Authorizes and reviews utilization of mental health and substance abuse services.
Collects and analyzes utilization data and assists with discharge planning and care coordination.
Provides member assistance with mental health and substance abuse issues, and participates in quality improvement projects.
Magellan Health, Inc. is committed to making a difference in the healthcare industry and communities. They value professional growth and development, total health and wellness, rewards and recognition, as well as employee unity, offering a place where you can thrive.
Supervise a team of approximately 10-15 Lead Care Managers to ensure high-quality care management services.
Oversee the creation of Individual Care Plans, assessing if clients' needs can be managed by an ECM Lead Care Manager.
Drive the team to meet key performance indicators (KPIs) effectively.
Vynca is dedicated to transforming care for individuals with complex needs, fostering a close-knit community. They are guided by core values such as Excellence, Compassion, Curiosity, and Integrity, committed to providing comprehensive care for more quality days at home.
Performing physician-level utilization management reviews for behavioral health services across all applicable levels of care.
Conducting peer-to-peer consultations with treating psychiatrists and other behavioral health providers.
Serving as a consultative clinical resource to behavioral health utilization management nurses, care managers, and operational leaders.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine for providers. Driven by empathy and AI, they leverage remotely-embedded Healthguides™ and a centralized Managed Service Organization.
Lead, mentor, and manage a team of clinical managers and clinicians to deliver mental health support.
Serve as a Subject Matter Expert, collaborating with teams to optimize programs and processes.
Develop strong relationships with customer success partners and other internal stakeholders.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. They partner with over 450 companies, from startups to multinational Fortune 500 corporations, providing care for 10 million people and are valued at $3.3 billion.
Oversees daily operations of the Care Management unit and ensures process implementation.
Facilitates staff development, provides regular performance feedback, and identifies areas of improvement.
Evaluates performance metrics, supports staff in care planning, and promotes interdisciplinary collaboration.
Capital Blue Cross promises to go the extra mile for our team and our community. They offer a caring team of supportive colleagues and invest heavily in training and continuing education. Employees consistently vote them one of the “Best Places to Work in PA.”
Act as a player/coach, working alongside Care Extenders to build their skills in everyday situations and to directly support members in more challenging situations or as needs arise.
Build communication strategies to ensure the team is engaging and building relationships with the member cohort in order to support members in reaching their goals.
Lead our Care Extender team to ensure member needs are assessed adequately and that all members have an appropriate care plan and are making consistent progress toward their goals and graduation from the program.
Mindoula delivers outcomes to our health plan partners through its Interpersonal Violence Reduction Program. Their team of Care Extenders empower members to actively participate in improving their own health and wellness through personalized case management that targets each member’s specific needs.
Supervise a team of approximately 10-15 Lead Care Managers.
Oversee the creation of Individual Care Plans.
Drive the team to meet key performance indicators (KPIs) effectively.
Vynca is passionate about transforming care for individuals with complex needs. They are a close-knit community guided by core values, aiming to provide comprehensive care for more quality days at home for their clients.
Serve as the primary point of contact for psychiatry providers and psychiatric patients.
Respond promptly to patient inquiries, clarifying processes and coordinating follow-up care.
Support providers with prescription refill requests, prior authorizations, and lab orders.
BetterHelp aims to remove barriers to therapy and make mental health care accessible. As the largest online therapy service, their 30,000+ therapists provide affordable and convenient therapy worldwide, and they deeply invest in employee well-being and professional development.
Deliver compassionate psychiatric care, addiction care and medication management through telehealth.
Partner with clinical team to assess and adapt treatment strategies for high-risk members.
Empower members with education on preventative practices and lifestyle habits.
ReKlame Health is a clinician-led, tech-enabled provider group focused on providing culturally competent behavioral health care, addiction care, medication management, and crisis intervention. They aim to expand access to care and create a future where individuals can readily obtain high-quality behavioral health and addiction care.
Assists in coordinating patient care with medical staff by reviewing and maintaining provider schedules.
Ensures patient-specific needs are met by arranging interpretation services as needed.
