Provide operational oversight for clinical escalations, patient safety, and abnormal laboratory result workflows.
Lead quality improvement initiatives and investigate patient safety events.
Manage cross-functional projects to improve workflows and drive operational excellence.
Sprinter Health is an on-demand mobile health service that sends medical professionals to patients’ homes for blood draws, diagnostics, and wellness visits. We have a rapidly growing team of visionary leaders passionate about increasing access to care, lowering costs, and improving patient outcomes.
Review Home Health prior authorization requests for medical necessity using CMS regulations and Clover clinical guidelines.
Perform initial and concurrent clinical reviews, ensuring appropriate care in the least restrictive setting.
Collaborate with providers and internal teams to support timely decision-making and positive member outcomes.
Clover Health is a healthcare company that uses data and technology to provide affordable, high-quality insurance plans for seniors. The company fosters a remote-first culture with a diverse and mission-driven team focused on improving member outcomes.
Perform utilization review including precertification and concurrent reviews using medical necessity criteria.
Collaborate with medical directors and providers on complex cases and integrate AI tools into workflow.
Initiate referrals to disease management programs and participate in quality improvement initiatives.
Guidehealth is a data-powered healthcare company that uses AI and predictive analytics to improve healthcare affordability and patient outcomes. It is a physician-led organization with a culture of accountability, learning, innovation, and empathy.
Provide telephonic triage assessments and health education using nursing protocols and algorithms.
Utilize critical thinking and communication skills to manage diverse patient populations.
Work a flexible schedule that includes evenings and weekend shifts from your home office.
Carenet Health provides telephonic clinical assessments, health education, and utilization management services to patients and members. They are a growing organization with a collaborative national team of Registered Nurses, offering work-from-home options and a supportive culture.
Provide professional and friendly proactive care and triage for clinical issues.
Perform comprehensive assessments and establish clinical milestones and goals.
Document all care management assessments and interventions.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group providing 24/7 virtual and in-home care for children with special health care needs. They are guided by five core values and offer a comprehensive benefits package.
Serves as the single point of contact for patients, building personalized relationships through empathy and clinical expertise.
Provides disease education, product overview, device training, and side effect management to support therapy adherence.
Utilizes motivational interviewing and health coaching to uncover barriers and empower patients to start and stay on therapy.
Momentum Life Sciences helps the healthcare industry connect, motivate, and empower people to engage in their health. With more than 30 years of experience, we partner with life science companies to design, build and deliver patient support programs.
Review and evaluate medical record documentation for completeness, accuracy, and compliance.
Collaborate with physicians, nurses, and coding professionals to ensure appropriate clinical documentation.
Identify opportunities for documentation improvement to support coding accuracy, reimbursement, and clinical outcomes.
We improve the quality and accuracy of clinical documentation through expert CDI consulting. Our collaborative, mission-driven team offers opportunities for continuous learning and professional growth.
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.
Deliver virtual, patient-centered care with empathy and clinical excellence.
Triage patient concerns using evidence-based protocols and sound clinical judgment.
Coordinate laboratory follow-ups, referrals, and diagnostic services across the care team.
MyLaurel is a healthcare organization delivering virtual acute care support to vulnerable patients. They are a collaborative, high-performing team focused on transforming healthcare delivery.