Provide case management addressing medical, social, psychological, physical, and spiritual needs of members.
Develop, implement, and monitor care plans in conjunction with the PCP, caregivers, and other team members.
Help members meet their needs through coordinated care and support.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that help members stay independent. MJHS is a supportive community committed to excellence, respect, and high-quality personalized care, fostering collaboration and career development.
Provide education and self-management support based on the patient's unique learning style, and coordinate care as an advocate and resource.
Conduct comprehensive assessments of medical, behavioral, pharmaceutical, and social needs, and collaborate with the care team to design care plans.
Support population health initiatives and measure quality outcomes to reduce unnecessary utilization and improve patient health.
Aledade PBC empowers independent primary care by creating value-based contracts and flipping the script on fee-for-service. Founded in 2014, it is the largest network of independent primary care in the country, with a remote-first, collaborative, and inclusive culture.
Provide high-quality, person-centered care management to high-risk members.
Coordinate care across medical, behavioral, and social services using evidence-based approaches.
Engage members through motivational interviewing and develop individualized care plans.
IEHP is a not-for-profit health plan serving members in Southern California's Inland Empire. It fosters a team culture focused on healing and inspiring the human spirit, offering competitive benefits and professional development.
Manage an assigned patient panel using clinical expertise and value-based care principles.
Build trusting relationships with patients and families to provide clinical and emotional support.
Coordinate interdisciplinary care across settings to reduce preventable readmissions and improve outcomes.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic approach. We are a growing team committed to improving patient outcomes and quality of life, and we thrive in an innovative, evolving environment.
Manage and triage patient vital signs remotely, using motivational interviewing to drive positive health behavior changes.
Perform monthly wellness calls with patients, collaborating with care teams to set patient-centric goals.
Escalate urgent care needs appropriately and meet program engagement metrics in a remote MST-based role.
Vivo Care is building a future where care is continuous, personal, and connected, challenging the status quo in healthcare. We are a fast-growing startup where everyone has a voice, fostering a culture of inclusion, collaboration, and innovation.
Performs pre-admission, admission, and continued stay reviews using approved medical necessity criteria.
Coordinates patient care and communicates with physicians, patients, caregivers, and third-party payers.
Manages patient progression through the healthcare system and proactively works with payers to secure certification and minimize denials.
Ochsner Health is a leading not-for-profit healthcare provider in the Gulf South, with 46 hospitals and 370+ care centers. It employs more than 38,000 team members and has been recognized as a top workplace and the No. 1 hospital in Louisiana.
Provide Utilization Review and Case Management to Emergency Department patients with social or discharge needs.
Offer hospital-wide Utilization Review and Case Management coverage as needed and time allows.
Hold a valid RN state licensure; 3-5 years of nursing experience preferred.
Freeman Health System is a not-for-profit health system serving communities across Missouri, Arkansas, Oklahoma, and Kansas through a network of hospitals, physician clinics, and specialty services. The system is supported by over 7,000 employees and is the only Children's Miracle Network Hospital in a 70-mile radius.
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.
Perform prospective, concurrent, and retrospective reviews of healthcare services to ensure medical necessity and appropriate level of care.
Contact medical and support personnel to recommend alternative treatment plans and coordinate care across the healthcare continuum.
Research and resolve issues related to benefits, eligibility, and appeals while delivering targeted education to providers.
HealthEdge provides AI-powered operational infrastructure for health insurance companies, covering claims administration, payment integrity, and care management. The company is experiencing significant momentum and investing in employees who directly shape the future of healthcare technology.
Provide virtual biopsychosocial support and care coordination to older adults and family caregivers navigating chronic and serious illnesses.
Develop personalized, culturally responsive care plans, connect families to community resources, and advocate within health and social systems.
Collaborate with a transdisciplinary team including MDs, neuropsychologists, nurse practitioners, and social workers to ensure continuity of care.
Nolia Health is a healthcare startup that provides personalized, clinically-supported, virtual-first services for older adults and their family caregivers. As an early-stage company, it fosters a caring, inclusive culture where many team members have lived experience as family caregivers.