Supervise day-to-day operations of assigned Utilization Management staff.
Provide full people management for assigned Utilization Management teams, including hiring and performance management.
Drive team performance against key metrics, including engagement, productivity, and quality scores.
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.
Perform telephonic symptom assessment and triage using evidence-based protocols to ensure appropriate care and disposition.
Document patient interactions accurately in the EMR and educate callers on virtual care, provider referrals, and available community resources.
Deliver excellent customer service while maintaining confidentiality, sound judgment, and effective communication with diverse populations.
UnityPoint Health is committed to team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare. They champion a culture of belonging where everyone feels valued and respected, honoring the ways people are unique and embracing what brings us together.
Oversee the Care Navigation program, ensuring efficient operation and successful implementation of new programs.
Manage relationships with health plan partners and oversee internal policies and procedures for care navigation activities.
Provide telephonic care navigation services to individuals receiving services through various programs as needed.
Mom's Meals is a provider of home-delivered meals. They focus on delivering medically tailored meals to individuals with chronic health conditions. The company values its team members and strives to show it through benefits and other offerings.
Answer high-volume inbound calls professionally, providing information and support with empathy.
Schedule, reschedule, or cancel patient appointments across multiple facilities, ensuring optimal provider capacity.
Screen calls for urgent/emergency needs (911) and accurately triage/route calls to nursing staff, providers, or relevant departments.
Heartland Women's Healthcare provides healthcare to its customers. They employ highly-qualified individuals and are an Equal Opportunity Employer that is committed to global diversity.
Supervise daily activities of QA specialists across multiple operational areas.
Review completed audits for accuracy and consistency.
Conduct calibration sessions to ensure scoring alignment.
Machinify is a leading healthcare intelligence company delivering unmatched value, transparency, and efficiency to health plan clients. They are deployed by over 85 health plans and are reimagining what’s possible in the industry to maximize financial outcomes and drive down healthcare costs.
Primarily responsible for making outbound calls to healthcare providers.
Accepting inbound calls from healthcare providers.
Answer questions about participation requirements, registration, assessment completion and scoring results.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With over 66,000 employees, we combine scale, expertise and execution to create meaningful, measurable impact.
Lead the day-to-day operations of a remote team of RNs and LPNs responsible for reviewing and resolving real-time patient alerts.
Conduct clinical audits and chart reviews to evaluate triage quality, documentation accuracy, and adherence to care protocols.
Provide structured coaching, real-time feedback, and formal performance management to improve both clinical judgment and productivity.
Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions. They pair patients with a dedicated clinical team and integrate deeply into health system EMRs and workflows. Cadence operates as a full clinical care delivery organization.
Perform outbound calls to engage patients about the benefits of Salvo’s program and tech-enabled services.
Enroll patients in Salvo’s program and schedule an initial virtual nurse visit to onboard patients.
Assist patients in understanding the cost of the program, including insurance coverage and financial responsibilities.
Salvo Health offers virtual care to patients at community specialty care practices, focusing on chronic gut health and metabolic conditions. The company has raised a Series A investment round and aims to provide continuous, interdisciplinary wraparound care.
Build and lead a compliant contact center of inside sales professionals dedicated to informing and supporting Healthcare Professionals.
Own forecasting, analytics, performance optimization, process excellence, and technology stack maturity for the Inside Sales team.
Create and manage incentive programs and coach to quality using call analytics and standardized scorecards.
CareTria helps to inform and support Healthcare Professionals through high‑quality outbound engagement. They seem to be a growing company with a focus on a positive and inclusive employee experience.
Handle inbound client contacts across phone, email, and chat
Monitor live call center queues and maintain service level expectations
Coach agents in real time and assist with escalations
The company helps clients navigate service animal and emotional support animal programs through documentation processes. They value supporting people and their animals.
Driving recovery team’s daily productivity, ensuring team is adhering to goals and SLAs.
Effectively collaborating with Management and teams to ensure departmental needs are met.
Machinify is a leading healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. They are deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives.
Monitor compliance with assigned responsibilities and coordinate with patient financial services.
Conduct initial and continued clinical authorization reviews.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Deliver virtual and classroom call center training for new hires and existing agents
Coach agents through live call monitoring, roleplay, and one-on-one feedback
Develop and update training materials, scripts, and sales exercises
SAPS LLC is seeking a Call Center Trainer to prepare new and existing agents for success in a sales-driven call center. They value diversity and do not discriminate based on various characteristics as an equal-opportunity employer.
Answer calls and resolve questions, routing to appropriate departments.
Complete documentation in EMR and marketing systems, including initial prescreening.
Schedule new and returning patients and complete follow-up duties.
Pyramid Healthcare provides addiction treatment, mental health recovery, and eating disorder treatment. They focus on client-centered care and offer supportive environments that help patients overcome life’s challenges.
Provide effective customer service to patients, internal departments, and other medical facilities and resolve customer complaints/concerns.
Demonstrate excellent telephone communication skills.
Enter data into the computer with proficiency and accuracy while talking with patients.
Bozeman Health is committed to caring for the communities of Southwest Montana by being their partner in health and wellness, compassionately delivering the best care. Their culture of excellence guides each employee to be a high performer, engage in transparent and timely communication.
Monitor and interpret patient vitals, assessments, and alerts within Welby Health’s platform.
Develop, implement, and adjust individualized care plans that address both clinical and social needs.
Deliver patient education and coaching via telephone and secure messaging.
Welby Health is committed to transforming the way complex conditions are managed. They aim to advance patient outcomes by integrating efficient care coordination, data-driven insights, and enhanced communication across the care continuum. Welby Health is headquartered in San Diego.
Conduct outbound calls and virtual outreach to provide information and education about Accompany Health services.
Support patients by answering questions, addressing concerns, and providing guidance.
Document interactions and maintain accurate records of patient outreach activities.
Accompany Health provides dignified, high-quality primary, behavioral, and social care to patients with complex needs, offering at-home and virtual care, plus 24/7 support. Their teams are distributed across the country and are committed to evidence-based practice, focusing on the health outcomes most important to their patients.
Directly lead and manage a team of Patient Support Associates to ensure medication adherence or timely prior authorization.
Proactively manage support in assigned hospitals and/or clinics to ensure patients receive medications on-time.
Provide front-line supervision and ongoing coaching and performance management to Patient Support team.
Shields Health Solutions is a specialty pharmacy management service provider. They are a fast-growing company that values motivated self-starters with a positive outlook and a focus on high-quality work.
Coordinate care and collaborate with multiple disciplinary team members to improve the quality of care and clinical outcomes.
Conduct thorough assessments to determine unmet needs and develop individualized care plans.
Promote quality cost-effective outcomes with the goal of improved care coordination.
Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Performs utilization review to determine medical necessity criteria compliance and facilitates resolution of escalated cases.
Collaborates with clients and physician reviewers, ensuring adherence to all HIPAA, state, federal, and regulatory standards like URAC & NCQA.
Utilizes various computer systems to manage cases, engages in provider communication, and participates in quality management programs while prioritizing independent work.
WNS, part of Capgemini, is an AI-powered leader in intelligent operations and transformation, serving over 700 clients across industries like Healthcare and Financial Services. It is a large global company with over 66,000 employees, combining deep domain expertise with AI platforms to create lasting business value.