Supervise daily operations of clinical compliance auditors and specialists.
Assist in developing coordinated team processes and managing UM and PHM plan adherence.
Serve as clinical services liaison to senior management and ensure timely documentation.
Guidehealth is a data-powered healthcare company focused on operational excellence and value-based care. They emphasize empathy, AI, and collaboration, with a remote-first culture.
Lead and develop a team of Patient Success Advocates, providing coaching and performance management.
Monitor team metrics like volume, response times, and patient satisfaction to drive improvements.
Serve as escalation point for complex patient interactions and collaborate cross-functionally.
Cadence is a clinical AI company that automates the treatment of chronic disease. It partners with 20+ leading health systems, serves over 100,000 patients, and has been recognized by TIME and LinkedIn as a top startup.
Supervise interdisciplinary team members including RNs, LVNs, and social workers to ensure high-quality care delivery.
Lead key initiatives to improve clinical care and launch new programs while resolving workflow issues.
Collaborate with providers to enhance patient care and support team performance reviews and onboarding.
Vynca provides comprehensive care for individuals with complex needs, aiming for more quality days at home. They are a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.
Provide virtual nursing care and leadership to diverse patient populations across acute and sub-acute settings.
Utilize critical thinking to diagnose clinical problems and implement evidence-based interventions.
Collaborate with onsite teams to coordinate care, mentor staff, and ensure patient-centered outcomes.
Equum Medical is an innovative leader in healthcare technology, revolutionizing acute care telehealth through cutting-edge solutions. They promote flexible scheduling and work-life balance for their dynamic team.
Deliver comprehensive, coordinated health services remotely using telehealth technology.
Assess patients, provide education, manage chronic conditions, and coordinate care plans with multidisciplinary teams.
Dedicate 50% of time to direct patient care and 50% to care transformation, including mentoring and leading simulations.
CommonSpirit Health is one of the nation's largest nonprofit Catholic healthcare organizations, providing integrated health services. With over 157,000 employees and 45,000 nurses, the organization operates more than 2,300 clinics and 137 hospitals across 24 states.
Provides disease-specific management and oncology care coordination for patients and families throughout treatment.
Documents assessments and interventions in real time, collaborates with oncologists, and proactively manages symptoms.
Requires two years of oncology experience, an active RN license, and strong computer skills for a remote work environment.
AON is an alliance of physicians and veteran healthcare leaders dedicated to ensuring the long-term success and viability of oncology diagnosis and treatment in community-based settings. It is the fastest growing national network of community oncology practices, employing staff across the country to empower physicians and deliver exceptional cancer care.
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.
Provide individualized clinical education, treatment-support services, and care coordination for patients in remote patient nutrition support and adherence programs.
Conduct structured outreach, identify barriers to treatment adherence, and develop practical strategies within program scope.
Document patient interactions, escalate clinical concerns per protocols, and collaborate with cross-functional teams.
PRO-spectus is a supportive, dedicated, and teamwork-driven company focused on improving the lives of patients they support. They have a culture that celebrates personal and professional accomplishments with humility and compassion.
Oversee and manage the CareConnect Clinical Triage and Treat team, ensuring timely, high-quality remote patient care 7 days a week.
Analyze operational data, lead performance improvement initiatives, and communicate staffing and operational needs to Market Leadership.
Provide backup clinical coverage and support recruitment, onboarding, training, and professional development of team members.
WellBe provides comprehensive healthcare services focused on helping patients lead healthier, more meaningful lives. They are a value-based care organization with a patient-first approach, operating across multiple states with a culture centered on teamwork and clinical excellence.
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.
Lead, coach, and develop a team of Engagement Specialists through regular feedback and performance management.
Conduct compassionate outreach to patients, explain services, and guide them through onboarding with accurate EHR documentation.
Oversee daily operations, optimize PRM workflows, and collaborate with clinical teams for seamless care transitions.
The employer is a mission-driven healthcare organization dedicated to improving access to behavioral health support for individuals navigating complex medical journeys. It is a fast-growing, startup-like company with a collaborative culture focused on continuous learning and innovation.
Provides visionary leadership and strategic direction for care coordination and service delivery teams.
Drives transformational initiatives to scale operations, enhance quality, and improve patient outcomes.
Uses data analytics and key performance indicators to monitor program effectiveness and guide evidence-based decision-making.
WellSky is a technology company that provides software, analytics, and services for intelligent, coordinated care across health and community care. The company fosters a culture of independent thinking, collaboration, and innovation, with a focus on improving outcomes and lowering costs.
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.
Manage UM nurse team performance, SLAs, and quality improvement.
Handle escalated UM cases and provider disputes 25% of time.
Partner with clients, medical directors, and IDTs to ensure consistent decision-making.
IntusCare builds an end-to-end ecosystem for Programs of All-Inclusive Care for the Elderly (PACE) to improve care, financial performance, and compliance. As a healthcare technology company, we empower teams to improve outcomes for dual-eligible seniors.
You are responsible for supporting care delivery by partnering with Advanced Practice Providers to execute individualized care plans for patients with chronic kidney disease, hypertension, diabetes, and congestive heart failure.
This role focuses on enhancing clinical outcomes, patient engagement, and care coordination through education, remote monitoring, medication management, and longitudinal patient support.
Key responsibilities include visit preparation, care plan execution, disease management education, medication management, quality measure support, and cross-functional collaboration.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They are a growing company building a healthcare delivery model focused on improving patient outcomes and quality of life, with a robust team and culture that emphasizes innovation and support.
Supervise day-to-day operations of clinical compliance auditors and specialists, serving as a liaison to senior management.
Coordinate orientation, training, and performance monitoring for clinical compliance auditors to promote professional growth.
Oversee development of UM and PHM agenda, audit guidelines, and ensure adherence to denial processes and compliance requirements.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, aiming to make healthcare affordable and improve patient health. It is a physician-led, remote-first organization that leverages AI and predictive analytics to empower partners in delivering high-quality, value-based care.
Conduct high-volume telehealth pre-assessment consults, educating patients on safe usage and side effects.
Provide empathetic, non-judgmental care while documenting accurately to support safe prescribing.
Liaise with prescribers and the Patient Care Team to ensure continuity of care in a fast-paced remote environment.
Montu is Australia's largest healthtech business focused on alternative healthcare, supporting patients through its Alternaleaf clinic and other platforms. Founded in 2019, it has grown rapidly, ranked #1 in Deloitte TechFast 50 for two consecutive years and #1 on LinkedIn's Top Startups Australia 2024, with a remote-first culture.
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 and video-based follow-up care for post-hospital discharge patients, focusing on medication reconciliation, symptom screening, and care coordination.
Collaborate with nursing team and coordinate across settings to keep patients connected and improve health outcomes.
Meet individual performance targets while contributing to team population health goals in a digital-first environment.
Galileo is a team-based medical practice working to improve the quality and affordability of health care for all. Operating across 50 states, Galileo offers high-touch, data-driven, multi-specialty, longitudinal care to diverse and complex patients. Founded by Dr. Tom X. Lee, the team of leading innovators from healthcare and technology is committed to transforming healthcare through inclusive and collaborative culture.
Conduct virtual exams and history for patients across all ages.
Diagnose and treat a broad range of acute, chronic, and mental health conditions.
Develop treatment plans, order tests, and educate patients and families.
Included Health is a healthcare company delivering integrated virtual care and navigation. They aim to break down barriers to provide high-quality care for everyone, offering services like urgent care, primary care, and behavioral health.