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.
Developmentally appropriate telephonic and telehealth screening, brief intervention, and referral of members to a trauma specialty treatment provider.
Apply active listening, psychoeducation, and motivational interviewing skills to understand each member’s or family’s needs and provide support as they set goals.
Identify an appropriate level of care, facilitate referral, and coordinate care with Spring Health providers and, when needed, community resources and schools.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. They partner with over 450 companies, from startups to multinational Fortune 500 corporations, providing care for 10 million people.
Engage and enroll eligible health plan members in supportive care services.
Educate members on Tuesday Health’s service offerings and support ongoing engagement.
Provide ongoing telephonic customer service to members and their caregivers.
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 and are shaping the future of community-based palliative care nationwide.
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.
Play an active role in member registration and enrollment, including organizing community engagement and outbound outreach calls/texts.
Engage with a panel of assigned members to provide care navigation, appointment logistics, prescription drug support, lab support, referral coordination, care plan adherence support, and resource sharing.
Serve as the primary relationship holder for members with behavioral health needs; provide consistent outreach, follow-up, and re-engagement support, including after ED/inpatient discharge when applicable.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. They combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live and receive support.
Own the end-to-end performance, and evolution of Spring Health’s 24/7 Crisis Line, Critical Incident Response (CIR), Mandatory Referral, and Manager Consultation services.
Translate enterprise customer needs and clinical quality requirements into scalable clinical operating models.
Partner cross-functionally with Product, Care Support, Customer Success, Legal, Network Operations, and Business Intelligence to continuously enhance service delivery and the member experience.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need. They partner with over 450 companies and provide care for 10 million people.
As the first point of contact, you'll assist patients and providers.
Interwell Health is a kidney care management company that partners with physicians to reimagine healthcare. They aim to set the standard for the industry and help patients live their best lives and is committed to diversity, equity, and inclusion.
Provides front-line support to community callers seeking healthcare-related information.
Triages the caller's condition/needs, giving appropriate protocol-driven guidance and directs callers to the most appropriate level of care.
Communicates effectively and efficiently to other members of the care team to ensure caller needs are met in a timely manner.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. Teammates live by our values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other.
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.
Collaborate with international teams and provider acquisition to move providers efficiently.
Partner with the team to pilot performance improvement projects and other projects as directed.
Call, text and email with Providers to encourage their activation and growth.
BetterHelp's mission is to remove the traditional barriers to therapy and make mental health care more accessible. Founded in 2013, they are the world’s largest online therapy service, providing affordable and convenient therapy across the globe.
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.
Deliver effective and enthusiastic communication to encourage members to utilize Transcarent's services
Provide concierge level service and instill trust in our team
Transcarent is a health and care platform bringing medical, pharmacy, and point solutions together. They empower health consumers with more choice, access to higher-quality care, and lower costs for 21 million members across 1,700 employers and health plans.
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.
Responsible for coordination of services for members, emphasizing education/self-management and quality care. \n- Assesses member needs, reviews service options, develops and implements care plans, and coordinates resources. \n- Manages a caseload of moderate-high risk members with complex medical/behavioral/psychosocial needs.
Capital Blue Cross is committed to improving the health and well-being of our members and the communities in which they live. They offer flexibility, prioritize health and well-being, and encourage employees to volunteer in their community.
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.
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.
Provide exceptional care, disease management and health education to patients
Support goal setting for individual patients asynchronously to help them better manage their chronic conditions
Create personalized action plans with guidelines to reduce or eliminate unwanted behaviors
Salvo is focused on chronic gut health and metabolic conditions from IBS to obesity, assigning patients a care team and providing app-based care seven days a week. Salvo is backed by leading health care investors from innovators; they offer a culture that drives constant innovation and is marked by relentless curiosity and a sense of empathy.
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.
Conduct patient onboarding via phone, explaining program goals.
Receive follow-up calls and document information in charting systems.
Communicate concerns and changes in condition to the Provider Team.
CopilotIQ + Biofourmis is transforming in-home care with the industry's first AI-driven platform for pre-surgical optimization to chronic care. With commitment to enhancing the lives of seniors with chronic conditions and advanced data-driven insights, they're setting a new standard in accessible healthcare.