Provides quality driven telephonic clinical assessments, health education, and utilization management services.
Provides assessments to individuals using telecommunications in accordance with computer-based algorithms, protocols, and guidelines.
Uses clinical knowledge to assess, disposition, make recommendations for care, provide education and health information.
Carenet Health values the expertise and dedication of their team members. They are committed to offering an appealing compensation package and creating an inclusive environment for all employees.
Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordination activities.
Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met.
Interview, hires, mentors, evaluates, coaches and manage performance for a diverse care coordination team.
Humana Inc. is committed to putting health first for its teammates, customers, and company. Through Humana insurance services and CenterWell healthcare services, they aim to make it easier for the millions of people they serve to achieve their best health.
Conduct thorough assessments of patients' needs and develop treatment plans.
Monitor treatment effectiveness and adjust plans while documenting outcomes.
Advocate for patients to ensure quality care delivery and assist in cost reduction.
The company provides remote case management nursing services. The posting mentions an engaging company culture that values diversity and continuous learning.
You will be responsible for using your assessment and communication skills to engage with patients in need of clinical support to determine and prioritize their needs.
Conduct timely telephonic clinical outreach to identified patients.
Collaborate with PCPs, NPs, and other members of the healthcare team to coordinate care for patients and actively help keep them stable at home.
Vytalize Health is building a market leader in value-based healthcare. They are a rapidly growing organization that embraces the power of AI and encourages innovative, responsible use of emerging technologies in their work.
Deliver patient centric health coaching that integrates medical needs with patient preferences.
Triage patient reported symptoms and side effects according to internal protocols, escalating to Providers when appropriate.
Provide comprehensive diabetes, hypertension, hyperlipidemia, and weight management care and education via chat, phone, and video.
9amHealth is a specialized cardiometabolic care provider, offering custom care plans, prescription medications, and expert guidance to help members live healthier. They are a San Diego, California-based company with a small, flexible team and are backed by 7Wire Ventures, Human Capital, Founders Fund, and Define Ventures.
Participate in provider case reviews to identify trends and deficits.
Coach providers and participate in client meetings to support expectations.
Contribute to workflow design, QA improvements, and risk management.
Amwell transforms healthcare with technology and people. They aim to provide convenient, affordable, and effective care, serving large healthcare organizations in the U.S. and worldwide.
Oversee the RN Reviewer team including one RN Team Lead
Manage the daily timeliness report and ensure all cases meet expected turnaround times
Monitor the nurse productivity reports daily and provide feedback to the nurses, managing performance to ensure consistency
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. They work with over 660,000 providers and handle over 12 million prior authorization requests annually.
Provides telephonic assessments of members’ medical, psychosocial, physical and spiritual needs.
Develops, implements, and monitors person centered service plan and ensures continuity of care across all healthcare settings.
Educates members on disease processes, preventative health, and quality of life interventions.
MJHS is a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. They foster collaboration, celebrate achievements, and promote fairness for all with comprehensive compensation and benefits.
Conducts telephonic visits with clients to complete assessments and provide disease management education.
Support program enrollment and monitor participation for clients post-discharge.
Document communication with clients, caregivers, and providers timely and accurately.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging our extensive global network, we connect clients with highly qualified professionals, offering tailored services to meet our clients' unique business needs.
Responsible for coordination of services for members, emphasizing education/self-management and quality care. \n- Assesses member needs, reviews service options, develops and implements care plans, and coordinates resources. \n- Manages a caseload of moderate-high risk members with complex medical/behavioral/psychosocial needs.
Capital Blue Cross is committed to improving the health and well-being of our members and the communities in which they live. They offer flexibility, prioritize health and well-being, and encourage employees to volunteer in their community.
Build meaningful relationships with patients and families, understanding their goals, barriers, and motivators.
Creating personalized care plans that go beyond diagnoses, addressing social determinants, emotional well-being, and behavioral health when applicable.
Coordinate care across providers and settings, ensuring safety, quality, and continuity.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Administer assessments/screening tools to identify and prioritize member needs.
Develop individualized care plans and lead care coordination efforts.
Build strong, empathetic relationships with members, driving collaboration.
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; through our leading-edge care model, Tuesday Health is shaping the future of community-based palliative care nationwide.
Strengthening the connection between the patient and their primary care physician/medical practice staff, as well as improving the patient’s health and well-being.
Engaging patients and helping them navigate their care, solve their healthcare issues, and improves communication with their medical practice.
Assisting the patient in achieving better health outcomes by addressing their questions and concerns, connecting them with the medical practice.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Their goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Responsible for quality assurance, accuracy and overall integrity of the UAS-NY assessment data and visit documentation completed by core team nurses as well as, business partners’ nurses.
Performing assessment audits, identifying trends that require staff retraining, and implementing corrective action plans in collaboration with Clinical management staff.
Responsible for ongoing orientation, training and education of Assessment Nurses conducting UAS-NY assessments, and participate in establishing educational modules for staff orientation and re-training.
Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that are expanding services in response to patients' and members' needs. MJHS is a supportive community committed to excellence, respect, and providing high-quality, personalized health care services.
Enhance healthcare quality by overseeing performance improvement initiatives.
Ensure compliance with regulations and support data analysis.
Monitor quality metrics and drive projects to improve healthcare outcomes.
Jobgether is a platform that connects job seekers with potential employers, using AI to match candidates with roles. They focus on ensuring applications are reviewed fairly and efficiently.
The NP will use their expertise and clinical judgment to provide telehealth sessions to patients via phone and/or video for prescriptive and/or informational sessions.
The NP will adhere to the required state telemedicine regulatory guidelines.
The NP will use their expertise and clinical judgment to conduct comprehensive health assessments on patients as they deem appropriate.
Everlywell's mission is to transform lives with modern, diagnostics-driven care. They are headquartered in Austin, Texas with a national clinician network composed of hundreds of physicians, nurses, genetic counselors, PharmDs, and member care specialists.
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.
Sees adults for metabolic health services in a virtual setting.
Listens to the aspirations of the patient and ensures care is tailored to the patient’s unique health journey.
Provides clinical guidance to medical assistants and nursing teams as assigned.
Knownwell delivers weight-inclusive healthcare. They offer weight management, primary care, nutrition counseling, and health coaching combining in-clinic and virtual care, backed by $50M in funding.
Utilize advanced clinical judgment to triage patient symptoms per protocol.
Conduct thorough reviews of refill requests and abnormal lab results.
Lead follow-up care for positive PHQ-9 screenings, ensuring patients are safely navigated to the appropriate level of care.
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, deeply invested in creating a culture where every employee is valued and we learn and improve together.