Evenings, Weekend Only, Full-time & Part-time opportunities available (20hrs +) Hiring for evenings and weekends (*weekends and holidays are required) Incentives for Bilingual Spanish Telephone Triage RNs! AccessNurse is the premier provider of medical call center solutions, including 24/7 telephone nurse triage, and answering services. In business since 1996, AccessNurse serves more than 20,000 clinicians and practices, along with healthcare systems, health plans and Federally Qualified Health Centers (FQHCs) across the country. AccessNurse is a TeamHealth Company.
The Telephone Triage Nurse role is a great alternative to bedside nursing working 12-hour shifts. This is an opportunity to work remote from home! Training and equipment are provided. Training classes are starting soon.
Overview
The Telephone Triage Nurse will take phone calls and help patients across the lifespan of the call and determine the best way to address their medical issues and concerns.
Essential Duties and Responsibilities
Assesses patient's symptoms utilizing a physician-written algorithms
When appropriate, provide home care instructions using the approved, written guidelines as well as approved reference material provided
Utilize all resources and guidelines to effectively assess, prioritize, advise, schedule classes or physician appointments, or refer calls when necessary to the appropriate medical facility, personnel or specialized community service
Completes all documentation in the appropriate software
Provides guidance recommending a variety of levels of care (e.g. home care, an office visit, emergency room)
Responds to patient's questions
Provides and documents health education to help patients manage their symptoms when indicated
Consults with physicians as needed
Job Requirements:
Qualifications / Experience
Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job offer
2+ years of nursing experience
Proficiency using computers and type a minimum of 25 wpm
Excellent listening and comprehension skills to determine key information by patient
Professional, courteous telephone voice
Ability to defuse conversations
Ability to handle confidential information; HIPAA compliance is mandatory
Flexibility with scheduling
Remote Workstation / HIPAA Requirements
Must have a high-speed internet connection
Workstation must be in a room where door can be locked
Desk should be large enough to hold 2 monitors, computer, accessories + hands-free headset
REMOTE: Training Class Dates
100% ATTENDANCE IS REQUIRED
4-week Remote Training over Zoom Video
Week 1: March 9th - March 13th M-F 9:00 am-5:00 pm EST
Week 2: March 16th - March 20th M-F 9:00 am-5:00 pm EST
Week 3: March 23rd - March 27th M-F 2:00 pm-10:00 pm EST
Week 4: Shift days/times with a preceptor will be discussed with education manager
$43k-64k yearly est. 4d ago
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Care Coordinator (Bilingual Spanish, Medical Assistant, California)
Alignment Healthcare 4.7
Remote job
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
Alignment Health is seeking an compassionate, customer service oriented, and organized, bilingual Spanish care coordinator in California to join the remote Care Anywhere team. The Care Coordinator is responsible for supporting the Care Anywhere Program field providers, scheduling, outreach, and managing all care coordination needs for high-risk members enrolled with the program. If you're looking for an opportunity to learn and grow, be part of a collaborative team, and make a difference in the lives of seniors - we're looking for YOU!
Individuals with front office medical assistant experience, experience supporting multiple providers, and high call volume experience are highly encouraged to apply.
Schedule: Mondays - Fridays
- Option 1: 8:00 AM - 5:00 PM Pacific Time (with 1-hour lunch)
- Option 2: 8:30 AM - 5:30 PM Pacific Time (with a 30- minute lunch) General Duties / Responsibilities
Manage (4) provider schedules to ensure schedules are filled.
Prepare charts for upcoming home visit appointments (check member eligibility, gather records needed by the provider prior to the home visit)
Conduct outreach for scheduling, appointment confirmation calls, wellness checks for high risk members, and to providers / pharmacies for member needs.
Handle inbound / outbound Call (60 - 80 calls / day)
Obtain medical records from provider offices, hospitals and skilled nursing facilities (SNF) and upload medical records to the electronic medical records (EMR).
Submit referral authorizations to independent physician association (IPA) / medical groups for specialty, durable medical equipment (DME), and home health (HH) services.
