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.
Build trusting relationships with patients and providers to address health barriers and coordinate care.
Navigate medical, behavioral, and social systems to connect patients with appropriate resources.
Support value-based care outcomes through proactive outreach, documentation, and quality measures.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. As a growing and innovative organization, we operate with a high degree of agility.
Lead, coach, and develop a team of Engagement Specialists through regular feedback and performance management.
Conduct compassionate outreach to patients, explain services, and guide them through onboarding with accurate EHR documentation.
Oversee daily operations, optimize PRM workflows, and collaborate with clinical teams for seamless care transitions.
The employer is a mission-driven healthcare organization dedicated to improving access to behavioral health support for individuals navigating complex medical journeys. It is a fast-growing, startup-like company with a collaborative culture focused on continuous learning 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.
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.
Take inbound calls from patients, providers, and members to assist with healthcare needs, insurance questions, and triage support.
Provide empathetic, patient-focused service in a remote environment, managing calls that may involve emergent situations.
Support members with insurance navigation, including changing primary care physicians, locating urgent care clinics, and obtaining prescription authorizations.
Carenet Health has pioneered healthcare consumer engagement for over 30 years, interacting with 1 in 3 Americans daily to deliver positive experiences and improve outcomes. We foster a culture of collaboration, creativity, and accountability, empowering growth through trust and opportunity.
Provide on-demand telephone-based care management services through a 24/7 Nurse Advice Line.
Assess symptoms and concerns of callers to determine urgency and type of care needed.
Coordinate care across the healthcare delivery system and record patient data in medical record systems.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and physician leadership, and focuses on reducing healthcare costs and improving outcomes.
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.
Provide clinical assessments, treatment plans, and direct care for cancer patients via telehealth.
Collaborate with local clinicians and Color's care team to ensure evidence-based cancer care delivery.
Educate patients on treatment options and assist with clinical decision-making.
Color Health operates the nation's first Virtual Cancer Clinic, providing physician-led multidisciplinary cancer care across all 50 states. The company uses technology to transform how employers and health plans address cancer, focusing on screening, diagnosis, treatment, and survivorship.
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.
Serve as a primary point of contact for patients through phone, email, and in-app messaging.
Partner with cross-functional teams to ensure coordinated support throughout the care journey.
Resolve non-clinical inquiries while delivering a positive, patient-centered experience.
Sunrise Group is building the future of sleep health by combining breakthrough technology with expert care. The company has grown from a single innovation into a complete sleep health company with an international team across the US, France, and Belgium, and values clarity, trust, collaboration, and compassion.
Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
Respond to provider appeals and meet client turnaround time and KPI goals.
Utilize coding validation training to become familiar with claims payment policies and regulations.
Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.
Provide compassionate telehealth patient engagement and monitoring for opioid use disorder treatment.
Coordinate care with multidisciplinary teams, including Nurse Practitioners and Peer Recovery Specialists.
Maintain accurate medical records and ensure HIPAA compliance while delivering patient education and support.
Boulder Care is a telehealth provider specializing in medication-assisted recovery for substance use disorder. They are a remote-first company focused on harm reduction and patient-centered care, with a supportive team culture that values empathy and innovation.
Assess and coordinate care for members, ensuring continuity and person-centered service plans.
Manage a caseload of 20-30 calls per day, including crisis calls, and lead interdisciplinary care teams.
Coach and mentor less experienced Care Managers to support team development.
Integrated Resources, Inc. is a workforce solutions company that delivers strategic talent management services. Founded in 1996, the company has grown steadily and focuses on matching qualified professionals with employers, building long-term partnerships based on performance and integrity.
Proactively engage with allied healthcare professionals to provide product and disease education for patient management on approved therapies.
Educate patient care teams on infusion processes, adverse event management, and patient diagnosis in a defined geographical region.
Collaborate with field teams and internal functions to support clinical education and training initiatives.
AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. They strive to have a remarkable impact on people's lives across several key therapeutic areas including immunology, oncology and neuroscience, with a global workforce and a culture of integrity and innovation.
You will serve as a critical liaison between patients, providers, care teams, and community resources to ensure continuity of care.
You will create and promote adherence to treatment plans developed by healthcare providers.
You will assess patients' unmet health and social needs and connect them to relevant community resources.
Point C is a national third-party administrator that delivers customized self-funded benefit programs. We are a mission-driven company focused on innovative cost containment strategies and driving down plan costs.
Provide personalized onboarding and ongoing adherence support to patients and caregivers throughout their treatment journey.
Coordinate insurance coverage verification, reimbursement support, and financial assistance enrollment for eligible patients.
Serve as the primary point of contact for healthcare providers, resolving access barriers and ensuring seamless coordination with internal teams.
The partner company provides comprehensive non-clinical patient support for individuals managing rare and ultra-rare diseases. They foster a collaborative, patient-focused culture with a remote work environment and a commitment to improving healthcare access.
Act as the primary customer contact, providing clinical knowledge of Amgen's oncology products and communicating clinical and economic benefits to medical professionals.
Create and execute comprehensive territory plans including branded sales messages, medical educational programs, and achieving sales targets.
Partner with colleagues to share best practices and continuously learn to grow as a Senior Oncology Specialist.
Amgen is a biotechnology pioneer dedicated to serving patients with serious illnesses by discovering and delivering innovative medicines. Founded in 1980, it has grown into one of the world's leading independent biotechnology companies, reaching millions of patients globally.
Execute and support the thought leader engagement strategy for the platinum resistant ovarian cancer asset ELAHERE.
Build long-term relationships with national/regional HCPs to support strategic engagement objectives and foster collaboration.
Oversee regional speaker programs, coordinate TL engagements at medical conferences, and collaborate with cross-functional teams.
AbbVie discovers and delivers innovative medicines and solutions for serious health issues in immunology, oncology, neuroscience, and aesthetics. It is a large global biopharmaceutical company with a culture focused on making a remarkable impact on patients' lives.
Lead the strategy and execution of oncology site relationship development and engagement initiatives for clinical trials.
Build and strengthen long-term partnerships with key clinical research sites and networks using data-driven approaches.
Collaborate with cross-functional teams to incorporate site insights into trial strategies and present engagement plans during client meetings.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They process applications and share shortlists with employers, focusing on efficient and objective recruitment.