Coordinate and oversee collaborative patient care under physician direction, guiding patients through intake, diagnosis, treatment, and discharge.
Communicate with patients, physicians, and agencies to manage referrals, treatment plans, and pre-authorizations for desired clinical and financial outcomes.
Perform patient intake and discharge activities, including vital signs, room turnover, and documentation in accordance with hospital policy.
Virginia Mason Franciscan Health provides exceptional healthcare services, building on a legacy of compassionate care and innovation dating back to 1891. The organization employs a dedicated team across 10 hospitals and nearly 300 care sites, committed to healing the whole person and fostering a collaborative purpose.
Analyze health plan reports and clinical data to identify members eligible for case management.
Conduct comprehensive telephonic and virtual assessments to evaluate medical, behavioral, and social needs.
Develop, implement, and monitor individualized care plans with measurable goals and interventions.
Duly Health and Care is a physician-led medical group offering a connected network of primary and specialty care, surgery centers, imaging, lab, and therapy services. They foster a collaborative culture centered on putting patients first and supporting team growth.
Manage the healthcare journey of kidney disease patients in the Compassionate Care Program, focusing on advance care planning and goals of care discussions.
Collaborate with physicians and interdisciplinary teams to coordinate transitions to hospice or ongoing care based on patient preferences.
Educate internal and external partners on identifying and referring patients to the program.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic approach. As a startup, it is committed to improving patient outcomes and quality of life with an innovative and evolving culture.
Provide professional and friendly proactive care and triage for clinical issues.
Perform comprehensive assessments and establish care plans with interdisciplinary teams.
Coordinate transitions of care and establish rapport with patients and families.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs, delivering 24/7 virtual-first and in-home medical, behavioral, and social care. We are a mission-driven team guided by five core values, committed to diversity, equity, and inclusion.
Manage an assigned patient panel, addressing specialized needs based on individual conditions and care goals.
Collaborate with physicians, APPs, and interdisciplinary team members to coordinate holistic care.
Perform assessments, create care plans, and monitor effectiveness to ensure high-quality outcomes.
Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered approach. They focus on improving patient outcomes and quality of life in an innovative and evolving environment.
Ensures prior authorization requests meet contractual requirements and are reviewed using evidence-based standards.
Performs concurrent or retrospective review of acute in-patient care services using established criteria.
Participates in Utilization Management Care Programs.
Central California Alliance for Health is a regional non-profit health plan providing accessible, quality health care guided by local innovation to members in five California counties. The organization employs over 500 dedicated employees in a respectful, diverse, professional, and fun culture.
Support assigned payer client implementations through prescriptive workflow execution and system build input.
Deliver end-user and super-user education using adult learning principles.
Monitor standard KPIs and review dashboards to identify adoption or utilization concerns.
We are an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Since 2013, we have grown to be recognized on the Inc. 5000 and Deloitte Technology Fast 500 lists, and we are one of the fastest-growing privately-held companies in the country.
Manage a portfolio of clients, providing clinical support, education, advocacy, and care coordination throughout their healthcare journey.
Conduct clinical intakes, collaborate with internal teams, and ensure smooth transitions across care delivery.
Communicate clearly and compassionately with clients, caregivers, providers, and internal partners.
Private Health Management guides patients and families through serious medical care, acting as an independent advocate to orchestrate the best treatment and support. The company is a mission-driven organization with a team of experts that provides compassionate, high-quality care coordination.
Applies approved utilization criteria to monitor appropriateness of admissions and continued stay reviews.
Communicates with third-party payers for initial and concurrent clinical review to ensure medical necessity.
Tracks length of stay and resource utilization to identify at-risk patients and supports appeals on denied cases.
University of Utah Health is a patient-focused healthcare organization dedicated to enhancing health and well-being through patient care, research, and education. It is a nationally ranked Level 1 Trauma Center with five hospitals and eleven clinics, fostering a culture of collaboration, excellence, and respect.