Provide case management addressing medical, social, psychological, physical, and spiritual needs of members.
Develop, implement, and monitor care plans in collaboration with PCP, caregivers, and team members.
Ensure members' needs are met through coordinated care and support.
Elderplan offers Medicare and Medicaid managed care health plans designed to keep members independent and living life on their own terms. As part of MJHS, it is a supportive community committed to excellence, respect, and high-quality personalized health care services.
Auditing claims for medically appropriate services in inpatient and outpatient settings using medical review guidelines.
Documenting findings with reference to appropriate policies and rules.
Generating letters articulating audit findings.
Machinify is a healthcare intelligence company delivering value and efficiency to health plan clients across the US. Deployed by over 85 health plans representing over 270 million lives, the company uses an AI-powered platform and best-in-class expertise to reimagine healthcare cost reduction.
Conduct comprehensive clinical assessments and develop individualized care plans for high-risk members.
Coordinate transitions of care and collaborate with interdisciplinary team members including Community Health Workers and providers.
Provide health coaching and disease management education to help members achieve their health goals.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving historically underserved populations. Founded in 2021 and backed by leading healthcare investors, it is scaling rapidly with a culture focused on value-based, whole-person care.
Provide health care services regarding admissions, case management, discharge planning and utilization review.
Review admissions and service requests for medical necessity and reimbursement compliance.
Assess and coordinate discharge planning needs with healthcare team members.
UAB St. Vincent's, part of UAB Medicine, provides trusted healthcare in Alabama for over 125 years. With five hospitals and numerous clinics, the organization is guided by compassion and service, employing more than 4,800 people as one of Alabama's best hospitals.
Conduct outbound telephonic patient outreach and provide one-on-one coaching to patients managing chronic conditions.
Help patients execute personalized care plans by providing education on behavior modification, nutrition, and self-management.
Monitor patients' progress, document interactions in the Cadence platform, and collaborate with clinicians to coordinate next steps.
Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions like hypertension, heart failure, and diabetes. They operate as a full clinical care delivery organization, working alongside health system partners to extend primary care into patients' homes.
Coordinate patient care remotely using phone or video, focusing on assessments, care plans, and resource access.
Identify process improvements through data collection and auditing, while navigating multiple EHR platforms.
Utilize home health expertise to triage patient needs and maintain open communication with patients, caregivers, and providers.
ThedaCare is a community health system consisting of seven hospitals and numerous clinics, serving as the third largest health care employer in Wisconsin. With approximately 6,800 employees, the organization emphasizes innovation, compassion, and a commitment to improving community health.
Provide real-time clinical support and triage for newly re-engaged patients, ensuring immediate response to clinical needs following outreach and enrollment interactions.
Deliver proactive, professional, and compassionate care, serving as an accessible first point of contact for patients and caregivers.
Collaborate with physicians, APPs, and interdisciplinary team members to develop and execute care plans aligned to patient needs and clinical goals.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs, delivering 24/7 virtual and in-home medical, behavioral, and social care. They are a startup committed to diversity and a values-driven culture, seeking a passionate nurse to join their team.
Lead diabetes education and management through phone visits, evaluating diagnoses, medications, and lab results to assess member acuity.
Identify and prescribe Continuous Glucose Monitors (CGMs) for eligible members, collaborating with a multidisciplinary care team.
Adhere to clinical policies and ensure high-quality, empathic care in a fast-paced remote environment.
Perry Health is rethinking chronic care through a fully remote, continuous care model, providing expert diabetes education and clinical management for Medicare patients. They are a small, patient-centered team that values ownership, authenticity, and rapid growth.
Conduct telehealth assessments and support patients through their medical journey at Alternaleaf Clinic.
Manage complex patient interactions including clinical escalations, adverse event follow-up, and complaint resolution.
Build strong knowledge of the medicinal cannabis framework and patient journey systems.
Montu is Australia's largest healthtech business specializing in alternative healthcare, supporting patients, doctors, and pharmacies through its Alternaleaf clinic, SAGED platform, and Leafio dispensing solutions. Recognized as the fastest-growing tech company in Australia by Deloitte TechFast 50 for two consecutive years and named #1 on LinkedIn's Top Startups Australia 2024, Montu has a team that values innovation and impact.
Lead and inspire a remote team of Nurse Practitioners across multiple states, ensuring high-quality patient care and compliance.
Oversee provider performance, documentation quality, and risk adjustment accuracy while fostering a supportive team culture.
Guide training, coaching, and development, collaborating cross-functionally to refine workflows and drive operational success.
Sprinter Health is an on-demand mobile health service that sends medical professionals to patients' homes for blood draws, diagnostics, and wellness visits. The company has a rapidly growing team of visionary leaders passionate about increasing access to care and lowering healthcare costs.