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.
Provide consistent, quality customer service to internal staff and external patients, taking ownership of each call to enhance the customer experience.
Manage patient requests including appointment scheduling, electronic messaging to clinical teams, and answering questions regarding medication refills.
Demonstrate proficient data entry skills, knowledge of insurance billing, and maintain confidentiality while performing other assigned duties.
Community Health Center, Inc. (CHC) is a creative and dynamic provider of primary medical, dental, and behavioral health services, with offices in Connecticut, Colorado and California. The organization employs several hundred providers, delivers over 500,000 patient visits annually, and is recognized for its Weitzman Institute research and practice transformation.
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.
Monitor and interpret patient vitals, assessments, and alerts within Welby Health’s platform.
Develop, implement, and adjust individualized care plans that address both clinical and social needs.
Deliver patient education and coaching via telephone and secure messaging.
Welby Health is committed to transforming the way complex conditions are managed. They aim to advance patient outcomes by integrating efficient care coordination, data-driven insights, and enhanced communication across the care continuum. Welby Health is headquartered in San Diego.
Lead the day-to-day operations of a remote team of RNs and LPNs responsible for reviewing and resolving real-time patient alerts.
Conduct clinical audits and chart reviews to evaluate triage quality, documentation accuracy, and adherence to care protocols.
Provide structured coaching, real-time feedback, and formal performance management to improve both clinical judgment and productivity.
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. Cadence operates as a full clinical care delivery organization.
Provide timely, efficient, and accurate triage response and documentation according to nursing standards and physician protocols.
Evaluate patient needs, perform triage, and coordinate with the clinical team in an ambulatory practice setting.
Maintain accurate documentation in medical records, schedule patient visits, and provide education on patient care and health promotion.
Piedmont Healthcare is a healthcare provider offering services across Georgia. It is a large organization with a focus on patient care and corporate operations.
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.
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.
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).
Provide clinical review and correspondence for utilization management, including medical necessity reviews and member communications.
Collaborate with Medical Directors to ensure evidence-based decisions that meet NCQA and CMS standards.
Maintain productivity and quality while working 100% remotely in a fast-paced environment.
Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With over 250 employees, the company fosters a supportive, growth-oriented environment and has been named to the Inc. 5000 list and a Top 5 LinkedIn Startup.
Answer inbound calls with professionalism and customer service, resolving inquiries and triaging as needed.
Assist with appointment scheduling, outreach for missed appointments, and document call data.
Maintain confidentiality and compliance with HIPAA while supporting clinical teams and call center metrics.
New York Psychotherapy and Counseling Center is New York State's largest community mental health clinic, serving over 15,000 clients monthly through in-person and telehealth services. A mission-driven organization with over 50 years of experience, recognized as a Top Place to Work and Top Mental Health Care Provider in New York.
Conduct follow-up and urgent telehealth assessments on flagged patients, adjusting plans of care and coordinating with providers.
Interpret trend-based insights from the Circadia platform to prioritize high-risk patients and intervene on weekend alerts.
Complete documentation same day using AI-powered tools and provide feedback to improve virtual workflows.
Circadia Health is a growth-stage healthcare AI company dedicated to preventing avoidable hospitalizations and transforming senior-care operations. Our technology touches 40,000+ post-acute patients daily and we are backed by leading healthcare and AI investors, headquartered in El Segundo, CA.
Answer emergency and non-emergency calls, dispatch responses, and monitor medical alerts with compassion.
Provide exceptional customer support using scripted and non-scripted responses in high-pressure situations.
Record call details accurately, troubleshoot alarms, and recommend preventative healthcare services.
VRI connects people with care through non-emergency medical transportation and personal home care services. They serve the underserved to improve access and outcomes, with a focus on compassionate support.
Perform concurrent and retrospective reviews on all facility and appropriate home health services.
Monitor level and quality of care and proactively manage acutely and chronically ill patients.
Act as liaison to Plan Medical Director and coordinate interdisciplinary approach.
Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities. Founded in 2021, they serve 200,000+ seniors in 1,500+ communities across 32 states with a team of over 1,000 clinicians.
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.
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.
Provide medication abortion care via video, phone, or asynchronous visits.
Review patient medical intake, communicate via HIPAA-compliant messaging, and determine eligibility.
Respond to medical inquiries, direct nursing staff, and support a patient-centered approach.
Hey Jane provides safe, discreet medication abortion treatment and reproductive health care via telemedicine. They are a startup committed to equitable healthcare, with an in-house clinical team and a mission to challenge the status quo in healthcare delivery.
Provide virtual comprehensive care to patients of all ages across a wide range of acute, chronic, and mental health conditions.
Conduct age-appropriate history and exams, order and interpret diagnostic tests, and develop treatment plans.
Collaborate with provider and support teams, maintain accurate records, and counsel patients and families.
Included Health is a healthcare company delivering integrated virtual care and navigation, on a mission to raise the standard of healthcare for everyone. They are an Equal Opportunity Employer with a remote-first culture and offer comprehensive benefits.
Support care navigation for oncology members by facilitating treatment, symptom tracking, and re-education.
Collaborate with RNs and providers to coordinate care plans, referrals, and authorizations.
Maintain regular contact with members via phone, text, email, and video calls for follow-up and support.
Renalogic helps clients manage the human and financial costs of chronic kidney disease. We hire people who are humble, hungry, and smart, and our 96% client retention shows we're building a company we're proud of.