Conduct medical necessity reviews and continued stay reviews using approved clinical criteria to support quality and financial outcomes.
Collaborate with liaisons, physicians, and revenue cycle teams to manage denials, appeals, and appropriate levels of care.
Maintain documentation, monitor utilization trends, and facilitate patient care planning across the care team.
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They empower associates to challenge the status quo and put people first, fostering a collaborative and innovative culture.
Work remotely from your computer to review patient information and conduct video consultations.
Diagnose and treat patients using a seamless online platform with comprehensive templates and treatment guides.
Prescribe based on predetermined regimens with no in-person patient interaction required.
Florida Telehealth Medical Group is an innovative telemedicine company operating in 49 states and growing rapidly. They treat tens of thousands of patients every month via a video chat platform.
Lead and mentor Nurse Practitioners and clinical teams in a remote telehealth environment.
Oversee clinical operations, quality assurance, and regulatory compliance.
Drive strategic initiatives to improve patient access and care delivery.
The company operates a remote telehealth-focused clinical environment, delivering personalized, data-driven, and preventive healthcare. It fosters a collaborative culture with clinical and administrative leadership, offering professional growth opportunities.
Supervise a team of 10-15 direct reports and ensure high-quality enrollments and care management.
Provide clinical oversight, lead IDT meetings, and serve as an escalation point for complex cases.
Drive team performance to meet KPIs and collaborate with directors on process improvements.
Vynca provides comprehensive care for individuals with complex needs, focusing on more quality days at home. The company is a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.
Support medication-focused clinical programs to improve patient health outcomes and medication adherence through education, outreach, and medication reviews.
Conduct outbound calls to confirm medication use, provide education, and counsel patients on complex regimens.
Use electronic health record systems to document interactions accurately and support efficient clinical workflows.
This company provides medication-focused clinical programs to improve patient health outcomes and medication adherence. It operates as a fully remote team with multidisciplinary collaboration, though specific size and culture are not detailed.
Conduct virtual wellness visits and comprehensive health assessments for diverse patients.
Partner with in-home clinical Sprinters to coordinate care and evaluate vital signs.
Empower patients through education, medication management, and specialist referrals.
Sprinter Health is an on-demand mobile health service that sends medical professionals to patients' homes for blood draws, diagnostic services, and wellness visits. The company is a rapidly growing team of visionary leaders dedicated to increasing access to care, lowering healthcare costs, and improving patient outcomes.
Provide high-quality triaging and coordination of transfers from other facilities.
Monitor and respond to triage needs and complete direct referral acceptance process using technology.
Collaborate with referral sources, physicians, and nurses to ensure prompt communication of acceptance or deflection.
PAM Health provides specialty healthcare services for chronically and critically ill patients requiring extended hospital care. With over 80 hospital locations and more than 11,000 employees, the organization is committed to compassionate care and supporting recovery through education and research.
Oversee system-level utilization management activities across the organization.
Ensure compliance with medical necessity criteria such as InterQual and Milliman.
Manage professional staff and review processes to optimize patient care.
Piedmont Healthcare is a healthcare system providing comprehensive medical services. It is a large organization focused on utilization management and quality care.
Provide direct clinical support to patients undergoing medication abortion, including triage, assessment, and nursing guidance.
Deliver culturally responsive, evidence-based care through chat and virtual visits, ensuring patients feel heard and supported.
Navigate clinical protocols and regulatory requirements while working in a fast-paced, mission-driven startup environment.
Hey Jane provides safe, discreet medication abortion and other reproductive health services via telemedicine. They have helped over 100,000 patients and employ an in-house clinical care team of board certified doctors, clinicians, nurses, and patient care advocates.
Provide effective individual psychiatric care via telehealth, including assessments, treatment plans, and medication management.
Ensure all patient care is delivered in accordance with applicable laws, regulations, and ethical standards.
Enjoy the autonomy of practicing in the best interest of the patient without corporate administrative interference.
BlueSky is a clinician-led, patient-centered behavioral health company focused on improving access to high-quality mental health care. They are a growing team of psychiatrists, psychiatric nurse practitioners, and therapists dedicated to evidence-based care.