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.
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.
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.
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.
Develop trusting relationships with patients, grounded in listening, respect, and clarity.
Assess the whole person — medical, social, and environmental factors — to pinpoint barriers and needs.
Create individualized care plans that integrate medical, social, and behavioral supports.
Baba makes navigating health, aging, and loneliness easier by pairing each patient with a real human advocate team that supports them between visits. Baba is backed by top tier investors and supports thousands of families across assisted living, nursing homes, and at-home settings.
Provide case management to members including medical, social, psychological, physical, and spiritual needs.
Develop, implement, and monitor the care plan in conjunction with the PCP, caregivers, and other team members.
Help meet the member's needs.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that are expanding services in response to patients' needs. At MJHS, they are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services.
Conducts psychosocial assessments to identify patient and family needs through video technology and telephone calls
Provides grief and bereavement support to patients and families, including anticipatory grief counseling
Completes financial needs assessments and assists with navigation on MediCare, MediCal, Disability and Social Security
Vynca is dedicated to transforming care for individuals with complex needs by providing comprehensive support for more quality days at home. They are a close-knit community guided by core values like Excellence, Compassion, Curiosity, and Integrity.
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.
Complete all documentation associated with client calls.
Complete all required reports associated with Needs Assessment/Referral Development.
Pyramid Healthcare is dedicated to offering high-quality care in addiction treatment, mental health recovery, and eating disorder treatment. They focus on client-centered care and comprehensive behavioral healthcare, supporting clients at every recovery stage.
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.
Enjoy making outbound calls and reaching out to patients, members, and customers
Outreach to patients to schedule appointments for preventative health screenings
Assist members and patients with benefits and insurance information
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. Interacting with 1 in 3 Americans every day, they deliver positive healthcare experiences and improving outcomes.
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.
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.
Play an active role in patient registration and enrollment, including organizing community engagement and outbound calls to patients.
Engage with a panel of assigned patients to provide care navigation, appointment logistics, prescription drug support, lab support, referral coordination, care plan adherence, and resource sharing.
Participate in community events to support patient activation and trust-building, including relationship-building with key contacts, facilitating group education sessions, and liaising with community organizations.
Zócalo Health is a tech-driven healthcare provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared experiences. Founded in 2021, they are backed by leading healthcare and social impact investors, aiming to improve the lives of communities with culturally competent primary care, behavioral health, and social services.
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.
Provides non-clinical administrative support to Case Managers and Care Coordinators.
Obtains and manages medical documents, ensuring accurate record retrieval.
Prioritizes tasks based on expedited requests with attention to detail.
Spectrum Healthcare Resources (SHR) delivers systems and processes designed to meet the unique needs of Military and VA Health Systems. They provide physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies.
You will be responsible for using your assessment and communication skills to engage with patients in need of clinical support to determine and prioritize their needs.
Conduct timely telephonic clinical outreach to identified patients.
Collaborate with PCPs, NPs, and other members of the healthcare team to coordinate care for patients and actively help keep them stable at home.
Vytalize Health is building a market leader in value-based healthcare. They are a rapidly growing organization that embraces the power of AI and encourages innovative, responsible use of emerging technologies in their work.
Provides after hours support to members and leaders seeking services.
Problem-solves and assists with high touch and escalated/sensitive calls.
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.
Answer a high volume of inbound calls; transfer and directs calls; provide exceptional customer service via telephone
You’ll be responsible for all front office patient coordination; to be completed in a timely manner (e.g. appointment scheduling, transport coordination)
Communicate clearly and effectively (both oral and written) with patients, clients, Team Members, peers and Leadership.
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.