Manage a panel of complex pediatric patients, overseeing care plans and collaborating with PCPs and specialists.
Work in a multidisciplinary team to provide wrap-around care in a virtual-first model.
Empower families by educating and supporting parents to navigate their child's health journey.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. It is a values-driven, inclusive startup focused on remote and in-home care.
Collaborate with physicians, APPs, and interdisciplinary team members to manage a patient panel and address specialized needs post-hospitalization.
Perform assessments and develop comprehensive care plans based on individual patient values, goals, and preferences.
Coordinate patient care delivery with clinicians, network providers, contracted vendors, and community-based services.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic approach. The company provides interdisciplinary clinical resources and analytical tools to improve patient outcomes, operating with a team that values innovation and comprehensive care.
Conduct clinical reviews of medical records to determine medical necessity and payer compliance.
Evaluate denial cases including appeals, audits, and no-authorization determinations.
Develop evidence-based clinical rationales aligned with payer and regulatory guidelines.
This partner company provides clinical review and healthcare reimbursement support services. The team is remote and operates in a fast-paced, performance-driven environment.
Provide high-quality nursing care and perform study procedures like vital signs, specimen collection, and ECGs in patients' homes.
Conduct patient assessments, monitor for adverse events, and document all activities per study protocols.
Maintain adherence to ICH-GCP guidelines, HIPAA regulations, and communicate effectively with patients and study teams.
WEP Clinical connects skilled nurses with flexible clinical research opportunities, bringing trials directly to patients' homes. The company operates as a contractor network with a focus on patient-centered care and medical innovation.
Conduct thorough patient assessments and develop personalized treatment plans via video visits
Collaborate with a multidisciplinary care team to deliver the highest standards of care
Educate patients on preventive care and wellness using evidence-based strategies
Allara is a comprehensive women's health provider that specializes in expert, longitudinal care for women through every life stage. Trusted by over 60,000 women nationwide, Allara is one of the fastest-growing women's health platforms in the U.S.
Conduct thorough patient assessments and develop personalized treatment plans via video visits.
Collaborate with a multidisciplinary care team to deliver the highest standards of care.
Educate patients on preventive care and wellness using evidence-based strategies.
Allara is a comprehensive women’s health provider that specializes in expert, longitudinal care for women. Trusted by over 60,000 women nationwide, they make expert healthcare accessible by connecting patients with multidisciplinary care teams.
Partner across five New Jersey hospice offices to support clinical quality, consistency, and regulatory readiness
Provide documentation support, clinical guidance, and education to office Clinical Managers and field clinicians
Participate in quality improvement activities and help prepare teams for audits, surveys, and operational reviews
BAYADA HOME HEALTH CARE is a nonprofit, leading home health care company. They believe their clients and their families deserve care delivered with compassion, excellence, and reliability. They are celebrating 50 years of compassion, excellence, and reliability.
Perform telephonic symptom assessment and triage using evidence-based protocols to ensure appropriate care and disposition.
Document patient interactions accurately in the EMR and educate callers on virtual care, provider referrals, and available community resources.
Deliver excellent customer service while maintaining confidentiality, sound judgment, and effective communication with diverse populations.
UnityPoint Health is committed to team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare. They champion a culture of belonging where everyone feels valued and respected, honoring the ways people are unique and embracing what brings us together.
Manages medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted.
Utilizes clinical background to address the clinical denials, as well as write sound, compelling factual arguments for appealing denials.
Responsible for maintaining a detailed knowledge of Third Party Payors and Governmental Payors clinical/medical necessity criteria, as well as filing compliant appeals.
Shriners Children’s respects, supports, and values each other. They are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact and were named as the 2025 best mid-sized employer by Forbes.
Review and process appeals submitted by members and providers, ensuring timely and accurate resolution.
Evaluate cases, determine next steps, and manage multiple priorities while meeting strict turnaround times.
Review clinical and medical records, summarize findings for Medical Director review, and operate within turnaround times as short as 24–72 hours.
BlueCross BlueShield of Tennessee has been helping Tennesseans find their own unique paths to good health since 1945. At BCBST, they empower their employees to thrive both independently and collaboratively, creating a collective impact on the lives of their members.