Review patient charts and verify eligibility for cardio-kidney-metabolic (CKM) conditions, releasing standing lab orders under the Regional ACCESS Director's authority.
Manage daily order queues with high clinical accuracy to maintain strict turnaround targets and prevent enrollment delays.
Act as a subject matter expert on lab ordering processes, identify friction, and partner with stakeholders to optimize workflows.
Conduct detailed assessments and coordinate individualized care plans with healthcare teams.
Educate patients and families on disease processes, treatment options, and self-care strategies.
Advocate for patients' needs within the healthcare system, ensuring timely access to services.
Empowers individuals facing health challenges by providing compassionate, expert-guided care advocacy services. Dedicated to ensuring personalized support and seamless care coordination.
Coordinate and provide care that is timely, effective, and member-centric while following HMO processes.
Manage case assignments including outreach, documentation, monitoring for case progression, and case closure.
Assist members in reaching wellness by addressing barriers, social determinants, and psychosocial issues.
Guidehealth is a data-powered healthcare company dedicated to making great healthcare affordable and improving patient outcomes. It is a physician-led, performance-driven organization with a culture of empathy, accountability, and continuous learning.
Review medical records to develop concise clinical reviews supporting authorization and reimbursement.
Facilitate communication with payors to ensure appropriate utilization management decisions.
Collaborate with interdisciplinary team to prevent denials and optimize patient care.
West Virginia University Health System is West Virginia’s largest health system, providing comprehensive healthcare services. With over 35,000 employees and 25 hospitals, it is the state's largest employer and offers a collaborative, patient-centered culture.
Review patient information and medical histories to provide online patient care and education.
Participate in patient visits and answer questions through our telehealth platforms.
Follow established protocols and collaborate with the healthcare team, all conducted 100% remotely.
Florida Telehealth Medical Group is an innovative telemedicine company currently operating in 49 states. We treat tens of thousands of patients every month and are growing rapidly.
Provides comprehensive remote patient support and care coordination to optimize health outcomes in a virtual environment.
Collaborates with physicians and healthcare team members to assess patient status and develop personalized care plans.
Monitors patient progress, educates on disease processes, and advocates for patient needs to ensure high-quality care.
St. Joseph's Hospital and Medical Center is a 571-bed not-for-profit hospital in Phoenix, Arizona, offering quaternary care, medical education, and research. It is a nationally recognized center with over 125 years of history, consistently named an outstanding place to work.
Apply HEDIS quality measure knowledge to ensure practices and ACOs receive credit for incentivized contract measures.
Access practices in-person or remotely to retrieve documentation and guide gap closure efforts.
Coordinate EHR system access, submit documentation to health plans, and consult with field teams on quality reporting strategy.
Aledade is a public benefit corporation that empowers independent primary care by helping practices thrive in value-based care. Founded in 2014, it is the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Analyze health plan reports and clinical data to identify members eligible for case management.
Conduct comprehensive telephonic and virtual assessments to evaluate medical, behavioral, and social needs.
Develop, implement, and monitor individualized care plans with measurable goals and interventions.
Duly Health and Care is a physician-led medical group offering a connected network of primary and specialty care, surgery centers, imaging, lab, and therapy services. They foster a collaborative culture centered on putting patients first and supporting team growth.
Handle inbound and outbound patient calls for appointment scheduling, reminders, and follow-ups.
Document interactions accurately in electronic medical records to support continuity of care.
Coordinate with onsite healthcare personnel and healthcare teams using digital collaboration tools.
This company partners with U.S. healthcare clinics to provide remote clinical support. It offers a structured, service-focused environment with a team of nursing professionals.
Engages members proactively and reactively to build trust and drive benefit and program engagement through motivational interviewing.
Develops individualized care plans based on comprehensive clinical, psychosocial, and SDOH assessments, coordinating resources across the care continuum.
Educates members and providers on benefits, digital health solutions, and self-management strategies while supporting utilization review and documentation.
Evry Health is a digital-first health plan focused on delivering comprehensive, member-centered care coordination for its fully insured commercial population. The company operates as a fully remote team with headquarters in Dallas, Texas, emphasizing a technology-forward and collaborative culture.
Provide clinical education, focused interventions, and care transition support for members with low-acuity needs.
Conduct in-person and virtual clinical exams, medication reconciliation, and chart reviews.
Triage referrals and collaborate with care team to ensure timely follow-up and handoffs.
