Educate recipients about the Pathways Program offerings and enrollment options.
Introduce managed care choices to recipients and aid in navigating health care and dental plans.
Cultivate positive relationships with county staff, state agencies, community groups, and recipients.
Knowledge Services is a company that provides workforce management solutions. They are committed to working with individuals with disabilities and providing reasonable accommodations.
Build trusting relationships with patients, families, and providers, addressing health questions and care needs.
Identify medical, behavioral, social, emotional, and financial needs to support whole‑person care.
Strengthen the connection between patients and healthcare providers by addressing barriers and facilitating communication.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, with the goal to make great healthcare affordable, improve patient health, and restore fulfillment for providers. They leverage remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.
Keystone is a fast-growing company seeking top talent employees. They match clients’ needs in the health insurance market and are proud of helping thousands of Americans to find peace of mind and economic stability.
Provide day-to-day administrative and clinical support to assigned medical provider(s).
Coordinate patient care for a geriatric and Medicare population receiving mobile medical services.
Support Chronic Care Management (CCM) activities and ongoing panel management.
They provide dedicated support to mobile geriatric medical providers serving Medicare patients in the field. The company seems to have a collaborative, mission-driven healthcare environment.
Research, verify and resolve inquiries related to Oregon Health Plan (OHP) or Medicare eligibility.
Respond and assist members with Primary Care Provider (PCP) assignments and explain OHP or Medicare benefit coverage.
Collaborate with providers, Division of Medical Assistance Programs (DMAP), and members to ensure effective customer service and the resolution of any health plan issues that arise.
CareOregon is a nonprofit, mission-driven health plan focused on providing care to low-income Oregonians. We are an equal opportunity employer that greatly encourages military veterans to apply and considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.
Evaluates certification requests by reviewing the group specific requirements.
Triage the call to determine if a Utilization Review Nurse is needed to complete the call.
Cottingham & Butler sells a promise to help their clients through life’s toughest moments. Their culture is guided by the theme of “better every day” constantly pushing themselves to be better than yesterday.
Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals
Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members
Assist individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups
Pair Team is an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, they deliver whole-person care, and leverage AI and automation to reduce administrative burden. They are deeply collaborative with nurses, social workers, community health workers, and medical professionals.
Conduct outbound telephone outreach to patients and engage patients in pharmacist-led consultations.
Serve as a liaison between patients and pharmacies to resolve medication barriers.
Collaborate closely with Care Management Pharmacists to support medication adherence initiatives.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach. They are committed to improving patient outcomes and quality of life by delaying disease progression and shifting care to the home.
Manage multiple channel interactions professionally and efficiently.
Effectively present products/services to providers with integrity, understanding, and accuracy.
Focus on provider retention through first call resolution and maintain positive relationships.
Capital Blue Cross promises to go the extra mile for its team and community. Employees consistently vote it one of the “Best Places to Work in PA”, valuing professional/personal growth by investing heavily in training and continuing education.
Guide older adults and their caregivers through the intake process.
Match patients with the right therapist with warmth and clarity.
Help each new patient navigate the journey into care.
Sailor Health is revolutionizing mental health care for older adults. They aim to provide seamless access to compassionate, effective, and personalized mental health care for seniors and has a thoughtful, collaborative team rooted in purpose.
Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc.
Creates cases, tasks, and completes assessments in Case Management module for all Hospital and SNF discharges
Works as a team with the Case Manager to engage and manage a panel of SNP members
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.
Provide compassionate support and expert guidance to Medicaid recipients.
Address inquiries and resolve issues to impact the health and satisfaction of clients.
Join a dynamic team dedicated to making a difference in the lives of underserved communities.
Avesis has been providing essential ancillary benefit solutions since 1978. Today, their programs cover more than 8.5 million members throughout the country. They strive for excellence in all that they do and their benchmark performance in terms of member satisfaction and client retention underscores this singular focus.
Investigate, evaluate, and negotiate healthcare subrogation matters
Understand and apply Medicare, Medicaid, ERISA, and related laws
Conduct outbound calls and communicate with attorneys and insurers
Katch is a healthcare technology company specializing in payment integrity and subrogation solutions. They partner with health plans, providers, and other stakeholders to identify, recover, and prevent payment errors to reduce costs and improve efficiency. Katch is a fast-growing team that thrives in a startup environment.
Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, professionally and document accordingly that can build patient trust and engagement.
Accurately track and document work on a variety of internal software tools and platforms.
Evry Health is on a mission to bring humanity to health insurance. They provide high-technology health plans that expand benefits, increase access and transparency, and feature a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL), which has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents.
Act as a Gentiva representative supporting patients seeking post-acute care.
Navigate healthcare options, including post-acute offerings and Medicare coverage.
Assist in the admissions process by coordinating with Gentiva branch staff.
Gentiva offers compassionate care in the comfort of patients' homes and is a national leader in hospice care, palliative care, home health care, and advanced illness management. They have nearly 600 locations and thousands of dedicated clinicians across 38 states, fostering a collaborative environment.
Collaborates with members, family, and healthcare providers to coordinate services and address barriers.
Guides members to achieve optimal health by providing tools and information to understand their healthcare options.
Identifies and assesses members’ medical, behavioral, social, emotional, and financial needs.
Capital Blue Cross promises to go the extra mile for their team and community. They are one of the “Best Places to Work in PA”, with a caring and supportive culture that values professional and personal growth through training and continuing education.
Deliver compassionate, personalized service to support each member’s unique therapy journey.
Manage new and ongoing therapy cases, ensuring accurate documentation and coordination.
Resolve inquiries quickly and accurately, using critical thinking to address complex issues.
VIVIO Health helps make data the basis for clinical decision-making. Their evidence-based, data-driven specialty drug management and cost control solution has improved healthcare outcomes and lowered costs for large, self-insured employers since 2016.
Maintain positive customer relationships by responding to inquiries via phone.
Provide information and education about IRS regulations and spending accounts.
Serve as a customer advocate by identifying needs and guiding them to resources.
HealthEquity's mission is to save and improve lives by empowering healthcare consumers. They are passionate about providing solutions that allows American families to connect health and wealth, valuing individuals more than positions and fostering a welcoming and inclusive environment.
Build trusting, ongoing relationships with patients, families, caregivers, and medical/behavioral health providers.
Engage high‑risk or targeted patient populations using bi-directional communication to address health questions, concerns, and care needs.
Accurately and promptly document all interactions, assessments, and interventions in the electronic health record (EHR) and Guidehealth documentation systems.
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.
Facilitate collaboration with health plan care managers
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. They deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers.