Provides quality driven telephonic clinical assessments, health education, and utilization management services.
Provides assessments to individuals using telecommunications, in accordance with computer-based algorithms and guidelines.
Uses clinical knowledge to assess, make recommendations for care, provide education and health information.
Carenet Health values expertise and dedication, committed to providing appealing compensation. They celebrate diversity, creating an inclusive environment and are an equal opportunities employer.
Maintain oversight over a specified panel of members by performing ongoing assessments.
Create comprehensive care plans addressing members' needs and conducting regular follow-ups.
Ensure achievement of targeted goals related to patient outcomes and care plan realization.
Jobgether is a company that uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Lead and manage clinical operations teams, ensuring high standards of service delivery and operational compliance.
Coordinate clinical programs, including utilization management, clinical review, and special initiatives.
Develop, implement, and maintain operational policies, procedures, and best practices.
Jobgether is a platform that uses AI to match candidates with job opportunities. They aim to ensure applications are reviewed quickly and fairly, connecting top-fitting candidates with hiring companies.
Serve as a patient advocate and navigator, guiding patients and caregivers through the healthcare system.
Complete emergency room and hospital follow-up calls, offering education on alternative access points to reduce avoidable ED visits.
Facilitate medication education and adherence support, including alignment with standing orders, protocols, and chronic disease management goals.
Praxis Health is a family of medical groups providing high-quality healthcare throughout the state of Oregon. They foster a supportive and collaborative workplace where every team member is valued and empowered to succeed with community-based clinics.
Complete monthly utilization management and appeals performance and process audits.
Present audit results to leadership to address issues.
Assist management in identifying, evaluating, and mitigating risks.
Judi Health provides a comprehensive suite of solutions for employers and health plans. They offer full-service health benefit management solutions and consolidate all claim administration-related workflows in one scalable, secure platform.
Jobgether is a platform that connects job seekers with companies. They use an AI-powered matching process to ensure applications are reviewed quickly and fairly.
Responsible for application of appropriate medical necessity tools to maintain compliance and achieve cost effective and positive patient outcomes.
Acts as a resource to other team members including UR Tech and AA to support UR and revenue cycle process.
Utilizes Payer specific screening tools as a resource to assist in the determination process regarding level of service and medical necessity.
Virtua Health strives to connect individuals to the care they need, building a healthier community in South Jersey. They are a Magnet-recognized health system with over 14,000 colleagues, including over 2,850 doctors, physician assistants, and nurse practitioners.
Provides telephone and walk-in triage to patients seeking advice and medical services.
Provides direct nursing care to patients and distributes medications and treatments according to accepted standards of care.
Teaches and counsels patients and families concerning health assessment and care including prevention of disease, disability, hygiene and health maintenance.
CommUnityCare Health Centers provides community-based healthcare services. The job posting does not specify the company's size or culture.
Provide health assessments and treatment solutions via telephone, video, or chat functions.
Track and monitor follow-up calls, escalate when appropriate.
Receive inbound phone calls from patients seeking answers to various medical conditions.
PWNHealth is a national clinician network working to improve early detection and prevention of disease using advanced diagnostics and telehealth. They are a mission-driven, positive culture made up of the best and brightest in the industry.
Oversee clinical quality assurance, develop training programs, and ensure regulatory compliance.
Design, implement, and oversee clinical quality assurance programs for in-home care delivery.
Design and implement onboarding and continuing education programs for clinical team members.
Sprinter Health is an innovative healthcare startup dedicated to providing high-quality, in-home and virtual care across the country. They employ a multidisciplinary team of clinicians, technologists and operators backed by investors including a16z, General Catalyst, GV, and Accel.
Provide remote supervision over group of RN’s, performing chart audits and reviewing adherence to company policies
Assess and document the health status of new patients
Assist with annual staff review process including skill competency assessments
Local Infusion is a venture-backed healthcare company that is shaping the way care is delivered to patients with chronic autoimmune disease on specialty infusion medications. They focus on patient experience, technology, and clinical integration that allows them to deliver a differentiated care model. At their care centers, all patients—and their team—can feel truly supported, every step of the way and they are a respectful, upbeat, and remote-first team.
Performs cancer registry duties related to completion of abstracts for benign and malignant processes for the cancer database. Complies with the established standards of Commission on Cancer, Georgia Cancer Registry, and the Piedmont Cancer Committee. This is a remote position.
Join Piedmont to move your career in the right direction and be recognized for your contributions to exceptional patient outcomes.
Lead and develop a team of RN Care Coordinators and non-clinical Care Coordinators.
Ensure timely progression of members through the surgical review and COE pathways.
Identify workflow issues and recommend process improvements.
Transcarent and Accolade have come together to create the One Place for Health and Care, the leading personalized health and care experience that delivers unmatched choice, quality, and outcomes. Together, more than 20 million people have access to the combined company’s offerings.
Build trusted relationships with older adults and their families, grounded in listening and empathy.
Serve as a go-to resource for navigating medical systems, social services, and emotional wellness needs.
Create individualized care plans that address both clinical needs and SDOH.
Sailor Health is revolutionizing mental health care for older adults, addressing one of the fastest-growing and most underserved healthcare segments in America. They aim to redefine the golden years, enabling older adults across the nation to live happier and healthier lives.
Gain a deep understanding of Cohere’s product and our health plan partners
Provide general supervision over the nursing staff including hiring, training, and coaching
Assist in addressing any case escalations or provider issues
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. They foster a supportive, growth-oriented environment.
Develop trusting long-term patient relationships and empower you to do the best work of your career. Conduct holistic assessments to identify conditions, functional status and member values. Support chronic disease management, using motivational interviewing techniques.
Devoted Medical was founded on the belief that if we treat each member like we would our loved ones, we can meaningfully improve healthcare experiences.
Conduct thorough reviews of medical records for accurate coding compliance.
Identify opportunities for documentation improvement to enhance code accuracy.
Educate healthcare providers on proper coding practices and HEDIS measures.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Own the end-to-end cycle of credentialing applications for new and existing providers under our contracts, ensuring all requirements are met for successful enrollment.
Assist in building NCQA compliant ongoing monitoring and delegation programs for the Nourish network of RDs.
Support efforts to streamline existing credentialing processes by providing suggestions for automation or new tools, optimizing individual steps, and ensuring smooth workflows.
Nourish is on a mission to improve people’s health by making it easy to eat well. They are building an AI-native, patient-friendly healthcare system centered on nutrition that improves outcomes, lowers costs, and helps people live healthier, longer lives. Nourish launched three years ago, are live in all 50 states, and already have thousands of dietitians and hundreds of thousands of patients on the platform.