Coordinate lab orders, transportation for high-risk members.
Documentation via EMR for Inbound / Outbound calls.
Support short message service (SMS) and member outreach campaigns.
Assist nurse practitioner (NP) team with visit preparation needs
Appointment reminders to members
Assign members to NP in EHR
Provide needed documentation to NP for visits each day
Direct inbound calls from members / family related to medication refills
Assist with maintaining and updating members' records
Assist with mailing or faxing correspondence to primary care physicians (PCP), specialists, related to, as needed.
Attend Care Anywhere meetings / presentations and participates, as appropriate.
Recognize work-related problems and contributes to solutions.
Work with outside vendors to provide appropriate care needs for members
Job Requirements:
Experience:
Required: Minimum (1) year experience entering referrals and prior authorizations in a healthcare setting.
Preferred: 2 years' healthcare experience.
Education:
Required: High School Diploma or GED.
Preferred: Completion of medical assistant program from an accredited school of training
Training:
• Preferred: Medical Terminology
Specialized Skills:
• Required:
Able to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Knowledge of ICD9 and CPT codes
Knowledge of Managed Care Plans
Able to type by 10-key touch minimum of 40 words per minute (WPM)
Proficient with Microsoft Outlook, Excel, Word
Effective written and verbal communication skills; able to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
Language Skills: Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Communicates effectively using good customer relations skills.
Mathematical Skills: Able to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Able to perform these operations using units of American money and weight measurement, volume, and distance.
Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations.
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Bilingual English / Spanish required.
• Preferred:
Knowledge working in Athena
Licensure:
• Required: None
• Preferred:
Medical assistant certificate
Medical terminology certificate
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Pay Range: $41,472.00 - $62,208.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
$41.5k-62.2k yearly Auto-Apply 3d ago
Home-Based Medicine Care Coordinator/Nurse Practitioner
Healthpartners 4.2
Remote job
HealthPartners is looking for a Certified Adult/Geriatric or Family Nurse Practitioner to join our Home-Based Medicine Team. Being a part of our team means you will have an impact on the care that our patients receive every day.
As a Home-Based Medicine Nurse Practitioner/Care Coordinator, you will be part of the largest multi-specialty care system in the Twin Cities. This position will provide both telehealth and fieldwork with seeing patients in their homes. Local travel required.
This individual will provide the primary health care for patients at home.
Provide care coordination to achieve patient centered, high quality and cost-effective care across the continuum
Provide nursing leadership in defining and achieving program goals in a changing healthcare environment
Utilizes principals of quality of life, maintenance of optimal function and the patient's advanced directives in developing plan of care
Supportive, patient-centered practice
MN RN and APRN licensure required along with prescriptive authority
Home Based Medicine experience (NP or RN) preferred
Must be able to provide own transportation for local travel.
You will be joining a team that is supportive and respectful of one another and deeply committed to the mission of HealthPartners. Here, you'll become a partner for good, helping to improve the health and well-being of our patients, members and community. Our commitment to excellence, compassion, partnership and integrity is behind everything we do. It's the type of work that makes a difference, the kind of work you can be proud of. We hope you'll join us.
WORK SCHEDULE:
8am - 5:00 pm
BENEFITS:
HealthPartners benefit offerings (for 0.5 FTE or greater) include medical insurance, dental insurance, 401k with company contribution and match, 457(b) with company contribution, life insurance, AD&D insurance, disability insurance, malpractice insurance for work done on behalf of HealthPartners as well as a CME reimbursement account. Our clinician well-being program provides a wealth of information, tools, and resources tailored to meet the unique needs of our health care professionals, including physicians, advanced practice clinicians (APCs) and dentists. HealthPartners is a qualified non-profit employer under the federal Public Service Loan Forgiveness program.
TO APPLY:
For additional information, please contact Judy Brown, Sr. Physician and APC Recruiter, *********************************. For immediate consideration, please apply online.
