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Guidehealth
Guidehealth
9 open remote positions
Guidehealth is a data-powered, performance-driven healthcare company focused on making healthcare affordable and improving patient health. As a growing, physician-led organization, we prioritize operational excellence and a collaborative, flexible culture.
Salary Distribution
9 of 9 jobs
Benefits Overview
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Open Positions
Engage in fully remote patient outreach to identify and address quality gaps, educating patients on preventive care. Collect quality data from EMR systems, claims, and provider outreach, managing multiple systems for daily work. Prioritize tasks to meet quality reporting deadlines and communicate performance internally and with customers.
Quality Improvement
EMR Systems
Data Abstraction
Patient Outreach
Medicare Advantage
Supervise day-to-day operations of clinical compliance auditors and specialists, serving as a liaison to senior management. Coordinate orientation, training, and performance monitoring for clinical compliance auditors to promote professional growth. Oversee development of UM and PHM agenda, audit guidelines, and ensure adherence to denial processes and compliance requirements.
Supervisory
EMR/EHR
Patient Outreach
Build trusting relationships with patients and providers to address health barriers and coordinate care. Navigate medical, behavioral, and social systems to connect patients with appropriate resources. Support value-based care outcomes through proactive outreach, documentation, and quality measures.
Care Coordination
EHR Systems
Motivational Interviewing
Act as the technical point of contact for external and internal stakeholders during onboarding and implementation. Manage data integration and tech implementation projects, including EMR integrations, API connections, and SFTP data feeds. Translate clinical and operational requirements into technical configurations and maintain integration documentation.
SQL
Python
AWS
Perform utilization review including precertification and concurrent reviews using medical necessity criteria. Collaborate with medical directors and providers on complex cases and integrate AI tools into workflow. Initiate referrals to disease management programs and participate in quality improvement initiatives.
Registered Nurse
Utilization Review
Clinical Judgment
Microsoft 365
Managed Care
Partner with clinical operations teams to identify and prioritize requirements for Rose's use cases. Own the project plan for Rose use cases from requirements through deployment, including timelines, milestones, and risk mitigation. Analyze performance data to identify trends, surface improvement opportunities, and inform the roadmap.
Python
SQL
Project Management
Data Analysis
Healthcare Operations
Own full-cycle recruitment for clinical and non-clinical roles, from sourcing through onboarding. Partner with hiring managers and leaders to develop role-aligned recruiting strategies and deliver high-touch candidate experiences. Manage compliance, credentialing, and pre-boarding activities while tracking metrics to improve hiring outcomes.
Recruiting
Healthcare
Compliance
Data Analysis
Sourcing
Build meaningful relationships with patients and families to understand their goals and barriers. Create personalized care plans addressing medical, behavioral, and social needs. Coordinate care across providers and settings, ensuring safety, quality, and continuity.
Care Management
Motivational Interviewing
Patient Education
EMR Systems
RN License
Provide friendly, accurate, and timely service to customers through inbound and outbound interactions across multiple channels, resolving issues and educating on healthcare benefits. Conduct outbound outreach for program enrollment and clinical quality calls, using consultative listening to overcome objections and guide customers. Document all interactions thoroughly, adhere to HIPAA and regulations, and meet or exceed performance goals for customer satisfaction and quality.
Customer Service
Healthcare
Problem-Solving
Communication
CRM