Source Job

• Act as the lead clinical liaison for partner providers across multiple regions
• Advocate for the clinical value of care models and address provider inquiries
• Stay updated on regulatory standards to ensure compliant, high-quality care

Jobgether uses an AI-powered matching process to ensure your application is 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.

• Monitor doctor performance across the clinic to ensure high clinical and service standards
• Analyse performance data including consultation quality, documentation, utilisation and complaints
• Conduct regular 1:1 performance conversations with doctors, providing coaching and feedback

Montu is Australia's largest healthtech business with a focus on alternative healthcare. Founded in 2019, it supports patients, doctors and pharmacies through its Alternaleaf clinic, offers accredited healthcare education to clinicians via its SAGED platform, and dispensing solutions to pharmacies across Australia through Leafio.

• 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.

• 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.

• 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.

• Provide case management to members including medical, social, psychological, physical, and spiritual needs.
• Develop, implement, and monitor the care plan in conjunction with the PCP, caregivers, and other team members.
• Help meet the member's needs.

Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that are expanding services in response to patients' needs. At MJHS, they are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services.

• Manage complex medical issues, coordinating care, facilitating best diagnostic and therapeutic treatment options available world-wide, and navigating the healthcare system.
• Offer high level clinical management and education to clients and families in a caring, compassionate manner.
• Work closely with clinical and research team, identifying latest therapies and delivering comprehensive information on medical conditions, medications, treatments, and clinical trials.

Private Health Management (PHM) supports people with serious and complex medical conditions, helping them obtain the best possible medical care. They guide individuals and families to top specialists, advanced diagnostics, and personalized care offering independent, science-backed insights to help clients make informed decisions and access the best care.

• 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.

• 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.

• Responsible for daily operations of direct reports while driving operational initiatives.
• Leads clinical implementation efforts within an assigned team or partner for new technologies and workflows.
• Drives change management and adoption of new tools and workflows at team level by partnering with training and peer leaders.

Twin Health empowers people to improve and prevent chronic metabolic diseases, like type 2 diabetes and obesity, with a new standard of care, applying AI Digital Twin technology exclusively toward metabolic health. The company has been recognized for its innovation and culture and is scaling rapidly across the U.S. and globally.

• Independently lead clinical projects in accordance with the study budget and scope of work.
• Serve as the primary point-of-contact liaison with the client to provide excellent customer service.
• Prepare project status updates for clients and management; identifying key deliverables and performance metrics of success and escalation.

Precision for Medicine combines novel clinical trial designs, operational and medical authorities, advanced biomarker and data analytics solutions. They are a people focused CRO with a supportive and collaborative environment which promotes work life balance and encourages team development.

• Serve as the vendor’s lead clinical subject matter expert on clinical denials management and prevention.
• Partner with provider clients to design and implement best practices for denial prevention and appeal workflows.
• Conduct complex clinical case reviews for DRG validation, identifying and defending clinically appropriate DRG assignments.

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage over 24 years of expertise and their E360 RCM ™ platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers. EnableComp is a multi-year recipient of the Top Workplaces award recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.

• Applies systems analysis skills and inductive reasoning skills to determine health care organizations' degree of compliance.
• Engages health care organization staff in interactive dialogues on standards-based issues.
• Prepares management reports that clearly link individual standards deficiencies with potential systems vulnerabilities.

They are seeking an Acute Care Registered Nurse with Leadership experience in quality, accreditation and/or regulations. They offer comprehensive benefits for their employees for full-time and part-time positions.

• Provides telephonic assessments of members’ medical, psychosocial, physical, and spiritual needs.
• Develops a Person-Centered Service Plan (PCSP) utilizing UAS-NY assessments.
• Revises the PCSP and communicates changes with interdisciplinary care team and PCP in response to changes in members’ condition.

MJHS provides high-quality, personalized health care services. At MJHS, they foster collaboration, celebrate achievements, and promote fairness.

• This position supports the Clinical Trial Patient Safety organization in evaluating and ensuring the quality of clinical trial patient safety data.
• Responsible for world-wide surveillance of clinical trial patient safety data, including organization, resourcing, and continuous improvement efforts.
• Manages assigned operational area(s)compound associated clinical studies and related systems to ensure clinical safety adverse event surveillance is managed in a compliant and timely manner.

AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. They strive to have a remarkable impact on people’s lives across several therapeutic areas including immunology, oncology and neuroscience.

• Coordinates and oversees all direct and indirect patient services provided by clinical organization personnel.
• Provides guidance and counseling to coordinators and Clinical Supervisors to assist them in continually improving all aspects of home health care services.
• Assists the Executive Director in the preparation and administration of the organization's budget.

Mission Healthcare, located in seven states, is the largest home health and hospice company in the western United States. They provide services that meet the needs of patients and families across the healthcare continuum and believe their people deserve care delivered with Compassion, Accountability, Respect, Excellence and Service.

• Answer and triage after-hours calls across Ohio markets.
• Conduct remote clinical assessments to determine patient and family needs.
• Evaluate patient status changes and provide symptom management guidance.

Luminary Hospice is a mission-driven organization that empowers its team members to shape the culture and provide high-quality support to patients and families during their end-of-life journey. They are centered on caring for the whole person, providing expert medical care, pain management, and emotional and spiritual support to families and caregivers.

• Act as a strategic advisor to internal Solventum teams on clinical strategy and industry best practices.
• Present compelling data and clinical application during priority planned customer engagements.
• Engage alongside local teams to plan & lead comprehensive customer education events.

Solventum is a healthcare company, newly formed from 3M, dedicated to solving challenges that improve lives and enable healthcare professionals. They are focused on innovations at the intersection of health, material, and data science, with a legacy built upon empathy and clinical intelligence.

• Enhance the quality of member management and maximize satisfaction.
• Assist in navigating the health care system as a collaborative health partner.
• Promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.

• Deliver coordinated, patient-centered virtual Care Management by telephone or video that improves members' health outcomes.
• Help members navigate complex medical conditions, treatment pathways, benefits, and the healthcare system in general.
• Assist throughout acute healthcare episodes, such as hospitalizations and rehabilitation stays, providing coordinated Case Management to support the member and their family.

Included Health is a healthcare company that delivers integrated virtual care and navigation, aiming to raise the standard of healthcare for everyone. They break down barriers to provide high-quality care for every person, offering care guidance, advocacy, and access to personalized virtual and in-person care.