$42k-53k yearly est. Auto-Apply 9d ago
Senior Home Base Coordinator
Prometheus Real Estate Group
Remote job
OUR PURPOSE
We are focused on Good Living for the Greater Good. This means providing a true sense of home and belonging for our Neighbors and Prometheans and giving our time and resources to bring positive change locally and beyond. It also means supporting you in your career goals with the very best working experience, and that starts with us having fun in the work we do together.
YOUR ROLE AND IMPACT
Some companies call them “Property Administrators”, but at Prometheus our Home Base Coordinators do so much more. Our Senior Home Base Coordinators focus on the administration of multiple properties, and your role is a constant blend of:
Financial Administration - Whether it is managing rent collections, reviewing ledgers, processing final account statements, or tracking invoices, you are on top if it all. You make every detail count and count every detail.
Leasing Administration - You will provide support to the leasing team in qualifying future Neighbors - verifying applications, performing credit investigations, creating all associated documentation accompanying the rental agreements, and recertifications specifically related to Below Market Rate Housing or similar.
Customer Service - You are a problem solver that makes renting easy. When Neighbors have questions about policies or deposit charges, you help them find the answers. When the office gets busy, you are the first one to jump in and answer the phones and provide support to the leasing team in qualifying future Neighbors.
JOB QUALIFICATIONS
Your Experience - Prometheans come from all walks of life and from all over the globe. We're also very diverse in that we hire talent with experience in other industries and who bring different skill sets and ideas to our company. You should bring a passion for working in a customer service, working knowledge of housing rental laws & ordinances, and enjoy solving problems.
Your Cultural Traits - Although we're a highly dispersed organization by the nature of our business, our Prometheans are strongly united by our Purpose, Mission and our Cultural Traits. These are the defining characteristics of a Promethean: Team Oriented, Communicator, Entrepreneurial, Passionate, Self-Starter, Creative, Principled, and Brand Ambassador.
Your Education - A Bachelor's degree is preferred and a High school diploma or general education degree (GED) is required.
COMPENSATION & BENEFITS
We offer a variety of benefits that take compensation well beyond a paycheck. This includes traditional benefits and benefits you might not expect or know about. The provided salary range is based on a number of factors, including location, job-related skills, experience and qualifications.
Compensation
Pay Range: $33.25 to 40.25 per hour
Discretionary Semi-Annual Bonus Plan
Benefits & Perks
Medical; Vision; Dental:100% Company-paid plans (including eligible dependents) and affordable buy-up options
Life insurance; Accidental Death & Dismemberment Insurance; Long Term Disability
Behavioral Health Program Accessible 24/7
Tax-Free Flexible Spending Accounts
401(K) Retirement Plan with Employer Matching
Recognition & Rewards Program (Torch)
Vacation: 10 days per year with accrual increasing over time
Anniversary Vacation: 40-hour Vacation Granted at Tenured Milestones
Sick Leave: 9 days per year
12 paid holidays, including your birthday!
Paid Volunteer Time
Tenured-based Housing discounts
Educational Assistance, Tuition Reimbursement
Learn more about these and other perks of being a Promethean by exploring our full Benefits Guide.
Prometheus is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, veteran status, or any other status protected under federal, state or local law. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.
If you'd like more information about your EEO rights as an applicant under Federal Employment Laws, please check out these FMLA, EEO, and EPPA pages.
$33.3-40.3 hourly Auto-Apply 13d ago
Primary Care Coordinator
Mayo Clinic 4.8
Remote job
This role provides essential operational and technical support for Primary Care in Rochester and Kasson by managing digital content, organizing key documents, and maintaining web-based resources. This role ensures that providers, staff, and patients have access to accurate, up‑to‑date information across internal and external platforms. Requires strong organizational skills, attention to detail, ability to manage multiple priorities, excellent communication and problem-solving abilities.
Manages and maintains Primary Care internet and intranet sites, ensuring all pages, documents, and resources remain current, accurate, and user‑friendly.
Creates, updates, and optimizes web content using appropriate web languages, content management tools, and software platforms.
Oversees the structure, layout, and navigation of SharePoint sites and subsites; organizes libraries, permissions, and document workflows to support operational efficiency.
