Provides telephonic assessments of members’ medical, psychosocial, physical and spiritual needs.
Develops, implements, and monitors person centered service plan and ensures continuity of care across all healthcare settings.
Educates members on disease processes, preventative health, and quality of life interventions.
MJHS is a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. They foster collaboration, celebrate achievements, and promote fairness for all with comprehensive compensation and benefits.
Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordination activities.
Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.
Interview, hires, mentors, evaluates, coaches and manage performance for a diverse care coordination team.
Humana Inc. is committed to putting health first for its teammates, customers, and company. Through Humana insurance services and CenterWell healthcare services, they aim to make it easier for the millions of people they serve to achieve their best health.
Conduct thorough assessments of patients' needs and develop treatment plans.
Monitor treatment effectiveness and adjust plans while documenting outcomes.
Advocate for patients to ensure quality care delivery and assist in cost reduction.
The company provides remote case management nursing services. The posting mentions an engaging company culture that values diversity and continuous learning.
Responsible for quality assurance, accuracy and overall integrity of the UAS-NY assessment data and visit documentation completed by core team nurses as well as, business partners’ nurses.
Performing assessment audits, identifying trends that require staff retraining, and implementing corrective action plans in collaboration with Clinical management staff.
Responsible for ongoing orientation, training and education of Assessment Nurses conducting UAS-NY assessments, and participate in establishing educational modules for staff orientation and re-training.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that are expanding services in response to patients' and members' needs. MJHS is a supportive community committed to excellence, respect, and providing high-quality, personalized health care services.
Work independently to make clinical decisions on routine patient care matters.
Provide patient-focused care and guidance on the phone or online.
Influence people to make better health decisions.
Carenet Healthcare Services provides telehealth and virtual care clinical triage assessments, health education and other services to diverse populations of patients and health plan members. They are a behind-the-scenes partner for 250+ of the nation’s premier health plans, health systems and their partners.
Deliver coordinated, patient-centered virtual Care Management by telephone or video that improves members' health outcomes.
Create impactful care plans together with members and our diverse care team, helping members achieve their desired goals.
Help members navigate complex medical conditions, treatment pathways, benefits, and the healthcare system in general.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Empowers patients toward optimal health through remote support and collaborative care coordination.
Assesses patient needs, develops personalized care plans, and provides direct clinical coaching.
Monitors progress, coordinates diverse services, and leverages telehealth, tracking compliance.
St. Joseph's Hospital and Medical Center, located in Phoenix, Arizona, is a 571-bed non-profit hospital offering various health services. Founded in 1895, it is known for quaternary care, medical education, and research, and it consistently ranks among the top hospitals in the U.S.
Engage with members to support their chronic and/or complex health care needs.
Create and manage individualized care plans to meet healthcare goals.
Partner with members, families, providers, and resources to coordinate care.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. They prioritize members' well-being and are committed to service, sustainability, and innovation.
Work remotely to enhance member management and maximize cost effectiveness.
Collaborate with clients and members to promote wellness and assist in achieving health goals.
Collect data, conduct clinical reviews, and ensure documentation complies with regulations.
Guidehealth is a data-powered healthcare company dedicated to operational excellence. They aim to make healthcare affordable and improve patient health, employing remotely-embedded Healthguides™ and a Managed Service Organization to build stronger connections with patients and providers.
Provide timely, high-quality clinical recommendations grounded in evidence-based practice.
Effectively communicate assessment findings and provide advice to the in-center team.
Provide input into resident care plans in collaboration with the in-center team.
Summerset is the second largest retirement village operator in New Zealand, passionately dedicated to providing quality service to its clients. They are growing quickly, with 39+ villages, and proud of their dynamic work environment and diverse workforce.
Sees adults for metabolic health services in a virtual setting.
Listens to the aspirations of the patient and ensures care is tailored to the patient’s unique health journey.
Provides clinical guidance to medical assistants and nursing teams as assigned.
Knownwell delivers weight-inclusive healthcare. They offer weight management, primary care, nutrition counseling, and health coaching combining in-clinic and virtual care, backed by $50M in funding.
Evaluates certification requests by reviewing group specific requirements.
Triage the call to determine if a Utilization Review Nurse is needed.
Cottingham & Butler sells a promise to help clients through life’s toughest moments by hiring, training, and growing the best professionals. The company culture is guided by the theme of “better every day” constantly pushing themselves to be better than yesterday.
Build meaningful relationships with patients and families, understanding their goals, barriers, and motivators.
Creating personalized care plans that go beyond diagnoses, addressing social determinants, emotional well-being, and behavioral health when applicable.
Coordinate care across providers and settings, ensuring safety, quality, and continuity.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
The NP will use their expertise and clinical judgment to provide telehealth sessions to patients via phone and/or video for prescriptive and/or informational sessions.
The NP will adhere to the required state telemedicine regulatory guidelines.
The NP will use their expertise and clinical judgment to conduct comprehensive health assessments on patients as they deem appropriate.
Everlywell's mission is to transform lives with modern, diagnostics-driven care. They are headquartered in Austin, Texas with a national clinician network composed of hundreds of physicians, nurses, genetic counselors, PharmDs, and member care specialists.
Complete timely review of healthcare services using appropriate medical criteria to support determinations.
Document clinical findings and rationale clearly and accurately in accordance with federal/state regulations, URAC standards, and Guidehealth policies.
Communicate precertification and concurrent review decisions—verbally and in writing—to required parties within defined timeframes.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.