Perform case reviews and process requests for elective services and durable medical equipment.
Collaborate with physicians, vendors, and providers to ensure regulatory compliance and timely service.
Provide high-quality customer service to members and healthcare professionals.
Elderplan provides Medicare and Medicaid managed care health plans designed to help people stay independent. They are part of MJHS, a supportive community committed to excellence, respect, and collaboration.
Conduct comprehensive clinical assessments and develop individualized care plans for high-risk members.
Coordinate transitions of care and collaborate with interdisciplinary team members including Community Health Workers and providers.
Provide health coaching and disease management education to help members achieve their health goals.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving historically underserved populations. Founded in 2021 and backed by leading healthcare investors, it is scaling rapidly with a culture focused on value-based, whole-person care.
Conduct telephonomic assessments of members' medical, psychosocial, physical, and spiritual needs.
Develop and revise Person-Centered Service Plans (PCSP) in response to changes in member condition.
Collaborate with interdisciplinary care teams and educate members on Advanced Directives and Health Care Proxy.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans designed to help keep people independent. MJHS is a supportive community of over 6,000 employees committed to excellence, respect, and providing high-quality, personalized health care services.
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.
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.
Serve as the main point of contact for patients and families transitioning from or seeking post-acute services.
Make clinical level-of-care determinations using discussions, medical records, and other clinical data.
Provide patient education on home health, hospice, palliative care, Medicare coverage, and billing.
Gentiva is a national leader in hospice, palliative, and home health care, providing compassionate care to patients in their homes. With nearly 600 locations and thousands of clinicians across 38 states, they offer a collaborative environment where inspiring achievements are recognized.
Provides telephonic and in-home assessments of members' medical, psychosocial, physical, and spiritual needs.
Develops, implements, and monitors care plans to ensure continuity of care and chronic care benefit management.
Demonstrates strong assessment, communication, interpersonal, and crisis intervention skills in an interdisciplinary environment.
MJHS Home Care provides Medicare and Medicaid managed care health plans designed to help people stay independent. They foster a supportive community committed to excellence, respect, and personalized health care services.
Act as a liaison for a patient panel of medically stable patients, coordinating care between internal and external providers.
Monitor and triage lab orders and results, providing education and medical management support to patients and families.
Triage emergent issues in a time-sensitive manner and coordinate care with hospitals for medical stabilization admissions.
Equip is the leading virtual, evidence-based eating disorder treatment program on a mission to ensure everyone with an eating disorder can access treatment that works. Founded in 2019, the company is fully virtual and has been recognized as one of the most influential companies of 2023, with a diverse and passionate team.
Assess member needs and oversee development of client care plans
Connect clients to social services and advocate with healthcare professionals
Complete documentation and maintain patient health records in EMR system
Vynca provides comprehensive care for more quality days at home for individuals with complex needs. They are a close-knit community operating with core values of Excellence, Compassion, Curiosity, and Integrity.
Conduct telephonic case management and thorough assessments of patients' physical, psychosocial, and financial needs.
Develop and monitor treatment plans in collaboration with patients, caregivers, and multidisciplinary teams.
Negotiate cost management strategies and maintain detailed documentation while meeting productivity and quality standards.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers and health plans with data-driven solutions and are on a mission to empower people to lead healthier lives.
Build meaningful relationships with patients and families to understand their goals and barriers.
Create personalized care plans addressing medical, behavioral, and social needs.
Coordinate care across providers and settings, ensuring safety, quality, and continuity.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to making great healthcare affordable and improving patient health. As a physician-led organization with a high degree of agility, it employs a remote team and fosters a collaborative, mission-driven culture focused on continuous learning.
Provide real-time clinical support and triage for newly re-engaged patients, ensuring immediate response to clinical needs following outreach and enrollment interactions.
Deliver proactive, professional, and compassionate care, serving as an accessible first point of contact for patients and caregivers.
Collaborate with physicians, APPs, and interdisciplinary team members to develop and execute care plans aligned to patient needs and clinical goals.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs, delivering 24/7 virtual and in-home medical, behavioral, and social care. They are a startup committed to diversity and a values-driven culture, seeking a passionate nurse to join their team.
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.
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.
Coordinate patient care remotely using phone or video, focusing on assessments, care plans, and resource access.
Identify process improvements through data collection and auditing, while navigating multiple EHR platforms.
Utilize home health expertise to triage patient needs and maintain open communication with patients, caregivers, and providers.
ThedaCare is a community health system consisting of seven hospitals and numerous clinics, serving as the third largest health care employer in Wisconsin. With approximately 6,800 employees, the organization emphasizes innovation, compassion, and a commitment to improving community health.
Provide health care services regarding admissions, case management, discharge planning and utilization review.
Review admissions and service requests for medical necessity and reimbursement compliance.
Assess and coordinate discharge planning needs with healthcare team members.
UAB St. Vincent's, part of UAB Medicine, provides trusted healthcare in Alabama for over 125 years. With five hospitals and numerous clinics, the organization is guided by compassion and service, employing more than 4,800 people as one of Alabama's best hospitals.
Conduct outbound telephonic patient outreach and provide one-on-one coaching to patients managing chronic conditions.
Help patients execute personalized care plans by providing education on behavior modification, nutrition, and self-management.
Monitor patients' progress, document interactions in the Cadence platform, and collaborate with clinicians to coordinate next steps.
Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions like hypertension, heart failure, and diabetes. They operate as a full clinical care delivery organization, working alongside health system partners to extend primary care into patients' homes.