Ensures timely loading, formatting, and lifecycle management of digital documents, policies, protocols, and reference materials.
Preferred experience with SharePoint site administration, website content management, or digital resource organization.
Other duties and responsibilities assigned as needed.
Work will primarily be performed remotely but at times will require incumbent to be on site. Therefore, the individual must live within driving distance of any Mayo Clinic Health System.
High school diploma or equivalent required. Formal education or experience with web development languages/software or two years administrative experience including web development required. Previous supervision experience beneficial. Experience with database software such as Access and Excel desired. Prefer experience working in a healthcare environment. Excellent time management, team facilitation, and team building skills required. Ability to coordinate multiple projects, provide attention to detail, ability to follow through on assignments/tasks and ability to work with others to ensure consistency, validity, and accuracy. Ability to exercise independent problem solving.
$43k-55k yearly est. Auto-Apply 7d ago
Primary Care Coordinator
Mayo Healthcare 4.0
Remote job
This role provides essential operational and technical support for Primary Care in Rochester and Kasson by managing digital content, organizing key documents, and maintaining web-based resources. This role ensures that providers, staff, and patients have access to accurate, up‑to‑date information across internal and external platforms. Requires strong organizational skills, attention to detail, ability to manage multiple priorities, excellent communication and problem-solving abilities.
Manages and maintains Primary Care internet and intranet sites, ensuring all pages, documents, and resources remain current, accurate, and user‑friendly.
Creates, updates, and optimizes web content using appropriate web languages, content management tools, and software platforms.
Oversees the structure, layout, and navigation of SharePoint sites and subsites; organizes libraries, permissions, and document workflows to support operational efficiency.
Ensures timely loading, formatting, and lifecycle management of digital documents, policies, protocols, and reference materials.
Preferred experience with SharePoint site administration, website content management, or digital resource organization.
Other duties and responsibilities assigned as needed.
Work will primarily be performed remotely but at times will require incumbent to be on site. Therefore, the individual must live within driving distance of any Mayo Clinic Health System.
High school diploma or equivalent required. Formal education or experience with web development languages/software or two years administrative experience including web development required. Previous supervision experience beneficial. Experience with database software such as Access and Excel desired. Prefer experience working in a healthcare environment. Excellent time management, team facilitation, and team building skills required. Ability to coordinate multiple projects, provide attention to detail, ability to follow through on assignments/tasks and ability to work with others to ensure consistency, validity, and accuracy. Ability to exercise independent problem solving.
$39k-47k yearly est. Auto-Apply 7d ago
Nurse Liaison - Remote
Gateway Rehabilitation Center 3.6
Remote job
Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and coordination of admission to care for substance use disordered patients referred from a hospital setting. To be considered for the position, you must live within the Pittsburgh, PA area or surrounding counties.
Responsibilities
Assesses admission candidates' medical and psychiatric appropriateness for treatment.
Determines level of care placement based on ASAM criteria.
Pre-certifies admissions as required.
Discusses treatment options with referral sources.
Acts as liaison between Gateway and outside referral sources.
Coordinates patient transfers from other facilities to Gateway Aliquippa/Westmoreland.
Responds to needs of referral sources and managed care representatives.
Interacts with the physician through coordination of patient assessments. Attends GRC mandatory training and in-services.
Other duties as required.
Knowledge, Skills, and Abilities
Strong communication skills required.
Able to work independently with minimal oversight.
Knowledge of skilled nursing
Requirements
Pennsylvania RN or LPN licensure
3+ years nursing experience preferred.
Experience identifying/treating drug and alcohol addictions.
Experience in conducting assessments and evaluations.
Additional Requirements
Pass PA Criminal Background Check
Obtain PA Child Abuse and FBI Fingerprinting Clearances.
Pass Drug Screen
TB Test
Access to reliable and dependable internet connection.
Work Conditions
Favorable working conditions.
Minimal physical demands
Significant mental demands include those associated with working with patients with addictive disorders and managing multiple tasks.
GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.
$60k-75k yearly est. 14d ago
Coordinator, Individualized Care
Cardinal Health 4.4
Remote job
Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.
**Together, we can get life-changing therapies to patients who need them-faster.**
**_Responsibilities_**
+ Responsible for handling inbound and outbound calls, with ability to determine needs and provide one call resolution
+ Responsible for reporting adverse events within the required timeframe
+ Create and complete accurate referrals and applications and keep updated on policy or procedural changes
+ Investigate and resolve patient/physician inquiries and concerns in a timely manner
+ Enter detailed information into company proprietary software while conversing via telephone
+ Place outbound phone calls for patient follow ups or confirmations
+ Demonstrate superior customer support talents
+ Interact with the patient referral sources to process new applicants
+ Steward patient accounts from initial contact through final approval/denial
+ Prioritize multiple, concurrent assignments and work with a sense of urgency
+ Maintaining quality and providing an empathetic and supportive experience to the patient by controlling the patient conversation, educating the caller as they provide effective and efficient strategies and processes
**_Qualifications_**
+ High School diploma or equivalent, preferred
+ Previous customer service experience, preferred
+ Knowledge of practices and procedures commonly used in a call center or customer service environment, preferred
+ Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
+ Ability to use well-known and company proprietary software for maximum efficiencies, preferred
+ Maintain a high level of productivity, preferred
+ Ability to multitask while conversing, preferred
**_What is expected of you and others at this level_**
+ Applies acquired job skills and company policies and procedures to complete standard tasks
+ Works on routine assignments that require basic problem resolution
+ Refers to policies and past practices for guidance
+ Receives general direction on standard work; receives detailed instruction on new assignments
+ Refers to policies and past practices for guidance
+ Receives general direction on standard work; receives detailed instruction on new assignments
+ Consults with supervisor or senior peers on complex and unusual problems
**TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required.
This position is full-time (40 hours/week). Employees are required to have ability to work the scheduled shift of Monday-Friday, 10:00am- 7:00pm CT.
**REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
+ Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.
+ Download speed of 15Mbps (megabyte per second)
+ Upload speed of 5Mbps (megabyte per second)
+ Ping Rate Maximum of 30ms (milliseconds)
+ Hardwired to the router
+ Surge protector with Network Line Protection for CAH issued equipment
**Anticipated hourly range:** $18.10 per hour - $25.80 per hour
**Bonus eligible:** No
**Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
+ Medical, dental and vision coverage
+ Paid time off plan
+ Health savings account (HSA)
+ 401k savings plan
+ Access to wages before pay day with my FlexPay
+ Flexible spending accounts (FSAs)
+ Short- and long-term disability coverage
+ Work-Life resources
+ Paid parental leave
+ Healthy lifestyle programs
**Application window anticipated to close:** 3/22/2026 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._
_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._
_To read and review this privacy notice click_ here (***************************************************************************************************************************
$18.1-25.8 hourly 3d ago
Utilization Review Nurse - Remote
Martin's Point Health Care 3.8
Remote job
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
Position Summary
The Utilization Review Nurse is responsible for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees with a need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific inpatient and outpatient medical services, notification of emergent hospital admissions, completes inpatient concurrent review, establishes discharge plans, coordinates transitions of care to lower/higher levels of care, makes referrals for care management programs, and performs medical necessity reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as specified clinical guidelines/criteria to guide medical necessity reviews and will use effective relationship management, coordination of services, resource management, education, patient advocacy and related interventions to ensure members receive the appropriate level of care, prevent or reduce hospital admissions where appropriate.
Job Description
PRIMARY DUTIES AND RESPONSIBILITIES
Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.
Key Outcomes:
Review prior authorization requests (prior authorization, concurrent review, and retrospective review) for medical necessity referring to Medical Director as needed for additional expertise and review.
Utilize evidenced-based criteria, governmental policies, and internal guidelines for medical necessity reviews.
Manage the review of medical claims disputes, records, and authorizations for billing, coding, and other compliance or reimbursement related issues
Collaborates with other members of the team, the MPHC Medical Directors, healthcare providers, and members to promote effective utilization of resources. This collaboration includes timely communications with in and out of network hospitals, post-acute care facilities, other providers, and internal departments to authorize services, establish discharge plans, assist to coordinate effective, efficient transitions of care.
