Remote Healthcare administration Jobs · Case Management

• Working with a team of Intake Coordinators and Utilization Review Nurses to ensure quality and timely determinations.
• Striving for continuous improvement and an excellent work-life balance to produce top-notch results.
• Coordinating and providing care management that is timely, effective, efficient, equitable, safe, and member centered.

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.

• Oversee Housing Services programs, ensuring operational excellence and quality of care.
• Provide leadership, coaching, and supervision to the Housing Navigator team.
• Drive process improvements and support member/partner escalations for housing stability.

Zócalo Health is a tech-driven healthcare provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared and lived experiences. Founded in 2021, it aims to improve the lives of communities with culturally competent care, backed by healthcare and social impact investors.

• Conduct clinical reviews for inpatient admissions and post-acute settings using evidence-based guidelines and CMS criteria.
• Serve as the primary physician reviewer for escalated or complex cases requiring high-level medical judgment.
• Partner with care management teams to identify utilization trends and develop interventions to reduce unnecessary admissions or extended stays.

It appears to be a healthcare organization. They ensure timely and appropriate care determinations for their Medicare Advantage members.

• Serve as the ongoing point of contact for Medicare patients after their intake appointment.
• Educate patients on how to access healthcare services (e.g., finding providers, using insurance, scheduling appointments).
• Troubleshoot issues related to online portals, referrals, or provider communication.

Understood Care aims to bridge the healthcare gap for Medicare patients needing help navigating the healthcare system. They seem to value compassion, proactivity, and patient empowerment in a fast-paced, startup environment.