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 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.
Guide patients through the healthcare system by translating medical complexity into plain language and coordinating care.
Build and own care plans that address both medical needs and social determinants like transportation and food access.
Solve real problems with persistence by navigating denied claims, missed referrals, and unaffordable medications.
Careway Health is building an advocacy-first telehealth platform to help seniors overcome complex health and social challenges and maximize independence. They are a growing company focused on democratizing access to high-quality care with a team of physicians and health advocates.
Build trusted relationships with older adults and their families, grounded in listening and empathy.
Serve as a go-to resource for navigating medical systems, social services, and emotional wellness needs.
Create individualized care plans that address both clinical needs and Social Determinants of Health.
Sailor Health is revolutionizing mental health care for older adults by addressing one of the fastest-growing and most underserved healthcare segments in America. They are a mission-driven team committed to compassionate, flexible support for seniors.
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.
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.
Learn Solace's proprietary system, tools, and technology while providing your unique experience in every interaction.
Build strong, trusting relationships with patients, using listening and empathy as the foundation for every interaction.
Identify and prioritize patients’ needs and build out a care plan that holistically addresses social determinants of health.
Solace helps patients navigate healthcare complexity by pairing them with expert advocates. They are a Series C startup founded in 2022, with a lean, mission-driven team growing quickly, and a culture that is intense and not for coasting.
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.
Provide telephonic case management and utilization review for assigned consumers.
Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
Collaborate with healthcare providers, payors, and internal teams to coordinate care.
Cottingham & Butler helps clients through life's toughest moments by providing insurance and benefits solutions. The company fosters a culture of continuous improvement, seeking to hire, train, and grow the best professionals in the industry.
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 telephonic case management to proactively drive return to work.
Perform utilization review and coordinate care with providers and adjusters.
Evaluate treatment plans and partner with adjusters to achieve optimal outcomes.
AmTrust Financial Services is a fast-growing commercial insurance company providing comprehensive telephonic case management. They foster a diverse and inclusive culture with a focus on attracting and retaining the best talent.
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.
Assess, plan, implement, and coordinate comprehensive care plans to meet individual health needs and ensure cost-effective healthcare delivery.
Serve as a liaison facilitating collaboration among patients, families, physicians, and providers to promote quality of care.
Provide specialized education on disease-specific conditions and remain current with medical trends and procedures.
Arkansas Blue Cross and Blue Shield is a health insurance company providing healthcare coverage and services. They are consistently ranked as a top workplace in Central Arkansas with an inclusive culture and average employee tenure of 10 years.
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.
Develop and coordinate individualized treatment plans and discharge services for patients.
Perform medical record reviews to assess admission appropriateness and ensure compliance with standards.
Support denials management and appeals for insurance claims to ensure quality care.
Northwestern Medicine is a healthcare system focused on patient-first care. We offer a supportive workplace with competitive benefits and a culture of growth.
Conduct comprehensive health assessments for Medicare Advantage members via telehealth.
Create personalized care plans and coordinate with primary care physicians and care teams.
Document visits and close gaps in care using Clover's software and EMR systems.
Clover is reinventing health insurance by combining data with human empathy to keep members healthier. The company is a mission-driven team focused on improving healthcare, with a culture that values diversity and inclusion.
Act as the primary point of contact for patients, healthcare providers, and program stakeholders.
Manage patient access, reimbursement, and therapy support processes.
Build trusted relationships with healthcare professionals and ensure coordinated care.
A healthcare services organization that partners with patients and providers to navigate complex treatment processes. The culture is purpose-driven, collaborative, and inclusive, with an emphasis on improving health outcomes.
Perform utilization review including precertification and concurrent reviews using medical necessity criteria.
Collaborate with medical directors and providers on complex cases and integrate AI tools into workflow.
Initiate referrals to disease management programs and participate in quality improvement initiatives.
Guidehealth is a data-powered healthcare company that uses AI and predictive analytics to improve healthcare affordability and patient outcomes. It is a physician-led organization with a culture of accountability, learning, innovation, and empathy.
Triage and provide clinical support for incoming patient communications.
Conduct phone assessments of clinical symptoms to determine the best path of care.
Assist in the development of processes and systems for urgent care and virtual triage.
Galileo is a team-based medical practice providing high-touch, data-driven, multi-specialty care across the United States. They are a team of healthcare and technology innovators focused on improving care quality and affordability for all.
Complete biopsychosocial assessments to identify clinical, behavioral, and social needs.
Proactively identify and resolve care gaps in patient records, ensuring timely clinician review.
Coordinate referrals, follow-up appointments, and community-based care support services.
Knownwell provides weight-inclusive healthcare for all, offering weight management, primary care, nutrition counseling, and health coaching. They are backed by $50M in funding, scaling fast to expand access to evidence-based obesity care nationwide.