Coordinates referrals to Care Management, as appropriate.
Manages health care within the benefits structures per line of business and performs functions within compliance, contractual and accreditation regulations, e.g. Department of Defense, Centers for Medicaid and Medicare, NCQA, Employer contracts and state insurance regulations, as applicable. Maintains knowledge of applicable regulatory guidelines.
Completes all documentation of reviews and decisions, in appropriate systems, according to process/ compliance requirements and within timeliness standards.
Participates as a member of an interdisciplinary team in the Health Management Department
May be responsible for maintaining a caseload for concurrent cases/ assisting in caseload coverage for the team
Establishes and maintains strong professional relationships with community providers.
Acts as a liaison to ensure the member is receiving the appropriate level of care at the appropriate place and time
Mentors new staff as assigned.
Meets or exceeds department quality audit scores.
Meets or exceeds department productivity standards.
Assists in creation and updating of department policies and procedures.
Participates in quality initiatives, committees, work groups, projects, and process improvements that reinforce best practice medical management programming and offerings.
Participates in the review and analysis of population data and metrics to inform development of programs and improved health outcomes.
Demonstrates flexibility and agility in working in a fast-paced, team-oriented environment, able to multi-task from one case type to another.
Assumes extra duties as assigned based on business needs
Responsible for weekend coverage on a rotating basis.
POSITION QUALIFICATION
Education/Experience
There are additional competencies linked to individual contributor, provider, and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.
Education
Associate's degree in nursing
Bachelor's degree in nursing preferred
Licensure/certification
Compact RN license
Experience
3+ years of clinical nursing experience as an RN, preferably in a hospital setting
2+ years Utilization Management experience in a health plan UM department
Certification in managed care nursing or care management (CMCN or CCM) preferred
Coding/CPC preferred
Knowledge
Demonstrates an understanding of and alignment with Martin's Point Values.
Maintains current licensure and practices within scope of license for current state of residence.
Maintains knowledge of Scope of Nursing Practice in states where licensed.
Thorough understanding of healthcare policies, insurance guidelines, and regulatory standards (e.g., Medicare, NCQA, TRICARE)
Familiarity with coding systems like ICD-10 and CPT preferred
Skills
Proficiency in conducting prospective, concurrent, and retrospective reviews using standardized criteria and guidelines like MCG
Ability to review and interpret medical records, treatment plans, and clinical documentation, with a keen eye for detail and compliance with healthcare standards
Technically savvy and can navigate multiple systems and screens while working cases
Excellent interpersonal, verbal, and written communication skills.
Critical thinking: can identify root causes and understands coordination of medical and clinical information.
Computer proficiency in Microsoft Office products including Word, Excel, and Outlook.
Abilities
Ability to analyze data metrics, outcomes, and trends.
Ability to prioritize time and tasks efficiently and effectively.
Ability to manage multiple demands.
Ability to function independently.
This position is not eligible for immigration sponsorship.
We are an equal opportunity/affirmative action employer.
Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact *****************************
Do you have a question about careers at Martin's Point Health Care? Contact us at: *****************************
$57k-67k yearly est. Auto-Apply 15d ago
Clinic Coordinator - RHC (15346)
Schoolcraft Memorial Hospital 3.8
Remote job
The Clinic Coordinator plays a key role in providing exceptional nursing care and support through phone interactions. This position involves assessing patient inquiries and managing messages to ensure that patients receive timely follow-up and comprehensive care. This is a fully remote position. While day-to-day work is performed remotely, the employee may be required to attend onsite meetings or trainings on an occasional basis
Duties & Responsibilities:
Manages incoming clinical phone calls, which may include routing to appropriate personnel or initiating messages to practices via Cerner.
Assess patient symptoms and concerns over the phone to determine urgency and need for follow-up care.
Document patient information and care interactions accurately in the electronic health record (EHR) system.
