Oversee the Care Navigation program, ensuring efficient operation and successful implementation of new programs.
Manage relationships with health plan partners and oversee internal policies and procedures for care navigation activities.
Provide telephonic care navigation services to individuals receiving services through various programs as needed.
Mom's Meals is a provider of home-delivered meals. They focus on delivering medically tailored meals to individuals with chronic health conditions. The company values its team members and strives to show it through benefits and other offerings.
Supervise day-to-day operations of assigned Utilization Management staff.
Provide full people management for assigned Utilization Management teams, including hiring and performance management.
Drive team performance against key metrics, including engagement, productivity, and quality scores.
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.
Supervise daily activities of QA specialists across multiple operational areas.
Review completed audits for accuracy and consistency.
Conduct calibration sessions to ensure scoring alignment.
Machinify is a leading healthcare intelligence company delivering unmatched value, transparency, and efficiency to health plan clients. They are deployed by over 85 health plans and are reimagining what’s possible in the industry to maximize financial outcomes and drive down healthcare costs.
Serve as primary onboarding liaison and support resource.
Conduct session audits and provide structured clinical coaching.
Evaluate facilitator competency using standardized rubric.
Charlie Health connects the world to life-saving behavioral health treatment, delivering personalized, virtual care. As a rapidly growing organization, it focuses on people with complex needs, expanding access to meaningful care and driving better outcomes from the comfort of home.
Monitor compliance with assigned responsibilities and coordinate with patient financial services.
Conduct initial and continued clinical authorization reviews.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Lead and manage a team of Credentialing Specialists and Operational Analysts to ensure timely and accurate credentialing file processing.
Oversee credentialing workflows to ensure compliance with NCQA guidelines, state regulatory requirements, and client-specific policies.
Partner with internal stakeholders to resolve escalations, streamline workflows, and improve operational outcomes.
CertifyOS is building the data infrastructure that powers modern healthcare. They value authenticity, accountability, collaboration, results, and openness to feedback, fostering a high-ownership team focused on solving real infrastructure problems.
Works with field staff and Manager, Clinical Services (MCS) to appropriately schedule clinicians for cases in assigned areas of responsibility.
Communicates appropriately regarding changes in schedule or service delivery.
Demonstrates the ability to be efficient and productive by organizing job duties and responsibilities.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, we are committed to finding new ways to improve the health of our patients and the health of the communities we serve.
Management and oversight of a quality team conducting quality assurance activities.
Responsible for the successful execution of the Quality Improvement Program in accordance with CMS requirements.
Plans, organizes, and directs activities of Clinical Quality, including planning, training, and staff development.
HealthEdge is committed to workforce diversity and actively encourages all qualified persons to seek employment. They provide effective and efficient solutions to complex business problems.
Directly lead and manage a team of Patient Support Associates to ensure medication adherence or timely prior authorization.
Proactively manage support in assigned hospitals and/or clinics to ensure patients receive medications on-time.
Provide front-line supervision and ongoing coaching and performance management to Patient Support team.
Shields Health Solutions is a specialty pharmacy management service provider. They are a fast-growing company that values motivated self-starters with a positive outlook and a focus on high-quality work.