Guidehealth

11 open remote positions

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.

Salary Distribution 9 of 11 jobs

Benefits Overview 11 of 11 jobs

401(k) (11) Dental (11) EAP (11) Medical (11) PTO (11) Vision (11) Disability insurance (6) Life insurance (6) Parental leave (6) Disability Insurance (5) Life Insurance (5) Parental Leave (5)

Open Positions

  • Strengthening the connection between the patient and their primary care physician/medical practice staff, as well as improving the patient’s health and well-being.
  • Engaging patients and helping them navigate their care, solve their healthcare issues, and improves communication with their medical practice.
  • Assisting the patient in achieving better health outcomes by addressing their questions and concerns, connecting them with the medical practice.

  • Assisting with provider credentialing by collecting documentation, entering provider data, submitting required materials to the health plan, tracking completion, and updating internal records.
  • Maintaining and updating provider records from various sources in internal systems to ensure accuracy and completeness.
  • Supporting reporting requirements, including completing health plan reports on assigned schedules.

$72,000–$75,000/yr

  • Complete timely review of healthcare services using appropriate medical criteria to support determinations.
  • Document clinical findings and rationale clearly and accurately in accordance with federal/state regulations, URAC standards, and Guidehealth policies.
  • Communicate precertification and concurrent review decisions—verbally and in writing—to required parties within defined timeframes.

  • Performing physician-level utilization management reviews for behavioral health services across all applicable levels of care.
  • Conducting peer-to-peer consultations with treating psychiatrists and other behavioral health providers.
  • Serving as a consultative clinical resource to behavioral health utilization management nurses, care managers, and operational leaders.