Karna, LLC

Job Listings

Here are our current job openings. Please click on the job title for more information, and apply from that page if you are interested. To apply and view consulting/1099 opportunities with Karna, please visit our consulting portal at https://consultants-karna.icims.com/jobs/intro.

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Company Code KARNA LLC [13868]
Job ID 2021-2340
- Works directly with providers to ensure they are serviced, maintained and educated on all policies and procedures in an efficient and professional manner - Collaborates with both internal and external stakeholders to meet existing and newly identified needs of the providers and their patients - Builds and maintains a comprehensive provider contact database - Provides positive, supportive communication to providers - Develops and implements various methods of communication with providers on requirements and best practices - Assists with ServiceNow tickets as assigned by the Call Center who routes incoming provider inquiries requiring Provider Services review and action (requests for Remittance Advice (RA) statements) - Receives grievances and complaints and works with appropriate stakeholders on timely resolution - Supports the exchange and management of Single Case Agreement (SCA) signatures and documentation - Assists with ensuring providers are compliant with all program requirements regarding availability and access standards, evaluating compliance as required - Provides education, coaching and guidance to providers on required metrics, programs and other quality initiatives - Manages the provider enrollment process, including outreach, education, and sending / receiving / processing agreements - Works with Network Management to ensure provider updates are sent for processing timely and ensures updates are performed accurately within the system - Performs research and analysis on pended / escalated claims, working with appropriate departments and providers to find resolution
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2339
- Develop custom analytics solutions using traditional statistical methods for surveys, questionnaires, experiments, and other selected forms of research - Utilize modern data science methods, such as Machine Learning (ML), Natural Language Processing (NLP), and Artificial Intelligence (AI) to address non-traditional quantitative analysis needs and process big data - Collaborate with client staff and colleagues to select the appropriate research design and conduct the appropriate analysis - Develop and manage databases, including codebooks, data dictionaries and documentation - Follow elements of the Software Development Life Cycle (SDLC) to support collaboration, including requirements gathering, continuous documentation, use of version control, and good coding practices - Communicate the results of analyses orally and in writing to scientific and non-scientific audiences - May supervise and train staff including statisticians and data scientists to assist with the design, collection, and analysis of data. This includes assigning and reviewing the data coding, computer programming, and other aspects of data management and analysis performed by other team members.  - May participate on internal and external committees and workgroups related to areas of expertise
Job Locations
US-Remote
Category
Data Science / Analytics
Company Code KARNA LLC [13868]
Job ID 2021-2337
- Develop training and communication plans and strategy for the program - Work with client and multi-disciplined teams to determine training and communications needs - Support the development, creation, testing and dissemination of science and audience based training and communication products, tools and messages to different audiences utilizing various formats - Coordinate efforts between the client, partners, stakeholders and the project ensuring project goals are being met - Provide technical assistance to internal and external partners and the client - Develop and/or re-design printed, digital and social media, and multi-media materials - Translate complex health information into evidence based messages for a variety of audiences - Determine appropriate training methods for topics (e.g., live instructor, computer-based, video, read and sign, on-the-job, etc.) and appropriate sources of training (e.g. corporate, external, or develop internally) - Implementation of literature searches and environmental scans - Manage Learning Management System (LMS) and training records - Train and mentors junior staff - Perform other related duties as required
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2336
In addition to demonstrating subject matter expertise (SME) in the Project Controls function, the Project Controls individual shall: - Act as the SME for Estimating, Work Breakdown Structure, Cost Control, Change Management, Progress & Performance Measurement and Project Reporting/Stewardship with the project team - Support the project team to achieve daily, monthly, and yearly Project Controls deliverables - Develop and maintain strong working relationships with project stakeholders - Collaborate with stakeholders to ensure business and project objectives are successfully achieved - Support on-going improvement initiatives including developments in PC tools, processes, templates, and deliverables. - Develop and maintain cost control budgets, ensuring costs are stewarded as per project requirements - Provide project cost forecasting based on trends (including earned value, labor rate analysis, commitments, change management, schedule impacts, etc.) - Coordinate and assist in identifying cost and schedule risks, and support risk mitigation/control throughout project execution - Prepare dashboard and other reporting of project performence
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2335