Prepares patients for virtual appointments by ensuring the patient has what is needed for their appointment.
Ascend Healthcare provides fully integrated, quality psychiatric and behavioral health services. They foster a professional, collaborative, and rewarding workplace culture, dedicated to making a profound impact on diverse communities through exceptional patient care.
Handle a high volume of calls requesting assistance with accessing behavioral health services.
Prioritize cases based on shifting needs and resources.
Work with on-call providers to triage requests, organize their workload, and secure documentation.
Array Behavioral Care is a virtual psychiatry and teletherapy practice. They aim to transform access to timely behavioral health care via telepsychiatry solutions and services.
Oversee day-to-day case management operations across BH Field.
Monitor case manager task completion and identify workflow gaps.
Collaborate with internal teams and support onboarding of new Case Managers.
BH Field focuses on providing case management operations. They value consistency, efficiency, and quality in case management, and they foster collaboration with Clinical Leadership, HR, and Operations.
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.
Directly manage a remote team of Care Partners, providing guidance and support.
Design and improve operational processes to ensure high clinical quality.
Monitor key performance indicators to measure success across different teams.
Medsien provides scalable remote care management for a quality patient experience. Hundreds of organizations trust Medsien's technology solutions to implement remote care management programs, personalize every interaction, and improve the lives of the people who need it most.
Oversee the daily operations of the Enrollment Specialist team, including planning daily team coverage for various tasks.
Ensure the efficient and accurate execution of all new patient onboarding processes, including effective management of incoming communications.
Lead, coach, and develop a team of Enrollment Specialists, providing ongoing performance feedback, conducting regular one-on-one meetings, and completing annual performance evaluations to ensure high-quality service and productivity.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Form Health is a venture-backed innovative startup with an experienced clinical and leadership team deeply invested in our core value to put patients first, and also deeply committed to creating a culture where every employee is valued and we learn and improve together.
Directly manage a team of clinicians through monthly 1:1s, ongoing check-ins, and clear expectation-setting.
Maintain an active clinical schedule, including patient panel visits, emergency visits, and recovery visits, as part of the hybrid role.
Reinforce Midi’s scope of care, protocols, and documentation standards within your clinician group.
Midi is a fast-scaling virtual care company on a mission to transform the way healthcare is delivered. With a focus on women’s health and whole-person care, our distributed clinical team delivers high-quality care through a modern, tech-forward platform.
Own and manage ongoing relationships with oncology practice partners, ensuring clear, consistent communication between key stakeholders on both teams
Monitor and report on partnership performance metrics, providing actionable insights to partner practices and internal leadership
Continuously evaluate and optimize workflows to improve efficiency, performance outcomes, and overall partner experience, including adapting to new software releases or operational updates
Protocol Behavioral Health provides cancer-specific behavioral health treatment to patients by partnering with oncology clinics and cancer centers. The team consists of top tier executives and operators who have depth in experience across behavioral health, healthcare services and oncology payer relationships.
Answer incoming inquiries from patients, answer questions, and schedule appointments
Make outbound phone calls to patients, pharmacies, and insurance companies
Create and triage tickets in ServiceNow
Talkiatry transforms psychiatry with accessible, human, and responsible care. They’re a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist to solve the problems both groups face in accessing and providing the highest quality treatment.
Lead, coach, and mentor PCA Leads; indirectly oversee the full PCA team.
Own forecasting, staffing plans, and scheduling strategy for all PCA coverage across chat, phone, and ticket queues.
Design and oversee quality assurance programs, including auditing, coaching, and root-cause analysis.
9amHealth is a cardiometabolic care company that offers custom care plans, prescription medications, and expert guidance to help members live healthier. It is a San Diego, California-based company with a collaborative learning mindset and a passion for improvement.
Facilitate all aspects of required medical licensure for clinical personnel.
Drive the licensing process in a proactive, organized and streamlined manner.
Collaborate with credentialing, onboarding, and clinical teams.
Talkiatry is a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist. They provide patients with the care they need and allow psychiatrists to focus on medicine with innovative technology and a human-centered philosophy.