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.
Manage a portfolio of clients, providing clinical support, education, advocacy, and care coordination throughout their healthcare journey.
Conduct clinical intakes, collaborate with internal teams, and ensure smooth transitions across care delivery.
Communicate clearly and compassionately with clients, caregivers, providers, and internal partners.
Private Health Management guides patients and families through serious medical care, acting as an independent advocate to orchestrate the best treatment and support. The company is a mission-driven organization with a team of experts that provides compassionate, high-quality care coordination.
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.
Provide on-demand telephone-based care management services through a 24/7 Nurse Advice Line.
Assess symptoms and concerns of callers to determine urgency and type of care needed.
Coordinate care across the healthcare delivery system and record patient data in medical record systems.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and physician leadership, and focuses on reducing healthcare costs and improving outcomes.
Coordinate patient identification and care planning for the Remote Care Management program, including attending inpatient rounds and reviewing charts.
Support program expansion by teaching and promoting RCM to primary care providers and community partners through virtual and in-person formats.
Track referrals, validate program data, and assist in developing new RCM pathways through collaboration with internal and external teams.
Halton Healthcare provides quality, compassionate healthcare services to rapidly growing communities in Ontario. As a progressive and vibrant organization, they are committed to being an innovative center of excellence in community hospital care, with a culture focused on exemplary patient and staff experiences.
Conduct virtual wellness visits and health assessments for patients in their homes.
Collaborate with in-home Sprinters to evaluate vital signs and coordinate care.
Perform comprehensive care coordination including medication management and referrals.
Sprinter Health reimagines how people access care by bringing high-quality care directly into the home. The company has supported millions of patients across 22 states and maintains a 90+ NPS, reflecting a culture of quality and patient experience.
Manage an assigned patient panel, addressing specialized needs based on individual conditions and care goals.
Collaborate with physicians, APPs, and interdisciplinary team members to coordinate holistic care.
Perform assessments, create care plans, and monitor effectiveness to ensure high-quality outcomes.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They focus on improving patient outcomes and quality of life in an innovative and evolving environment.
You will serve as a critical liaison between patients, providers, care teams, and community resources to ensure continuity of care.
You will create and promote adherence to treatment plans developed by healthcare providers.
You will assess patients' unmet health and social needs and connect them to relevant community resources.
Point C is a national third-party administrator that delivers customized self-funded benefit programs. We are a mission-driven company focused on innovative cost containment strategies and driving down plan costs.
Conduct comprehensive health assessments for Medicare Advantage members via telehealth.
Create personalized care plans and coordinate with primary care physicians and care teams.
Document visits and close gaps in care using Clover's software and EMR systems.
Clover is reinventing health insurance by combining data with human empathy to keep members healthier. The company is a mission-driven team focused on improving healthcare, with a culture that values diversity and inclusion.
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.
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.
Triage and provide clinical support for incoming patient communications.
Conduct phone assessments of clinical symptoms to determine the best path of care.
Assist in the development of processes and systems for urgent care and virtual triage.
Galileo is a team-based medical practice providing high-touch, data-driven, multi-specialty care across the United States. They are a team of healthcare and technology innovators focused on improving care quality and affordability for all.
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.
Learn Solace's proprietary system, tools, and technology while providing your unique experience in every interaction.
Build strong, trusting relationships with patients, using listening and empathy as the foundation for every interaction.
Identify and prioritize patients’ needs and build out a care plan that holistically addresses social determinants of health.
Solace helps patients navigate healthcare complexity by pairing them with expert advocates. They are a Series C startup founded in 2022, with a lean, mission-driven team growing quickly, and a culture that is intense and not for coasting.
Serve as a vital link between patients and healthcare services, coordinating care across primary, specialty, and behavioral health divisions.
Conduct patient assessments and community outreach to engage underserved populations in the Bronx, addressing barriers to care.
Utilize remote patient monitoring tools and electronic health records to track patient progress and adjust care plans.
Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to underserved residents. Founded in 1999, the company has grown to 50+ locations with 500+ providers, focusing on a population health model and a supportive team environment.
Conduct telehealth visits for patients in the House Calls program, managing chronic conditions and geriatric syndromes.
Perform care management assessments, coordinate care with providers, and document accurately in the EMR.
Ensure compliance with clinical protocols and participate in interdisciplinary case reviews.
Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to underserved residents. Founded in 1999, the network has grown to 50+ locations with 500+ providers, fostering a team-oriented culture focused on population health.
Build trusted relationships with older adults and their families, grounded in listening and empathy.
Serve as a go-to resource for navigating medical systems, social services, and emotional wellness needs.
Create individualized care plans that address both clinical needs and Social Determinants of Health.
Sailor Health is revolutionizing mental health care for older adults by addressing one of the fastest-growing and most underserved healthcare segments in America. They are a mission-driven team committed to compassionate, flexible support for seniors.
Ensures prior authorization requests meet contractual requirements and are reviewed using evidence-based standards.
Performs concurrent or retrospective review of acute in-patient care services using established criteria.
Participates in Utilization Management Care Programs.
Central California Alliance for Health is a regional non-profit health plan providing accessible, quality health care guided by local innovation to members in five California counties. The organization employs over 500 dedicated employees in a respectful, diverse, professional, and fun culture.
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.
Provide fully remote virtual serious illness care management to patients and families throughout the continuum of care.
Perform virtual assessments, manage medications, and collaborate with interdisciplinary teams to ensure optimal patient care.
Maintain licensure and prescriptive authority in multiple states, and participate in quality assurance and regulatory compliance activities.
Chapters Health System is a community-based not-for-profit organization dedicated to providing hospice, palliative care, and serious illness care to patients and families. It has been a progressive leader since 1983, offering services through multiple managed affiliates across the Southeast and Mid-Atlantic regions.