Administer and interpret multiple assessments and screening tools to identify and prioritize member needs.
Develop individualized care plans and lead care coordination through internal and joint rounds.
Build strong, trusting relationships with members, serving as the quarterback of the multidisciplinary team.
Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. Their interdisciplinary care teams reduce avoidable hospitalizations and improve quality of life wherever individuals call home.
Perform clinical reviews to evaluate medical necessity, level of care, and benefit coverage for members.
Apply internal policies, MCG, and NCCN guidelines to deliver timely and compliant utilization management decisions.
Escalate complex cases and build audit-ready documentation for Medical Director review.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. Their mission-driven culture empowers diverse perspectives to drive real impact on people's health.
Conduct peer-to-peer educational programs for advanced practice providers and nurses on Legend cell therapy products.
Collaborate with sales, marketing, and cross-functional teams to deliver on-label education and support regional initiatives.
Build relationships with key nurse opinion leaders and provide training on disease management and adverse event identification.
Legend Biotech is a global biotechnology company dedicated to treating and curing life-threatening diseases through innovative cell therapies. It partners with Johnson & Johnson to develop and commercialize CARVYKTI® and is committed to discovering safe, effective therapies for patients worldwide.
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.