Partner with cross functional leaders to ensure internal processes and care delivery are in accordance with health plan needs across commercial and Medicaid lines of business
Translate health plan contracts, provider manuals, and regulatory requirements into scalable operational workflows
Serve as the internal subject-matter expert on credentialing and payor operational requirements
Equip is a virtual, evidence-based eating disorder treatment program. They aim to provide accessible and effective treatment. Founded in 2019, Equip has been a fully virtual company and has a highly-engaged, passionate, and diverse culture.
Establish operating cadence that aligns clinical operations around shared priorities.
Design and implement a company wide operating rhythm.
Partner closely with Regional General Managers to ensure markets operate with clear accountability.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the healthcare system. Founded in 2021, it's backed by leading healthcare investors and is scaling rapidly across states and populations.
Track and manage prior authorization requests, renewals, and extensions.
Verify member eligibility and benefits to confirm coverage requirements.
Upload, organize, and maintain member records and clinical documentation accurately and timely.
Leap is a benefits solution company focused on reshaping how life-changing therapies are delivered and financed. They are a fast-growing company that partners with Fortune 500 companies and leading TPAs, focusing on lower costs, improved access, and better care.
Own the Care Operations product roadmap end-to-end, including problem identification, prioritization, and delivery
Own product direction for outreach, intake, authorization, scheduling, and care team tooling
Define and drive your own roadmap, grounded in real care team needs and aligned with company priorities, rather than executing against a pre-defined backlog
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the healthcare system. Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations.
Shapes vital subfunction with strategic leadership and operational oversight.
Builds scalable processes for accuracy, timeliness, and quality of authorizations.
Collaborates across functions for data discrepancies and continuous process improvement.
Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with their leading healthcare partners, including Kaiser Permanente. They build engaged, fulfilled care teams to deliver personalized care in their centers and in the home.
Set, track, and achieve engagement and enrollment goals.
Lead and manage Community Engagement Specialists.
Develop and execute regional outreach strategy.
Zócalo Health is a tech-driven provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared and lived experiences. Founded in 2021, they are backed by leading healthcare and social impact investors to bring their vision to life, aiming to improve the lives of communities with culturally competent primary care, behavioral health, and social services.
Lead HR operations and compliance workflows for CNA and IHSS onboarding and employment.
Oversee end-to-end onboarding of CNAs and IHSS families in EHR and HRIS systems.
Monitor and track required employment documents and credentials, maintaining complete personnel files.
Abby Care tackles the challenge of family caregiving. They train and employ family caregivers, building a tech-powered, family-first care platform to deliver care and improve health outcomes nationwide, partnering with insurance plans, healthcare providers, and organizations across the country.
Architect the systems and processes that power Form Health’s patient experience.
Build the infrastructure needed to support growth while preserving clinical quality, efficiency, and empathy.
Drive operational transformation by designing scalable workflows, data-supported resource models, and technology-enabled efficiencies.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, Form Health is a venture-backed innovative startup with an experienced clinical and leadership team.
Provide direct supervision, coaching, and performance oversight to clinical managers.
Serve as a primary operational liaison between clinical teams and health plan care management teams.
Oversee onboarding and training for care teams and clinical managers.
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. They deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers. They cultivate a dynamic and inclusive team environment.
Help patients access care more quickly by ensuring referrals are processed smoothly.
Support Midi’s rapidly growing network of health system partnerships.
Directly improve the experience for referred patients.
Midi Health is expanding its health system and provider partnerships. They're committed to pay equity and ensuring that all qualified applicants receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Conduct insurance verification for new referrals and ongoing patients.
Initiate and obtain prior authorizations for home health services.
Maintain insurance, authorization, and eligibility information in real-time.
VitalCaring is a leading provider of home health and hospice services. Founded in 2021, they have over 65 locations across the country and are committed to fostering a culture of support, growth, and excellence for their team, ensuring exceptional patient care.
Own market growth strategy across priority Medicaid markets.
Lead the evolution of our value proposition for legacy health plan partners and new prospects.
Serve as a strategic bridge between Payor Partnerships and internal teams.
Equip is the leading virtual, evidence-based eating disorder treatment program. They ensure that everyone with an eating disorder can access treatment that works, leveraging evidence-based treatments to empower individuals to reach lasting recovery. Founded in 2019, they're a fully virtual company.
Own day-to-day HR operations, including benefits, payroll, leaves of absence, and employee records
Lead HR investigations and ensure proper documentation and process consistency
Build scalable HR processes that support growth beyond 250 employees
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.
Directly lead and manage a Patient Support team to ensure medication adherence or provide timely prior authorization and financial assistance.
Proactively manage support in assigned hospitals/clinics to ensure patients receive medications on time and that all service level goals are met.
Manage all aspects of ADP, Paid Time Off (PTO), and Time Reports for team members while completing audits of the team in supported systems.
Shields Health Solutions provides specialty pharmacy management services, helping patients get medications on time. They are a fast-growing company that values motivated self-starters focused on high quality.
Serve as the primary operations day-to-day point of contact for the clinical team
Develop and implement standard operating procedures to improve team efficiency and client engagement
Jobgether is a company that uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Play an active role in member registration and enrollment, including organizing community engagement and outbound outreach calls/texts.
Engage with a panel of assigned members to provide care navigation, appointment logistics, prescription drug support, lab support, referral coordination, care plan adherence support, and resource sharing.
Serve as the primary relationship holder for members with behavioral health needs; provide consistent outreach, follow-up, and re-engagement support, including after ED/inpatient discharge when applicable.
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. They combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live and receive support.
Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc.
Creates cases, tasks, and completes assessments in Case Management module for all Hospital and SNF discharges
Works as a team with the Case Manager to engage and manage a panel of SNP members
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.