Provide strategic leadership and operational oversight for care management functions across the assigned region.
Ensure alignment with systemwide standards and regulatory requirements for hospital Care Management.
Collaborate with leadership to formulate strategies that drive organizational objectives and patient-centered outcomes.
CommonSpirit Health is a nonprofit Catholic healthcare organization delivering integrated health services through a network of hospitals, clinics, and care sites across 24 states. With over 157,000 employees and 25,000 physicians, it is one of the largest nonprofit healthcare systems, committed to creating a more just and equitable healthcare delivery system.
Provide telephonic triage assessments and health education using nursing protocols and algorithms.
Utilize critical thinking and communication skills to manage diverse patient populations.
Work a flexible schedule that includes evenings and weekend shifts from your home office.
Carenet Health provides telephonic clinical assessments, health education, and utilization management services to patients and members. They are a growing organization with a collaborative national team of Registered Nurses, offering work-from-home options and a supportive culture.
Lead the execution of national clinical education programs and manage cross-functional teams.
Drive customer success strategies and ensure operational excellence across multiple specialties.
Manage budgets, KPIs, and stakeholder relationships to achieve program objectives.
The partner company is a healthcare technology organization that delivers clinical education and adoption programs to improve patient outcomes. The company operates nationally with a collaborative culture and a focus on customer success.
Provides remote RN approvals and support for field users, responding to requests via phone, fax, and email.
Manages workflow tasks such as data entry, eligibility, scheduling, and POC approvals within 30 minutes.
Monitors communication systems, prioritizes tasks by patient needs, and escalates unresolved issues to management.
Moments Hospice is a leading hospice organization dedicated to personalizing end-of-life care and treating patients, families, and team members like family. The company fosters a supportive community and workplace culture where employees are proud to be part of the Moments family.
Supervise daily operations of clinical compliance auditors and specialists.
Assist in developing coordinated team processes and managing UM and PHM plan adherence.
Serve as clinical services liaison to senior management and ensure timely documentation.
Guidehealth is a data-powered healthcare company focused on operational excellence and value-based care. They emphasize empathy, AI, and collaboration, with a remote-first culture.
Provide clinical and operational leadership to support timely, evidence-based coverage determinations in Utilization Management.
Coach reviewers on consistent application of medical-necessity criteria, medical policy, and benefit plan language.
Monitor daily workflow health, coordinate coverage plans, and communicate barriers and risks to the UM Manager.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. The company serves employers, health plans, and health systems with data-driven solutions and is on a mission to empower people to lead healthier lives.
Provide operational oversight for clinical escalations, patient safety, and abnormal laboratory result workflows.
Lead quality improvement initiatives and investigate patient safety events.
Manage cross-functional projects to improve workflows and drive operational excellence.
Sprinter Health is an on-demand mobile health service that sends medical professionals to patients’ homes for blood draws, diagnostics, and wellness visits. We have a rapidly growing team of visionary leaders passionate about increasing access to care, lowering costs, and improving patient outcomes.
Oversee and manage the CareConnect Clinical Triage and Treat team, ensuring timely, high-quality remote patient care 7 days a week.
Analyze operational data, lead performance improvement initiatives, and communicate staffing and operational needs to Market Leadership.
Provide backup clinical coverage and support recruitment, onboarding, training, and professional development of team members.
WellBe provides comprehensive healthcare services focused on helping patients lead healthier, more meaningful lives. They are a value-based care organization with a patient-first approach, operating across multiple states with a culture centered on teamwork and clinical excellence.
Provide virtual nursing care and leadership to diverse patient populations across acute and sub-acute settings.
Utilize critical thinking to diagnose clinical problems and implement evidence-based interventions.
Collaborate with onsite teams to coordinate care, mentor staff, and ensure patient-centered outcomes.
Equum Medical is an innovative leader in healthcare technology, revolutionizing acute care telehealth through cutting-edge solutions. They promote flexible scheduling and work-life balance for their dynamic team.
Provide fully remote virtual serious illness care management to patients and families throughout the continuum of care.
Perform virtual assessments, manage medications, and collaborate with interdisciplinary teams to ensure optimal patient care.
Maintain licensure and prescriptive authority in multiple states, and participate in quality assurance and regulatory compliance activities.
Chapters Health System is a community-based not-for-profit organization dedicated to providing hospice, palliative care, and serious illness care to patients and families. It has been a progressive leader since 1983, offering services through multiple managed affiliates across the Southeast and Mid-Atlantic regions.
