Coordinate care and collaborate with multiple disciplinary team members to improve the quality of care and clinical outcomes.
Conduct thorough assessments to determine unmet needs and develop individualized care plans.
Promote quality cost-effective outcomes with the goal of improved care coordination.
Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Supervise day-to-day operations of assigned Utilization Management staff.
Provide full people management for assigned Utilization Management teams, including hiring and performance management.
Drive team performance against key metrics, including engagement, productivity, and quality scores.
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.
Assist in monitoring compliance of medication prescribed by the physician or psychiatric provider.
Provide psychoeducation, coping skills, and therapeutic worksheets through a structured care plan.
Provide information to patient on community services and resources.
Optima Medical is an Arizona-based medical group with 30 locations and over 130 medical providers, who care for more than 200,000 patients statewide. They aim to improve the quality of life throughout Arizona by helping communities live better and longer through personalized healthcare.
Meet client needs by collaborating across business functions and following through on outstanding items.
Track internal performance to confirm client expectations are consistently met while maintaining accurate client records.
Research issues, access necessary resources, and escalate to appropriate internal experts for comprehensive resolution.
Personify Health created a personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. Our team is on a mission to empower people to lead healthier lives.
Serve as a liaison between contracts, patients, patient families, and HHAs.
Ensure effective communication and identify areas of concern.
Support the delivery of high-quality care by completing required tasks.
SnappyCX connects experienced Patient Coordinators with its clients’ care teams. They focus on ensuring effective communication and supporting the delivery of high-quality care.
Works with field staff and Manager, Clinical Services (MCS) to appropriately schedule clinicians for cases in assigned areas of responsibility.
Communicates appropriately regarding changes in schedule or service delivery.
Demonstrates the ability to be efficient and productive by organizing job duties and responsibilities.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, we are committed to finding new ways to improve the health of our patients and the health of the communities we serve.
Serve as the first point of contact, creating a welcoming experience for patients.
Partner with the branch team to coordinate timely equipment delivery and solutions.
Secure health plan authorizations, ensure compliance, and maximize patient health plan benefits.
Accendra Health simplifies healthcare by delivering care beyond traditional settings. They provide essential products and services, promoting health outside hospitals with brands like Apria and Byram Healthcare, aiming for personalized, long-term patient care.
Compiles daily schedules of clinical staff within the HCHB workflow.
Assigns POD clinicians to patients with the direction of the Assistant Clinical Manager.
Serves as a liaison between field staff, patients/clients, and POD personnel for care coordination.
Graham Healthcare Group designs business and technology solutions to drive better care, outcomes, and productivity within its own home health and hospice companies. The company is a subsidiary of Graham Holdings Company committed to radically changing the home care model.
Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement.
Accurately track and document work on a variety of internal software tools and platforms.
Evry Health is on a mission to bring humanity to health insurance. They are a high-technology health plan that expands benefits, increases access and transparency, and features a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.
Serve as the primary contact for CM/UM programs and operational questions related to the MyCare Platform.
Build relationships with provider offices through outreach and timely follow-up, resolving issues within defined turnaround times.
Educate providers on submission requirements, documentation, timelines, and available CM/UM resources.
Personify Health created a personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while improving health outcomes.
Serve as the primary financial and billing contact for caregivers during the onboarding process into behavioral health services.
Explain insurance benefits, coverage details, and estimated out-of-pocket costs in a clear and compassionate manner.
Respond to initial billing, insurance, and payment-related questions, escalating complex inquiries to appropriate insurance providers or internal teams.
Jobgether helps partner companies find candidates for their open positions. They use an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements.
Oversee the Care Navigation program, ensuring efficient operation and successful implementation of new programs.
Manage relationships with health plan partners and oversee internal policies and procedures for care navigation activities.
Provide telephonic care navigation services to individuals receiving services through various programs as needed.
Mom's Meals is a provider of home-delivered meals. They focus on delivering medically tailored meals to individuals with chronic health conditions. The company values its team members and strives to show it through benefits and other offerings.
Performs utilization review to determine medical necessity criteria compliance and facilitates resolution of escalated cases.
Collaborates with clients and physician reviewers, ensuring adherence to all HIPAA, state, federal, and regulatory standards like URAC & NCQA.
Utilizes various computer systems to manage cases, engages in provider communication, and participates in quality management programs while prioritizing independent work.
WNS, part of Capgemini, is an AI-powered leader in intelligent operations and transformation, serving over 700 clients across industries like Healthcare and Financial Services. It is a large global company with over 66,000 employees, combining deep domain expertise with AI platforms to create lasting business value.
Take inbound calls from patients, providers and members.
Support members with their insurance needs, questions or concerns.
Provide 24/7 Triage Support and assign priority for a Registered Nurse to provide health advice.
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. The company interacts with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.
Deliver an outstanding customer experience by supporting inquiries across phone, email, text, and chat.
Manage high-complexity insurance workflows and inbound support requests to collect documentation.
Partner with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment and continuity of care.
Expressable is a virtual speech therapy practice that aims to transform care delivery and expand access to high-quality services. Since 2019, they serve thousands of clients with a focus on parent-focused intervention and an e-learning platform with home-based learning modules.
Performs customer scheduling functions via high-volume customer phone calls, emails, and online scheduling requests.
Communicates with team members regarding schedule additions/changes.
Communicates with hospital staff and/or doctors regarding schedule additions/changes.
ForTec is an industry leader in improving patient health and healthcare by delivering innovative surgical laser technology to hospitals and healthcare professionals completely on demand. Present in more than 40 states, physicians enjoy the latest generation of surgical technologies from certified medical device manufacturers through our pay-per-use model.
You'll spend your day reaching out to health plan members.
You'll guide them toward scheduling their care assessments, and giving them the encouragement they need to take that next step.
You'll be the reason someone gets the care they deserve.
Carenet Health turns everyday conversations into meaningful connections that help people take charge of their health. The company values expertise and dedication, fostering a supportive environment for its team members.
Act as the first contact for new patients, discussing services with a supportive approach and coordinating patient/provider matching.
Conduct insurance eligibility verification and update patient charts with benefit information like copay and deductible.
Manage patient intake via phone, email, and text, schedule evaluations, and handle tasks like waitlist management and processing referrals.
Rivia Mind is a psychiatrist-owned mental health practice providing compassionate, science-based care through virtual and hybrid appointments across multiple US states. The company cultivates a collegial, growth-oriented culture rooted in shared values, curiosity, and authentic connection.
Answer calls and resolve questions, routing to appropriate departments.
Complete documentation in EMR and marketing systems, including initial prescreening.
Schedule new and returning patients and complete follow-up duties.
Pyramid Healthcare provides addiction treatment, mental health recovery, and eating disorder treatment. They focus on client-centered care and offer supportive environments that help patients overcome life’s challenges.
Support referral tracking, specialty care coordination, and documentation workflows within the electronic health record system.
Monitor referral activity, including STAT, urgent, and priority cases, to support continuity of patient care.
Collaborate with appointing, referral, and operational support teams to help maintain workflow accuracy, service quality, and reporting consistency.
They support coordinated healthcare operations within a structured, technology-supported environment. International SOS Government Medical Services delivers high-quality care in dynamic healthcare environments while collaborating with experienced clinical and operational teams.