Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement.
Accurately track and document work on a variety of internal software tools and platforms.
Evry Health is on a mission to bring humanity to health insurance. They are a high-technology health plan that expands benefits, increases access and transparency, and features a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.
Analyze "trigger reports" to identify potential financial exposure early in the claims process.
Gather clinical information to evaluate liability and make recommendations to stakeholders.
Provide cost containment by managing Stop Loss claims and negotiating prices for medical services.
Ullico is the only labor-owned insurance and investment company and has been a partner of the labor movement for over 95 years. The company provides insurance products for members, leaders, and employers, as well as investments.
Review and process appeals submitted by members and providers, ensuring timely and accurate resolution.
Evaluate cases, determine next steps, and manage multiple priorities while meeting strict turnaround times.
Review clinical and medical records, summarize findings for Medical Director review, and operate within turnaround times as short as 24–72 hours.
BlueCross BlueShield of Tennessee has been helping Tennesseans find their own unique paths to good health since 1945. At BCBST, they empower their employees to thrive both independently and collaboratively, creating a collective impact on the lives of their members.
Coordinate care and collaborate with multiple disciplinary team members to improve the quality of care and clinical outcomes.
Conduct thorough assessments to determine unmet needs and develop individualized care plans.
Promote quality cost-effective outcomes with the goal of improved care coordination.
Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Function autonomously and in collaboration with healthcare teams to coordinate quality, cost-effective care for ESRD and CKD patients.
Coordinate care between patient, family, physician, provider, community, and Regional Operations Manager.
Minimize fragmentation of the healthcare delivery system.
DaVita Inc. is a comprehensive kidney care provider focused on transforming care to improve the quality of life for patients globally. As of March 31, 2022, DaVita served 200,800 patients at 2,809 outpatient dialysis centers in the U.S.
Monitor high-risk pediatric patients, ensuring appropriate follow-up and assistance with meeting resource needs.
Conduct comprehensive assessments to address behavioral, social, emotional, and systemic needs of patients and families.
Perform daily tracking of family needs, continuously evaluate the effectiveness of the patient/family care map, and modify plans based on evolving needs.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans.
Provide exceptional care, disease management and health education to patients.
Support goal setting for individual patients asynchronously to help them better manage their chronic conditions.
Create personalized action plans with guidelines to reduce or eliminate unwanted behaviors.
Salvo Health is a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions from IBS to obesity. They bring multidisciplinary virtual care to patients at community specialty care practices. Salvo offers a competitive salary and health benefits, a remote work environment, flexible time-off, a larger sense of mission, and professional development and entrepreneurial opportunities.
Completes telephonic outreach to engage and schedule patients for health assessments.
Maintains call targets and metrics to ensure program success and volume goals are met.
Provides patient education and coordinates appointments and resources as needed.
Lumeris empowers value-based care, making healthcare safer, more affordable and personalized for providers, patients, and payers. The company is an EEO/AA employer with a focus on growth and employee engagement in a fast-paced environment.
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.
Collaborate with physicians, APPs, and interdisciplinary team members to manage a patient panel and address specialized needs post-hospitalization.
Perform assessments and develop comprehensive care plans based on individual patient values, goals, and preferences.
Coordinate patient care delivery with clinicians, network providers, contracted vendors, and community-based services.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic approach. The company provides interdisciplinary clinical resources and analytical tools to improve patient outcomes, operating with a team that values innovation and comprehensive care.
Conduct IOP orientations for new patients, introducing program structure, expectations, and resources.
Lead discharge planning beginning at admission, ensuring linkage to outpatient providers, community resources, and payor-approved step-down services.
Track engagement, discharge, and readmission metrics; report trends to the Clinic IOP Director for quality-improvement initiatives.
Salma Health is reimagining brain healthcare by bringing together advanced diagnostics, evidence-based treatments, and continuous support under one connected system. Their multidisciplinary team delivers personalized care for people living with brain and mental health conditions.
Serve as a liaison between contracts, patients, patient families, and HHAs.
Ensure effective communication and identify areas of concern.
Support the delivery of high-quality care by completing required tasks.
SnappyCX connects experienced Patient Coordinators with its clients’ care teams. They focus on ensuring effective communication and supporting the delivery of high-quality care.
Perform telephonic outreach to enroll and engage patients in the clinical program.
Develop and implement care plans addressing the unique needs of patients.
Guide members in understanding and utilizing health and social services.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach. They are committed to improving patient outcomes and quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants.
Process referrals to MTM team and schedule appointments for patients.
Provide phone support and document patient information in electronic health records.
Assist with prior authorizations and billing to help patients access affordable medications.
UnityPoint Health is a healthcare system providing medical services. It is recognized as a Top 150 Place to Work in Healthcare and offers a supportive culture for team members.
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.
Conduct outbound telephonic patient outreach and provide one-on-one coaching and support to patients managing chronic conditions.
Help patients execute personalized care plans and achieve their goals by providing education and coaching focused on behavior modification, nutrition, physical activity, and self-management strategies.
Document patient interactions, outcomes, and follow-up plans in the Cadence platform; identify barriers to care and connect patients with resources or internal support pathways.
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, integrate deeply into health system EMRs and workflows, and use their Clinical Intelligence platform.
Manage a caseload of ECM members with complex behavioral health needs.
Conduct in-person home visits and community-based meetings.
Utilize brief behavioral health therapeutic interventions as necessary.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations.
Conduct outbound calls and virtual outreach to provide information and education about Accompany Health services.
Support patients by answering questions, addressing concerns, and providing guidance.
Document interactions and maintain accurate records of patient outreach activities.
Accompany Health provides dignified, high-quality primary, behavioral, and social care to patients with complex needs, offering at-home and virtual care, plus 24/7 support. Their teams are distributed across the country and are committed to evidence-based practice, focusing on the health outcomes most important to their patients.
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.
Handle inbound and outbound calls to ensure patient satisfaction, troubleshoot concerns, and explain insurance coverage.
Obtain and process authorizations for reorders, resolve patient issues, and ensure accurate reorder processing via phone and document processing.
Maintain patient documentation, insurance requirements, and company procedures with high confidentiality.
CCS is a strategic partner addressing America's healthcare challenges through intelligent chronic care management, focusing on diabetes and chronic conditions. Recognized as a Great Place to Work®, they support over 200,000 people nationwide with home-delivered medical supplies and pharmaceuticals.