You are responsible for supporting care delivery by partnering with Advanced Practice Providers to execute individualized care plans for patients with chronic kidney disease, hypertension, diabetes, and congestive heart failure.
This role focuses on enhancing clinical outcomes, patient engagement, and care coordination through education, remote monitoring, medication management, and longitudinal patient support.
Key responsibilities include visit preparation, care plan execution, disease management education, medication management, quality measure support, and cross-functional collaboration.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They are a growing company building a healthcare delivery model focused on improving patient outcomes and quality of life, with a robust team and culture that emphasizes innovation and support.
Lead execution and optimization of integrated clinical service operations across behavioral health, pharmacy, and nursing service lines.
Oversee workforce planning, capacity management, and performance tracking against key clinical and operational metrics.
Manage unit economics and translate growth strategies into operational roadmaps for new markets and payer partnerships.
Our partner is a mission-driven, high-growth healthcare organization focused on improving outcomes for complex patient populations through coordinated, value-based care. They operate in a fast-paced, remote-first environment with a strong focus on professional growth and cross-functional collaboration.
Provides visionary leadership and strategic direction for care coordination and service delivery teams.
Drives transformational initiatives to scale operations, enhance quality, and improve patient outcomes.
Uses data analytics and key performance indicators to monitor program effectiveness and guide evidence-based decision-making.
WellSky is a technology company that provides software, analytics, and services for intelligent, coordinated care across health and community care. The company fosters a culture of independent thinking, collaboration, and innovation, with a focus on improving outcomes and lowering costs.
Manage patient physiological markers and provide clinical triage.
Conduct wellness calls and collaborate with care teams to set health goals.
Drive patient engagement and ensure adherence to RPM program standards.
Vivo Care is building a platform to make healthcare continuous, personal, and truly connected. It is a fast-growing startup with a culture of inclusion, collaboration, and innovation.
Collaborate with primary care providers to coordinate care for patients with multiple chronic conditions, ensuring high-quality care through telephonic and in-person outreach.
Conduct transitional care management including post-discharge follow-up and provide education on lifestyle coaching and dietary improvements.
Operate independently to achieve goals, attend regular care team meetings, and perform other duties as assigned.
Privia Health is a technology-driven national physician enablement company that collaborates with medical groups and health systems to optimize practices and improve patient care. The company is led by top industry talent and focuses on scalable operations and cloud-based technology to reduce healthcare costs and improve outcomes.
Lead the strategic development and optimization of physician and APP compensation programs and contracting processes.
Oversee quality assurance, fair market value assessments, and compliance with regulatory requirements.
Collaborate with executive leaders and cross-functional teams to resolve complex workforce and financial challenges.
The partner company is a healthcare organization that specializes in physician and APP compensation and contracting. It offers a supportive and collaborative work environment focused on employee well-being and professional growth.
Provide clinical assessment and nursing triage to diverse patients across the health continuum.
Assist in directing patients to the most appropriate level of care via telephonic health information.
Work in collaboration with Telehealth providers for virtual care visits and follow-up calls.
We bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, and 400 healthcare facilities, we are a leader in clinical practice management with a culture of belonging and empowerment.
Provide leadership, coaching, and development for direct reports to maintain an engaged workforce.
Monitor and balance workflow of the interdisciplinary virtual clinical care team.
Ensure adequate staffing and manage clinician schedules to meet patient demand.
Interwell Health is a kidney care management company that partners with physicians to reimagine healthcare. The company is committed to diversity, equity, and inclusion and values collaboration and joy in work.
Review Home Health prior authorization requests for medical necessity using CMS regulations and Clover clinical guidelines.
Perform initial and concurrent clinical reviews, ensuring appropriate care in the least restrictive setting.
Collaborate with providers and internal teams to support timely decision-making and positive member outcomes.
Clover Health is a healthcare company that uses data and technology to provide affordable, high-quality insurance plans for seniors. The company fosters a remote-first culture with a diverse and mission-driven team focused on improving member outcomes.
Responsible for using assessment and communication skills to engage patients in need of clinical support, determine priorities, and deliver patient-centered care.
Identify patient education needs through telephonic assessment and collaborate with healthcare teams to coordinate care and keep patients stable at home.
Serve as point of contact for patients, families, and providers, implementing interventions to improve health outcomes and reduce costs.
Vytalize Health is a value-based healthcare company that coordinates care for patients with chronic conditions, aiming to improve outcomes and lower costs. It is a rapidly growing organization with a startup culture, offering a dynamic environment.