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.
Provide patient-focused telehealth clinical triage assessments and health education via phone, video, and chat.
Work independently to make clinical decisions, assess needs, and direct patients to appropriate care levels while documenting interactions.
Monitor performance metrics, participate in coaching sessions, and communicate with clients and team members.
Carenet Health is a behind-the-scenes partner for over 250 of the nation's premier health plans and health systems, providing telehealth and virtual care clinical triage assessments and health education. Named one of America's fastest-growing private companies by Inc. Magazine for eight consecutive years, the company is integrity-driven and focused on compassionate, evidence-based care.
Act as a liaison for a patient panel of medically stable patients, coordinating care between internal and external providers.
Monitor and triage lab orders and results, providing education and medical management support to patients and families.
Triage emergent issues in a time-sensitive manner and coordinate care with hospitals for medical stabilization admissions.
Equip is the leading virtual, evidence-based eating disorder treatment program on a mission to ensure everyone with an eating disorder can access treatment that works. Founded in 2019, the company is fully virtual and has been recognized as one of the most influential companies of 2023, with a diverse and passionate team.
Provide clinical support and handle medical inquiries via a ticketing system with empathetic written communication.
Manage inbound and outbound calls to address patient queries and offer support.
Maintain accurate documentation and collaborate with internal teams across time zones.
Eucalyptus is a digital healthcare company on a mission to make good health last a lifetime, building clinics like Juniper for weight management and other personalized care programs. The company, now part of Hims & Hers, has supported over 350k patients, achieved 130% YoY revenue growth, and operates across multiple countries.
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.
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 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.
Supports clinical safety, accuracy, and oversight of integrated AI tools by reviewing AI-assisted outputs and surfacing risks.
Applies nursing judgment to review charts, calls, messages, and other member interactions to assess quality, safety, and member experience.
Assists with data collection and basic analysis for quality and safety work, and participates in cross-functional improvement efforts.
Included Health is a healthcare company delivering integrated virtual care and navigation. They are on a mission to raise the standard of healthcare for everyone, and offer members care guidance, advocacy, and access to personalized virtual and in-person care.
Serve as the main point of contact for patients and families transitioning from or seeking post-acute services.
Make clinical level-of-care determinations using discussions, medical records, and other clinical data.
Provide patient education on home health, hospice, palliative care, Medicare coverage, and billing.
Gentiva is a national leader in hospice, palliative, and home health care, providing compassionate care to patients in their homes. With nearly 600 locations and thousands of clinicians across 38 states, they offer a collaborative environment where inspiring achievements are recognized.
Provide direct clinical support to patients undergoing medication abortion through telemedicine, including triage, assessment, and nursing guidance.
Deliver culturally responsive, evidence-based care ensuring every patient feels heard and supported during critical moments.
Maintain active RN licensure in CA and at least one other state, with bilingual Spanish fluency and 2+ years clinical experience.
Hey Jane provides safe, discreet medication abortion and reproductive health care via telemedicine, having helped over 100,000 patients. The in-house clinical care team includes board-certified doctors, advanced practice clinicians, nurses, and patient care advocates, fostering a mission-driven culture focused on equitable healthcare.
Support payer audits and medical record reviews, ensuring timely submission of documentation.
Manage medical review requests and appeals associated with CMS contractors and regulatory agencies.
Review clinical documentation using audit checklists and partner with teams to gather required records.
VitalCaring is a provider of home health and hospice services founded in 2021. They are a growing company focused on quality and compliance, with a mission to deliver exceptional patient care.
Manage the member's clinical experience from request through desired outcome, including account activation and medical history drafting.
Coordinate video or phone consults with specialists and schedule monitors in advance, troubleshooting issues as needed.
Conduct ongoing follow-up post-consult and facilitate local recommendations, communicating with primary care physicians or specialists.
Transcarent is a health and care platform that combines medical, pharmacy, and point solutions with a generative AI-powered experience for health consumers. With over 1,700 employer and health plan clients serving 21 million Members, they foster a culture of People First, Care, Resilience, Results, and Humble and Human.
Coordinate and oversee the MDS process for all residents, ensuring accuracy, completeness, and regulatory compliance.
Collaborate with interdisciplinary teams to maximize reimbursement through accurate documentation and chart review.
Maintain knowledge of Medicare, Medicaid, and regulatory requirements, and educate staff on documentation best practices.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. We leverage our global network to connect clients with qualified professionals and offer tailored services to meet unique business needs.
Provide virtual comprehensive care to patients of all ages across a wide range of conditions.
Evaluate, diagnose, and treat acute, chronic, and mental health conditions for pediatric and adult patients.
Collaborate with provider and support teams to improve healthcare access and quality.
Included Health is a healthcare company delivering integrated virtual care and navigation to members. It is a remote-first organization offering comprehensive benefits and a focus on high-quality care for everyone.
Conducting virtual assessments, diagnoses, and evidence-based treatment for patients.
Managing and coordinating care for chronic conditions.
Providing preventive care, wellness counseling, and health education.
Curai Health aims to transform healthcare using AI and clinical expertise to make care more affordable and accessible. They are a mission-driven team committed to collaboration and driving meaningful impact in healthcare.
Provide high-quality nursing care and perform study procedures like vital signs, specimen collection, and ECGs in patients' homes.
Conduct patient assessments, monitor for adverse events, and document all activities per study protocols.
Maintain adherence to ICH-GCP guidelines, HIPAA regulations, and communicate effectively with patients and study teams.
WEP Clinical connects skilled nurses with flexible clinical research opportunities, bringing trials directly to patients' homes. The company operates as a contractor network with a focus on patient-centered care and medical innovation.
Provide telephonic nursing assessment and care planning for pediatric patients using established protocols.
Prioritize patient interactions by acuity and collaborate with on-call providers as needed.
Document all encounters in the electronic medical record and communicate follow-up instructions.
Advocate Health is the third-largest nonprofit, integrated health system in the US, created from the combination of Advocate Aurora Health and Atrium Health. It employs 155,000 teammates across 69 hospitals and over 1,000 care locations, focusing on clinical innovation and equitable care.
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.
Providing remote health coaching to members at risk for chronic kidney disease or have chronic kidney disease.
Working in partnership with participating members to increase their understanding and management of conditions that impact kidney health.
Establishing and maintaining contact with assigned and active members via video, phone, text, and email.
Renalogic is dedicated to helping clients manage the human and financial costs of chronic kidney disease. They hire people who are humble, hungry, and smart, and they have a 96% client retention rate.
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.