Cityblock Health is a tech-driven provider for communities with complex needs, offering personalized primary care, behavioral health, and social services. Founded in 2017 and backed by Alphabet, the company has a diverse, inclusive culture and is growing rapidly.
Review OASIS documentation and plan of care to ensure compliance with regulations and accuracy.
Evaluate patient visit frequency and utilization to align with clinical needs and provider orders.
Collaborate with coding partners and escalate documentation improvement opportunities to leadership.
Graham Healthcare Group designs business and technology solutions to drive better care and outcomes in home health and hospice. As a subsidiary of a publicly traded company, they've been improving care coordination for over 20 years, focusing on patient-centered home care.
Apply specialized clinical knowledge to categorize, code, and summarize patient data from medical records with high accuracy.
Manage multiple concurrent tasks, prioritize deadlines, and propose solutions to obstacles in a timely manner.
Navigate electronic medical records and registry tools, contributing to team best practices and process improvements.
Q-Centrix delivers data abstraction solutions for hospital partners to improve patient outcomes and advance research. They have a supportive, remote-first culture recognized as a Great Place to Work multiple years in a row.
Take triaged cases and build urgent execution plans using resource directories and independent research.
Work the plan, call patients to update them, and document every interaction accurately for seamless 24/7 handoffs.
Push through obstacles like busy signals, denials, and system hurdles until the problem is solved, typically within 2–3 days.
Mira Mace is a venture-backed company on a mission to help people navigate a complicated healthcare system with clarity and confidence. They pair people-centered navigation with technology, and their advocates cut through insurance denials, medication costs, and paperwork so patients get what they need without fighting alone.
Build meaningful relationships with patients and families to create personalized care plans addressing medical, behavioral, and social needs.
Coordinate care across providers and settings while educating and empowering members to navigate the healthcare system confidently.
Collaborate with an interdisciplinary team, using data for insight and maintaining compliance while prioritizing compassion and connection.
Guidehealth is a data-powered, performance-driven healthcare company using AI and predictive analytics to improve healthcare affordability and patient outcomes. It is a physician-led, fully remote organization with a collaborative, agile culture focused on innovation and empathy.
Provide high-quality consulting services including clinical and regulatory compliance audits to long-term care facilities nationwide.
Manage assigned client facilities with emphasis on service quality, cost-effectiveness, and timely delivery of consulting visits.
Collaborate with teams and maintain effective communication with leadership about customer issues and industry regulations.
Assembly Health is a healthcare company providing clinical consulting services to long-term care facilities nationwide. The team is motivated, client-focused, and committed to excellence and integrity.
Coordinate and oversee collaborative patient care under physician direction, guiding patients through intake, diagnosis, treatment, and discharge.
Communicate with patients, physicians, and agencies to manage referrals, treatment plans, and pre-authorizations for desired clinical and financial outcomes.
Perform patient intake and discharge activities, including vital signs, room turnover, and documentation in accordance with hospital policy.
Virginia Mason Franciscan Health provides exceptional healthcare services, building on a legacy of compassionate care and innovation dating back to 1891. The organization employs a dedicated team across 10 hospitals and nearly 300 care sites, committed to healing the whole person and fostering a collaborative purpose.
Review medically complex claims, pre-authorization requests, appeals, and fraud and abuse referrals.
Assess payment determinations using clinical information and established guidelines.
Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business, we empower clients with tailored solutions, operating with integrity and collaboration.
Conduct monthly clinical check-ins and build ongoing relationships with patients and caregivers.
Perform structured symptom assessments and escalate clinical concerns using licensed judgment.
Collaborate with providers and care teams to ensure accurate documentation and care coordination.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They are building a team focused on improving outcomes for kidney disease patients with a supportive culture.
Process approved physician orders and manage referrals with attention to detail.
Track documentation requiring physician signatures and escalate as needed.
Ensure timely billing and complete EMR files for discharged patients.
CommonSpirit Health at Home is a full-service health care organization that provides home health and hospice services. As a faith-based organization, it is committed to improving patient health and community well-being through compassionate care.
Perform clinical reviews for medical necessity, level of care, and authorization compliance.
Prepare and submit high-quality appeals related to DRG downgrades and clinical validation denials.
Apply payer-specific guidelines and document review findings accurately in designated systems.
CorroHealth helps clients exceed their financial health goals through scalable revenue cycle solutions and clinical expertise. The company builds long-term careers by investing in team members' professional development and personal growth.