- Coordinate workload and performance across a team of claims analysts and processors - Responsible for team quality and volume metrics; audits the work of claims analysts and claims processors - Manage business processes to include developing and implementing process improvements - Act as a liaison to upper management and the client as required - Handle escalated or complex claims issues - Research and provide insight on pertinent industry best practices, legislation and program changes and claims trends - Responsible for cost, schedule and performance of an Operational Unit - Manage all staff within the Operational Unit to include: recruitment, placement, development, performance, compliance, succession planning, terminations and backfills - Plan and implement improvements to increase efficiencies and quality - Collaborate in the development and implementation of policies, procedures and operating goals - Serves as a primary contact for the claims operations for other WTCHP functional areas such as member and provider services, call center, medical management, and finance - Prepares reports for program management team - Other duties as assigned
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2334
- Manages national provider relationships and network development for the World Trade Center National Provider Network - Leads a team of network development professionals - Provides expert support, analysis and research into complex and escalated issues and processes - Maintains and develops key relationships and acts as primary liaison with the WTCHP client for matters of provider networks on behalf of Karna - Responsible for client specific network development with national and regional health systems and providers - Responsible for researching and answering escalated provider inquiries regarding fee schedules and/ or reimbursement - Works closely with other program leaders on complex, strategic issues as a senior level SME
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2333
- Provides expert support, analysis and research into complex problems and processes relating to the World Trade Center Health Program (WTCHP) - Responsible for educating new providers on all WTCHP policies and procedures - Responsible for researching and answering provider inquiries regarding Fee Schedules and/ or Reimbursement - Works closely with other department staff and escalates issues as needed to senior level SME - Works with CCE Case Managers to assist with referrals to network providers (assists in locating the closest provider based on specialty and where patient resides/ works) - Provider and CCE Outreach to include, but not limited to, the following: - Obtain updated demographic information when RAs are returned due to invalid addresses - Clarify vendor NPI setups - Validate incorrect NPIs - Gather information about claims payments - Obtain updated EFT information when payments fail due to invalid bank account information - Process provider information into to send to claims subcontractor for entry into their claims system and portal - Other duties as assigned
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2332
  - Lead a team of Pharmacy Analysts by providing work direction and conducting quality reviews of daily assignments. Assess team workloads, prioritize projects, ensure completion within specified deadlines and assist with daily work or projects as needed.  - Assist the Manager in coaching team for continued job growth and skills development as the work necessitates. - Serve as a subject matter expert for pharmacy reporting requirements - Ensure eligibility and coordination of benefit files are sent to the PBM for processing and assess if file enhancements are needed. - Ensure PBM oversight of claims adjudication to minimize fraud/waste/abuse. - Analyze and monitor large data sets that are exchanged with the PBM using a variety of reporting tools.  - Ensure audit documentation is prepared according to audit instructions and provided within the specified audit time frame. Prepare written responses or documentation for pharmacy audits. - Provide Pharmacy Analyst team support by communicating job expectations, giving continual feedback, enforcing policies and procedures, and conducting training programs. - Perform routine monitoring to ensure compliance and detect performance issues or operational gaps. Provide corrective feedback and recommendations to staff or PBM, and ensure follow through. - Provide assistance to internal and external customers by troubleshooting and problem solving pharmacy related issues. - Conduct training sessions on pharmacy benefit program to other departments as needed. - Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies. - Other duties as assigned.
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2331
- Provide input and expertise to more complex statistical analysis plans - Program moderately complex tables and maps using publicly available datasets - Collaborate  in the planning and implementation of data quality assurance plans including questionnaire development, data collection, and data management - Maintain advanced skills with respect to applicable SAS programming and statistical methodology and in applying new and varied methods - Perform moderately complex statistical analyses with other staff - Prepare data visualizations and graphics to identify and report on trends - Effectively justify methods selected and implement previously outlined analysis plans - Conduct peer-review of work products from statistical colleagues - Write reports, communicate results, and contribute to publications
Job Locations
US-Remote
Category
Public Health
Company Code KARNA LLC [13868]
Job ID 2021-2309
- Assist statistical colleagues and study personnel to provide input to statistical analysis plans - Program tables and maps using publicly available datasets - Collaborate in the planning and implementation of data quality assurance plans including questionnaire development, data collection, and data management - Maintain proficiency with respect to applicable SAS programming and statistical methodology and in applying new and varied methods - Assist in statistical analyses with other staff - Effectively justify methods selected and implement previously outlined analysis plans - Conduct peer-review of work products from statistical colleagues - Assist in writing reports and communicating results
Job Locations
US-Remote
Category
Public Health