quality audit findings and conducts one-on-one coaching with staff to assist with resolving issues related to education and adherence to ...

Maintains written documentation according to HealthHelp's documentation policy * Has a working knowledge of regulations, accreditation requirements, and payer-specific guidelines by state and market ...

Conducts focused training to ensure that all staff are properly educated on HealthHelp policies and clinical processes. Reviews monthly quality audit findings and conducts one-on-one coaching with ...

Sr Nurse - Clin. Education

Houston, TX · On-site +1

$80K - $95K/yr

... HealthHelp policies and clinical processes • Reviews monthly quality audit findings and conducts one-on-one coaching with staff to assist with resolving issues related to education and adherence to ...

... HealthHelp policies and clinical processes Reviews monthly quality audit findings and conducts one-on-one coaching with staff to assist with resolving issues related to education and adherence to ...

Care Coordinator

Louisville, KY · On-site

$17 - $24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

$24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Care Coordinator

Pembroke Pines, FL · On-site

$17 - $24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Care Coordinator

Lauderhill, FL · On-site

$17 - $24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Care Coordinator

Broadway, VA · On-site

$24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Patient Referral Coordinator

Tamarac, FL · On-site

$16.50 - $23.56/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Care Coordinator

Louisville, KY · On-site

$17 - $24.26/hr

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing). * Completes orders with proper documentation on where patient ...

Healthhelp information

What is the difference between Healthhelp vs Medical Billing Specialist?

AspectHealthhelpMedical Billing Specialist
CredentialsTypically requires healthcare or insurance-related certificationsRequires coding and billing certifications, such as CPC or CCS
Work EnvironmentHealthcare facilities, insurance companies, or third-party billing servicesMedical offices, hospitals, or billing companies
Industry UsageUsed in healthcare and insurance sectorsPrimarily in healthcare billing and coding
Job FocusManaging insurance claims, authorizations, and patient dataProcessing medical bills, coding diagnoses, and ensuring accurate billing

While both roles operate within the healthcare financial ecosystem, Healthhelp focuses on insurance authorizations and claims management, whereas Medical Billing Specialists handle billing and coding processes. Understanding these differences helps job seekers identify the right career path in healthcare administration.

What is Healthhelp and what do they do?

HealthHelp is a healthcare management company that provides specialty benefit management services for health plans and providers. They focus on improving patient outcomes and reducing unnecessary healthcare costs by using evidence-based guidelines and clinical expertise to review and authorize medical procedures, imaging, and other specialty services. HealthHelp partners with payers and providers to ensure that patients receive appropriate care while streamlining administrative processes. Their services often include prior authorization, clinical review, and education for both patients and healthcare professionals.

What are some common challenges faced when working at HealthHelp, and how can new employees prepare for them?

One common challenge at HealthHelp is adapting to the fast-paced environment and rapidly changing healthcare regulations. New employees should be prepared to handle high volumes of information and multi-task between various cases and systems. Effective communication and collaboration with clinical and administrative teams are essential, as the role often involves coordinating care and ensuring compliance. Proactively seeking feedback and utilizing available training resources can help new hires acclimate more quickly and perform confidently.

What are the key skills and qualifications needed to thrive as a Utilization Review Nurse at HealthHelp, and why are they important?

To excel as a Utilization Review Nurse at HealthHelp, you need a current RN license, strong clinical background, and expertise in medical necessity criteria and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of CMS regulations are typically required. Critical thinking, attention to detail, and effective communication are vital soft skills for collaborating with physicians and insurance providers. These competencies ensure accurate case evaluations, regulatory compliance, and optimal patient outcomes within managed care environments.
What cities are hiring for Healthhelp jobs? Cities with the most Healthhelp job openings:
What states have the most Healthhelp jobs? States with the most job openings for Healthhelp jobs include:
Infographic showing various Healthhelp job openings in the United States as of June 2026, with employment types broken down into 80% Full Time, and 20% Contract. Highlights an 20% In-person, and 80% Remote job distribution.
Sr Nurse Clin Education

Sr Nurse Clin Education

HealthHelp

Houston, TX • Remote

$80K - $95K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago


Job description

Job Description

• Conducts training for staff members pertaining to Utilization Review process, clinical rules/guidelines, client/module/modality-specific workflows, and software enhancements
• Creates educational material for review tiers by collaborating with key resources across departments to ensure clinical scenarios are properly incorporated into the educational content
• Partners with Workforce Planning to develop training schedules conducive to achieving desired program specific outcomes
• Proactively identifies targeted improvement opportunities
• Partners with Human Resources and Clinical Operation leaders to highlight possible concerns amongst staff
• Conducts focused training to ensure that all staff are properly educated on HealthHelp policies and clinical processes
• Reviews monthly quality audit findings and conducts one-on-one coaching with staff to assist with resolving issues related to education and adherence to process and/or client-specific directives
• Leverages tools and methodologies to assess the effectiveness of educational content and delivery
• Advises Leadership Teams/Medical Director of opportunities for individual performance improvement
• Reviews reports from the Quality Department to identify training opportunities
• Serves as contact point for staff in order to answer questions/provide clarification related to criteria, policy, and process
• Partners with Products to develop training material designed to promote process efficiency and desired program-specific outcomes
• Recognizes and informs management of process/performance gaps and offers solutions
• Adheres to all regulatory requirements and complies with HealthHelp policies and procedures
• Upholds professional standards and performs all work in a manner respectful of others
• Provides a high level of service and support to both internal and external clients
• Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy
• Performs other duties as assigned to meet business needs

Qualifications:
Qualifications

• Graduate of an accredited school of nursing, required
• Current, active, and unrestricted RN, LVN, or LPN license in a state or territory of the U.S., required
• 2 years of prior experience in direct clinical care or managed care setting, required
• 1 year of direct virtual and/or face-to-face training experience, required
• 1 year of Utilization Management, Case Management, or Clinical Care Coordination, preferred
• Remote education/training experience, preferred
• Ability to flex work hours based on business needs
• Excellent listening, oral, and written communication/presentation skills
• Ability to communicate complex information in a clear and concise manner
• Strong problem solving, interpersonal, and customer service skills in both face-to-face and remote settings
• Ability to work on multiple projects simultaneously and prioritize work to meet adapting deadlines
• Ability to recognize potential and actual problems and work effectively within a team to develop appropriate solutions and implement effective action plans to address the problems
• Ability to effectively perform in a fast-paced environment
• Demonstrated knowledge and experience in using critical thinking skills
• Proficient with Microsoft Office Suite and Windows products
• Proficient with setting up webinars and multi-participant conference calls

Additional Information

The base salary range for this position is $80,000 to $95,000 annually. This represents the base pay range that we reasonably expect to offer for this position.

Final compensation will be determined based on a variety of factors, including but not limited to the candidate’s experience, education, skillset, and location.

In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range.

WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois.

Note: For complete compensation information, please refer to the job posting on our official careers page.

Benefits Overview

Our benefits package includes (but is not limited to):
- Medical, dental, and vision insurance
- Paid time off (PTO), holidays, and sick leave
- 401(k) with company match or other retirement plan
- Life and AD&D Insurance
- Employee Assistance Program

Equal Opportunity Employer Statement

WNS/HealthHelp is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law.

We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process.

How to Apply

Please submit your application, including a resume and optional cover letter, through our careers page or email to talent@healthhelp.com.