Assist in responding to messages, ensuring that patients receive accurate information and timely support.
Assist with managing Cerner pools by reviewing and responding to patient-related tasks, such as lab results, medication refills, and patient inquiries within the Cerner system.
Provides clinical guidance for the scheduling of patients.
Notify patients of test results, medication refills, and other necessary follow-ups as directed by physicians.
Assists with Transitions of Care Program when needed.
Performs other duties as assigned
Qualifications
Current MI LPN or CMA Certification required.
Recent experience in a professional office setting.
Experience with phone triage, call center nursing, or patient care coordination preferred.
Strong communication and interpersonal skills, with the ability to listen, empathize, and clearly explain medical information.
Critical thinking and problem-solving skills to assess and prioritize patient needs effectively.
Working knowledge of modern professional office practices and procedures.
Working knowledge of public relations and telephone etiquette.
Ability to establish and maintain effective working relationships with doctors, other employees, and patients.
Ability to deal with people tactfully and courteously.
$39k-58k yearly est. 19d ago
Health Home Care Coordinator Pullman, WA (Whitman County - Remote)
Rural Resources Community Action 3.2
Remote job
Part-time Description
We're pleased to announce an opportunity for the position of Health Home Care Coordinator within the Community Based Teams Department.
The Health Home Care Coordinator provides comprehensive care coordination services to eligible individuals and their families. This role involves assessing member needs, developing and monitoring individualized service plans, making appropriate referrals, and advocating on behalf of members with other service providers. Care Coordinators maintain a dedicated caseload and ensure consistent monthly engagement with assigned members across various settings. Health Home Care Coordinator's support members in identifying and accessing resources, delivering health education, and applying motivational interviewing techniques to foster goal achievement, resilience, and healthy lifestyle choices. The Care Coordinator promotes wellness through coaching and awareness of chronic health conditions, aiming to reduce emergency service usage and prevent hospital readmissions.
*Prefer that the candidate resides in Whitman County, WA (or nearby) to provide in-person support as needed. Position is primarily remote but includes local travel (Whitman County) for member meetings.
Benefits Information
Medical and Dental insurance options for employees and families
Vision and Life insurance as well as other auxiliary insurance options
403(b) retirement plan with up to 6% matching contribution
Health Savings Account and Flexible Spending Account options
Paid vacation earned on a pro-rated basis according to worked/paid leave hours
Paid Sick leave earned on a pro-rated basis according to actual hours worked
Eleven paid holidays per year on a pro-rated basis according to hours worked
*Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Salary Description Offered At: $21.65 - $23.42 per/hr.
$21.7-23.4 hourly 31d ago
Care Coordinator (Remote US)
Maximus Health 4.3
Remote job
is Remote (US/Canada)
No agencies please
Maximus (****************************** is a mission-driven consumer performance medicine telehealth company that provides men and women with content, community, and clinical support to optimize their health, wellness, and hormones. Maximus has achieved profitability, 8-figure ARR, and is doubling year over year - with a strong cash position. We have raised $15M from top Silicon Valley VCs such as Founders Fund and 8VC as well as leading angel investors/operators from companies like Bulletproof, Tinder, Coinbase, Daily Stoic, & Shopify.
Position Summary
In this role as a Care Coordinator supporting Maximus patients, you will be instrumental in delivering a seamless care experience. Your primary responsibilities include managing provider video conferencing schedules, coordinating with lab and pharmacy partners, and overseeing patient messaging queues. You will also serve as a key contributor to our patient concierge experience. The ideal candidate is driven by a passion for lifestyle, wellness, and fitness, constantly seeks innovative approaches to their work, and is eager to shape the overall patient journey.
Key Responsibilities
Video Conferencing & Scheduling
Coordinate and maintain provider schedules for video consultations, ensuring efficient appointment booking and minimizing scheduling conflicts.
Monitor upcoming telehealth appointments, confirm patient/provider availability, and troubleshoot any technical issues that may arise.
Lab & Pharmacy Coordination
Liaise with laboratory partners to manage test orders, track results, and ensure timely communication of lab outcomes to providers and patients.
