Supervise interdisciplinary team members including RNs, LVNs, and social workers to ensure high-quality care delivery.
Lead key initiatives to improve clinical care and launch new programs while resolving workflow issues.
Collaborate with providers to enhance patient care and support team performance reviews and onboarding.
Vynca provides comprehensive care for individuals with complex needs, aiming for more quality days at home. They are a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.
Manage care for high-risk members by identifying needs and coordinating clinical, community, and in-network resources.
Perform utilization management reviews, ensure quality oversight, and support accreditation readiness.
Collaborate with multidisciplinary teams to analyze member outcomes and drive continuous improvement.
They are a health plan focused on improving outcomes for high-risk members through care coordination and quality initiatives. Their team values collaboration, clinical excellence, and mission-driven work to enhance community health.
Supervise and lead a clinical team delivering virtual EAP mental health services, ensuring high-quality, timely care and operational performance.
Monitor team caseloads and metrics, implement workflows, and drive performance to meet internal SLAs.
Deliver case audit feedback, coaching, and clinical consultation to ensure adherence to quality standards.
Spring Health is a global mental health company on a mission to eliminate every barrier to mental health. Their AI-native platform reaches over 170 million people worldwide, and they foster a collaborative, mission-driven culture.
Assess and coordinate care for members, ensuring continuity and person-centered service plans.
Manage a caseload of 20-30 calls per day, including crisis calls, and lead interdisciplinary care teams.
Coach and mentor less experienced Care Managers to support team development.
Integrated Resources, Inc. is a workforce solutions company that delivers strategic talent management services. Founded in 1996, the company has grown steadily and focuses on matching qualified professionals with employers, building long-term partnerships based on performance and integrity.
Coordinate comprehensive, person-centered care for clients with complex needs, partnering with healthcare providers and social services.
Assess member needs across physical health, mental health, social supports, and more, and oversee development of care plans.
Utilize evidence-based practices like Motivational Interviewing and Trauma-Informed Care to empower clients and promote wellness.
Vynca provides comprehensive care for individuals with complex needs, with a mission to enable more quality days at home. They describe themselves as a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.
Lead daily workflow of a remote team of up to 20 RNs, ensuring productivity and operational metrics are met.
Audit RN performance and clinical documentation to ensure compliance with APCM protocols.
Coach RNs through structured feedback and manage performance improvement plans.
Cadence is a clinical AI company that automates chronic disease treatment. It partners with over 20 health systems, serves 100,000+ patients, and was named a Top HealthTech Company by TIME and a Top Startup by LinkedIn.
Manage UM nurse team performance, SLAs, and quality improvement.
Handle escalated UM cases and provider disputes 25% of time.
Partner with clients, medical directors, and IDTs to ensure consistent decision-making.
IntusCare builds an end-to-end ecosystem for Programs of All-Inclusive Care for the Elderly (PACE) to improve care, financial performance, and compliance. As a healthcare technology company, we empower teams to improve outcomes for dual-eligible seniors.
Set daily direction for your UM team, establishing priorities and reinforcing expectations.
Coach reviewers on criteria application, guiding consistent use of medical-necessity criteria.
Monitor workflow health daily, tracking intake volume and turnaround risk.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. The team is on a mission to empower people to lead healthier lives.
Serve as lead clinician and engagement manager for complex care clients, collaborating with PhD scientists and care coordinators.
Utilize clinical expertise to assess key issues, identify top experts, and guide patients to optimized care plans.
Build strong client relationships and coordinate with external providers and internal teams to deliver personalized care.
Private Health Management guides patients and families through the chaos and complexity of serious medical care as an independent advocate. The company is a remote organization with team members across the United States, focused on delivering personalized, measurably better outcomes.
Oversee all nursing activities for clinical research studies in the Southeast region, ensuring compliance with regulations and protocols.
Manage per diem mobile research nurses, including training, documentation, and quality control of data collection.
Serve as the nursing subject matter expert for assigned studies, collaborating cross-functionally to support study execution.
Science 37 accelerates clinical research by enabling universal trial access for patients through Direct-to-Patient Site and Patient Recruitment solutions, powered by a proprietary technology stack. The company employs in-house medical and operational experts to enhance quality and streamline study orchestration, fostering a culture of innovation and teamwork.
Provide telehealth clinical triage assessments and health education to diverse populations via phone, video, and chat.
Utilize critical thinking and clinical skills to assess patient needs, direct to appropriate care, and influence health decisions.
