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.
Provide direct clinical support to patients undergoing medication abortion through telemedicine.
Respond to medical questions, deliver triage, clinical assessment, and nursing guidance.
Ensure patients feel heard, supported, and cared for with trauma-informed, culturally responsive care.
Hey Jane provides safe, discreet medication abortion treatment and reproductive health services via telemedicine. They have helped over 100,000 people, with a clinical care team of board certified doctors, advanced practice clinicians, nurses, and patient care advocates.
Conduct Skilled Nursing Facility medical claims audit reviews applying medical review guidelines.
Document findings and generate articulation letters for audit results.
Collaborate with audit team and clients to improve medical policies and workflows.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. Deployed by over 85 health plans representing more than 270 million lives, the company uses an AI-powered platform and best-in-class expertise to reimagine healthcare.
Lead clinical excellence managers in their region through account management and customer success.
Partner with customers to ensure highest standards of patient care and drive long-range sales plan.
Collaborate with cross-functional teams to align clinical strategies with company objectives.
Outset Medical is a trailblazing medical device company that is revolutionizing dialysis by pioneering groundbreaking technology. They focus on creating a high-performing team obsessed with progress in an atmosphere of transformative opportunities.
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.
Support assigned payer client implementations through prescriptive workflow execution and system build input.
Deliver end-user and super-user education using adult learning principles.
Monitor standard KPIs and review dashboards to identify adoption or utilization concerns.
We are an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Since 2013, we have grown to be recognized on the Inc. 5000 and Deloitte Technology Fast 500 lists, and we are one of the fastest-growing privately-held companies in the country.
Evaluate AI agent conversations for acute symptom triage, diabetes management, and travel health guidance.
Score and annotate agent performance using structured rubrics and provide actionable feedback.
Participate in calibration sessions and help refine test scenarios for clinical safety.
Hippocratic AI develops AI-driven clinical agents to support healthcare delivery. As a specialized AI company, it focuses on patient safety and clinical accuracy, engaging clinical experts to evaluate and refine its systems.
Design and build triage logic and escalation pathways for clinical red flags.
Keep clean, versioned documentation of protocols and changes for team accuracy.
Run QA programs to track triage performance and drive corrective actions.
Lark Health uses advanced AI techniques to provide scalable, affordable cardiometabolic care, helping partners manage over 30 million lives. As a remote-first company, they foster a mission-driven culture and are an Equal Opportunity Employer.
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.
Provide direct patient care as a PMHNP in a remote telehealth setting.
Conduct chart reviews and deliver empathetic feedback to improve clinical quality.
Cultivate supportive relationships with a network of psychiatric providers.
Rula is a mental health company dedicated to making mental healthcare work for everyone. They are a remote-first company with a strong focus on diversity, equity, and inclusion.