Coordinate telehealth services and patient care activities as defined by the program.
Facilitate communication between patients and healthcare professionals to support continuity of care.
Collaborate with clinical colleagues to promote quality, patient-centered care and follow applicable standards.
The hiring company is a healthcare organization focused on quality, collaboration, and innovation. It operates within a large regional healthcare network that emphasizes teamwork, professional development, and equitable access to quality services.
Conduct clinical and billing reviews of claims, itemized bills, and UB-04 forms to ensure accuracy.
Perform utilization reviews to assess medical necessity and validate charges against policies.
Mentor reviewers, meet productivity targets, and maintain active RN licensure with CEUs.
Our partner is a healthcare services company that conducts medical claims and utilization reviews to ensure accurate billing and appropriate care. They offer a collaborative, quality-focused remote environment with opportunities for professional development.
Analyze and summarize medical records, highlighting relevant clinical findings for attorneys.
Prepare medical chronologies and long-term care assessments to support case evaluations.
Provide objective, evidence-based medical insights and coordinate with expert witnesses.
The partner company provides specialized legal nurse consulting services to attorneys, analyzing medical records and supporting injury-related cases. This role offers flexible, part-time contract work in a fully remote environment.
Provide direct patient care, symptom triage, and care navigation for oncology patients over virtual platforms.
Collaborate with an integrated Care Team to coordinate care, education, and support across the cancer journey.
Address clinical and social needs while building trusting relationships with patients and their care networks.
Daymark Health is a value-based oncology company redefining the cancer care experience through a personalized care platform. The company is backed by leading investors and led by CEO Dr. Justin Bekelman, with a mission to improve outcomes for patients, providers, and health plans.
Provide direct patient care and comprehensive care coordination through virtual platforms for oncology patients.
Triage symptoms, escalate to Nurse Practitioners, and support patients from screening to survivorship.
Build trusting relationships and collaborate with an integrated care team to address social and clinical needs.
Daymark Health is a value-based oncology company that redefines the cancer care experience with a personalized care platform including navigation, symptom support, and behavioral health. It is led by a pioneer in cancer care, backed by multiple venture funds, and fosters a mission-driven culture focused on improving patient outcomes.
Provide fully remote virtual serious illness care management to patients and families across hospice, palliative care, and PACE programs.
Perform virtual assessments, prescribe medications and equipment, and support plans of care in collaboration with interdisciplinary teams.
Maintain licensure and certifications, document in EMR, and participate in QAPI activities to ensure quality and compliance.
Chapters Health System is a community-based, not-for-profit organization delivering innovative care through chronic illness progression and beyond. Since 1983, it has grown into a multi-state health system across the Southeast and Mid-Atlantic, with a mission-driven culture focused on outstanding patient care.
Conduct monthly clinical check-ins and structured symptom assessments for assigned patient panels.
Collaborate with providers to escalate clinical concerns and reinforce care plans.
Maintain accurate documentation across EHR and CCM platforms while meeting quality metrics.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, and holistic approach. The company thrives on innovation and evolution, with a culture that embraces change and focuses on improving patient outcomes.
Provide patient-centered care navigation and telephonic clinical outreach to patients with chronic conditions.
Collaborate with PCPs, NPs, and care teams to coordinate treatment and support safe transitions home.
Serve as a key resource for patients, caregivers, and community agencies, implementing interventions that improve outcomes.
Vytalize Health is a healthcare company focused on value-based care for patients with chronic or serious conditions. It is a rapidly growing organization with an entrepreneurial, patient-forward culture, and you will play a key role in building a market leader.
Assess mental and physical health, diagnose psychiatric disorders, and prescribe medications.
Collaborate with an interdisciplinary team to plan and evaluate treatment, including individual psychotherapy.
Document in EHR, comply with HIPAA, and educate patients and families on care.
Brave Health expands access to mental health care by leveraging technology to bring treatment directly to patients, focusing on closing the gap for Medicaid beneficiaries. They are a community health-centered organization with a diverse team dedicated to compassionate, high-quality care.
Review a variety of claim types including Radiology, Ambulance, Physical Therapy, and Surgical for medical necessity and coverage.
Document medical rationale for payment or denial decisions using Medicare guidelines and established criteria.
Educate internal and external staff on medical review, terminology, coverage determinations, and coding.
We transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business, we are built on integrity, collaboration, and excellence.