Document interactions and monitor performance metrics while participating in coaching sessions to improve quality.
Carenet Health provides telehealth and virtual care clinical triage assessments, health education, and services to patients and health plan members. The company has been named one of America's fastest-growing private companies by Inc. Magazine for eight consecutive years and fosters a culture of compassion, innovation, and work-life balance.
Review Home Health prior authorization requests using CMS guidelines and clinical judgment.
Lead and mentor the Home Health UM nursing team, ensuring quality and compliance.
Collaborate with cross-functional partners to optimize care and improve utilization.
Clover Health provides high-quality, affordable healthcare for America's seniors by combining data, technology, and preventive care. They are a mission-driven team with diverse expertise, focused on improving members' lives through innovation and empathy.
Directly supervise, coach, and develop the non-clinician care team, setting performance expectations and productivity targets.
Own clinician scheduling and coverage planning across a 24x7x365 operation, managing PTO, shift swaps, and real-time staffing decisions.
Drive patient queue management and throughput to meet SLAs, identifying bottlenecks and implementing AI-driven improvements.
Curai Health is an AI-powered virtual multispecialty primary care clinic that uses machine learning to deliver affordable and accessible healthcare. It is a remote-first company with a mission-driven team committed to improving health outcomes at scale.
Lead and manage the clinical team including physicians, APPs, physical therapists, and coaches.
Oversee hiring, staffing, capacity planning, and clinician development.
Own clinical quality, patient experience, and care-delivery operations.
Protera Health is a fast-growing digital health company reimagining musculoskeletal care. Their multidisciplinary virtual care team includes medical providers, physical therapists, health coaches, and other healthcare professionals, and they aim to treat patients as they would their own loved ones.
Provide direct operational oversight and support of teams, ensuring performance and service standards are met.
Lead scheduling, staffing, and queue management to maintain 24/7 coverage while leveraging data analytics for KPI monitoring.
Collaborate with clinical leadership to optimize workflows, implement innovations, and support value-based care goals.
Privia Health is a technology-driven physician enablement company collaborating with medical groups, health plans, and health systems to optimize practices and improve patient care. It is led by top industry talent and physician leadership, focusing on scalable operations and cloud-based technology.
Monitor and interpret patient vitals, assessments, and alerts within Welby Health’s platform to provide timely, evidence-based guidance and escalate clinically significant findings.
Develop, implement, and adjust individualized care plans addressing both clinical and social needs, coordinating with physicians, specialists, and community resources.
Deliver patient education and coaching via telephone and secure messaging, empowering patients to manage chronic conditions and build sustainable health habits.
Welby Health is a San Diego-based healthcare organization committed to transforming the way complex conditions are managed. The company leverages technology and clinical expertise to improve patient outcomes and practice efficiency.
Supervise daily operations of clinical compliance auditors and specialists.
Assist in developing coordinated team processes and managing UM and PHM plan adherence.
Serve as clinical services liaison to senior management and ensure timely documentation.
Guidehealth is a data-powered healthcare company focused on operational excellence and value-based care. They emphasize empathy, AI, and collaboration, with a remote-first culture.
Review and evaluate electronic medical records of emergency department admissions to screen for medical necessity using InterQual or MCG criteria.
Apply evidence-based clinical guidelines to assess and ensure proper utilization of healthcare resources.
Enter clinical review information into the system for transmission to insurance companies for authorization.
Netsmart provides advanced healthcare technology solutions for post-acute and human services clients, enabling better care through a comprehensive platform. We are a vision-driven team passionate about innovation, and we have been recognized as one of the best companies to work for.
Oversee daily operations of the Patient Connection team, including referral tracking, outreach, and quality assessment.
Design and optimize workflows for referral intake, outreach, enrollment, and follow-up to drive efficiency and scale.
Set and achieve team performance targets, develop individuals, and collaborate cross-functionally to improve patient experience.
Concert Health is a national behavioral health medical group integrating the Collaborative Care model into healthcare practices to improve patient lives. They are a diverse and inclusive Equal Opportunity Employer focused on providing high-quality behavioral health support.
Provide exceptional care, disease management and health education to patients.
Support goal setting for individual patients to help them better manage chronic conditions.
Coordinate with other clinical team members to provide an exceptional patient experience.
Salvo Health is a tech-enabled healthcare company focused on chronic gut and metabolic conditions. Backed by leading health investors, it offers a multidisciplinary care team approach with board-certified specialists and digital tools.