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.
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 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.
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 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.
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.
Perform concurrent inpatient utilization review using InterQual criteria to determine medical necessity.
Engage in clinical collaboration with physicians and care teams to support appropriate level-of-care decisions.
Maintain documentation, comply with regulations, and ensure quality customer service.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations serving over 700 clients across 10 industries. With over 66,000 employees across 13 countries and 65 delivery centers, the company combines scale and expertise to create meaningful impact.
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.
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 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.
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.
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.
Conducts training for staff members related to Utilization Review process, clinical guidelines, and workflows.
Creates educational material by collaborating with key resources to incorporate clinical scenarios.
Reviews monthly quality audit findings and provides one-on-one coaching to staff for performance improvement.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, the company combines scale, expertise and execution to create meaningful, measurable impact.
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.
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.
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.
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 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.
Conducts utilization review to determine medical necessity of admission and continued stay using established criteria.
Communicates with payers to secure authorization and negotiate medical necessity decisions.
Educates providers on documentation requirements and participates in strategies to reduce length of stay and readmissions.
OHSU is Oregon’s only public academic health center, providing patient care and conducting groundbreaking research while training health care professionals. As Portland’s largest employer, it offers a diverse and inclusive culture with opportunities for growth across Oregon and Southwest Washington.
Provide education about a patient’s diagnosis, test results and treatment plan.
Collaborate with cardiologists, PCPs and other healthcare professionals to ensure comprehensive and coordinated care for patients.
Maintain accurate and detailed patient records, including patient interactions, medical histories, assessments, treatment plans, progress notes, and discharge summaries.
Heartbeat Health is a virtual-first cardiovascular care company, providing patients with convenient, high-quality heart care through telemedicine, diagnostics, and virtual care programs. The team is redefining how cardiovascular care is delivered, and values diversity and mutual respect.