Nurse conducts clinical review of cases not meeting criteria by performing clinical intake.
Adjudicates (closes), requests additional clinical information or escalates to Medical Directors.
Active PRC and USRN License required with 2 years Bedside Experience.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact.
Manage patients through virtual encounters, reviewing vital signs and symptoms to drive treatment adjustments.
Conduct clinical audits and implement quality improvement strategies to improve patient outcomes.
Coach and develop a team of Nurse Practitioners through feedback and clinical education.
Cadence Health delivers proactive care to seniors by extending the reach of primary care providers. Their technology and clinical care team support patients every day at home, partnering with leading health systems to monitor patients and improve outcomes.
Provides nursing assessments within the standards outlined in the state Nurse Practice Act.
Provides clinical assessments and health education using telecommunications in accordance with protocols and guidelines.
Uses the nursing process to identify patient care needs, risk and safety issues, and appropriate health care referrals.
Carenet Health delivers patient-centric healthcare solutions. We foster a collaborative team of RNs across the country and are committed to creating an inclusive environment for all employees.
Handle calls and respond appropriately within their scope of practice.
Coordinate telehealth meetings between participants and clinicians and ensure timely care delivery.
Troubleshoot logistical care delivery issues and support smooth care transitions between settings.
WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. They serve the most vulnerable seniors with better quality and compassion in a value-based model, showing they care about their team members and offer great benefits.
Handle calls (inbound/outbound) as assigned, responding as appropriate within their scope of practice, and consulting with other clinicians, including on-call providers
Coordinate telehealth meetings between participants and clinicians
Support the clinical care and home health teams to manage smooth care transitions between settings (hospitals, skilled nursing facilities, etc.), escalating changes in participants’ conditions as appropriate
WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. The company serves the most vulnerable seniors with better quality and compassion in a value-based model.
Rapidly assess and prioritize patients' healthcare needs and direct them to the appropriate level of care.
Conduct patient interviews, evaluate symptoms, perform initial assessments, and apply critical thinking to determine urgency and disposition.
Provide advice, educate, and coordinate care, while managing priorities effectively under pressure to ensure timely and appropriate patient attention.
Virginia Mason Franciscan Health provides exceptional healthcare. They have a comprehensive network of 10 hospitals and nearly 300 care sites across the greater Puget Sound region.
Perform telephonic symptom assessment and triage using evidence-based protocols to ensure appropriate care and disposition.
Document patient interactions accurately in the EMR and educate callers on virtual care, provider referrals, and available community resources.
Deliver excellent customer service while maintaining confidentiality, sound judgment, and effective communication with diverse populations.
UnityPoint Health is committed to team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare. They champion a culture of belonging where everyone feels valued and respected, honoring the ways people are unique and embracing what brings us together.
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program.
Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes.
Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure.
Guidehealth is a data-powered healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine. Guidehealth is a growing and innovative organization and employees are expected to adapt to evolving business needs.
Supervise day-to-day operations of assigned Utilization Management staff.
Provide full people management for assigned Utilization Management teams, including hiring and performance management.
Drive team performance against key metrics, including engagement, productivity, and quality scores.
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.
Provide empathetic, non-judgmental care while maintaining clear emotional boundaries
Accurately document consult outcomes to support safe and effective prescribing
Montu is Australia's largest healthtech business focusing on alternative healthcare. Founded in 2019, it supports patients, doctors, and pharmacies, and is known for its rapid growth and being named #1 on LinkedIn’s Top Startups Australia 2024.
Drive quality, safety, and compliance through systems by identifying issues and implementing process improvements.
Execute order management and EMR workflows by reviewing and approving new orders and supporting clinical escalations.
Manage end-of-episode processes, hospital holds, and monitor patient status and quality compliance through dashboards and alerts.
They are building an AI-native physical care platform to fix US healthcare, starting with home health. The company has assembled a team of AI experts from leading firms and paired them with healthcare veterans to operate at the speed of an AI company.
Supervise call center staff and provide day-to-day supervision to communicators, implementing performance standards.
Monitor inbound/outbound customer service calls to ensure script adherence, call integrity, compliance, and proper phone technique.
Analyze call metric and productivity reports, share analysis with leadership, and offer recommendations based on analysis.
Inizio Engage is a strategic, commercial, and creative engagement partner that specializes in healthcare. We have a passionate, global workforce of over 7,000 experts in more than 20 countries and an exceptional, collaborative culture.
Provide empathetic, non-judgmental care while maintaining clear emotional boundaries
Accurately document consult outcomes to support safe and effective prescribing
Montu is Australia's largest healthtech business with a focus on alternative healthcare. Founded in 2019, it supports patients, doctors and pharmacies through its Alternaleaf clinic, offers accredited healthcare education to clinicians via its SAGED platform and dispensing solutions to pharmacies across Australia through Leafio.
Serve as the lead clinical liaison for partner providers across multiple regions.
Partner with PRMs on clinic visits and ongoing relationship management to strengthen long-term program engagement.
Translate field insights into actionable intelligence for clinical, product, and engineering teams, directly informing service improvements and care model refinement.
Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions. They pair patients with a dedicated clinical team and integrate deeply into health system EMRs and workflows.
Provide health assessments and treatment solutions via telephone, video, or chat functions.
Receive inbound phone calls from patients seeking answers to various medical conditions.
Stay up to date with current health trends and recommendations.
PWNHealth is a national clinician network improving early disease detection and prevention using advanced diagnostics and telehealth, serving all 50 states and Puerto Rico. They are a mission-driven company with a positive culture, backed by leading growth equity firms Spectrum Equity and the Blue Venture Fund (BVF).