Collaborate with pharmacy partners to facilitate prescription orders, refills, and medication-related inquiries.
Messaging Queue Management
Oversee and triage patient messages in digital platforms, ensuring inquiries are addressed promptly and directed to the appropriate clinical team member.
Escalate urgent or complex issues to the appropriate care team members, keeping patients informed of next steps.
Patient Communication & Support
Provide friendly and empathetic support to patients, answering questions related to appointments, lab tests, prescriptions, and follow-ups.
Educate patients on the use of telehealth platforms, including troubleshooting basic technical issues and sharing best practices for virtual visits.
Digital Healthcare Administration
Maintain accurate and up-to-date electronic health records (EHR), ensuring data integrity and confidentiality.
Identify opportunities to streamline workflows and enhance patient experiences, bringing recommendations to leadership.
Quality Assurance & Compliance
Ensure compliance with all relevant healthcare regulations and company policies, including HIPAA and data privacy laws.
Participate in team meetings to review patient feedback, address operational challenges, and discuss quality improvement initiatives.
Qualifications
Experience: 1-3 years of experience in a care coordinator, healthcare administration, or telehealth support role.
Education: Associate's or Bachelor's degree in Healthcare Administration, Public Health, or a related field preferred.
Technical Skills: Familiarity with EHR systems, telehealth platforms, scheduling software, and basic troubleshooting of common technical issues.
Communication Skills: Excellent verbal and written communication skills to effectively coordinate with patients, providers, and partners.
Organizational Skills: Strong attention to detail and ability to manage multiple tasks efficiently in a fast-paced, digital environment.
Interpersonal Skills: Empathetic, patient-focused approach with a commitment to delivering high-quality care and exceptional patient experiences.
Compliance Knowledge: Understanding of healthcare regulations, especially HIPAA and data privacy guidelines.
What We Offer (Benefits):
Full Suite: Medical, Dental, Vision, Life Insurance
Flexible vacation/time-off policies
Fully remote work environment
Maximus is an equal opportunity employer, which not only includes standard protected categories, but the additional freedom from discrimination against your free speech and beliefs, as long as they are aligned with company values. We celebrate intellectual diversity.
Note: We utilize AI note-taking technology during our interview sessions to ensure we capture all answers and details accurately. Candidates are also encouraged to use AI note-takers for their own records if they wish.
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This position is responsible for assisting with the management of the pharmacy benefit and developing and delivering clinical and educational interventions designed to improve pharmaceutical use. Responsibilities include formulary management; assisting with management of specific patients in the multidisciplinary case management/medication therapy management program, P&T, developing and conducting educational initiatives to improve prescribing patterns; develop and conduct quality improvement programs related to the pharmacy program; evaluating medication authorization requests and providing oversight to the medication PA process; and other pharmacy program activities as assigned.
NOTE: This is a temporary position expected to last 9 months.
Estimated Hiring Range:
$151,965.00 - $185,735.00
Bonus Target:
Bonus - SIP Target, 5% Annual
Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.
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Essential Responsibilities
Prepare drug utilization reports and analyses for the Pharmacy & Therapeutics Committee.
Use an evidence-based process to perform new drug reviews, and to develop formulary recommendations and drug use criteria for the Pharmacy & Therapeutics Committee.
Critically evaluate drug therapy regimens for patients enrolled in the case management program and assist with developing treatment plans.
Provide medication therapy management services.
Develop and conduct retrospective drug use reviews.
Review medication prior authorization requests and appeals.
Develop and implement clinical educational programs to improve drug utilization and quality.
Review and refine policies and procedures regarding Pharmacy Department functions including medication therapy management, DUR programs, medication prior authorization, and others.
Develop and conduct quality improvement programs related to the pharmacy program.
Monitor functions provided by the plans' Pharmacy Benefit Manager including pharmacy benefit coding, customer service guidelines, prior authorization activities, and other delegated services.
Develop and critically evaluate pharmacy claim data analysis/reports in support of specific projects or program objectives.
Assess, review, and respond to federal and state regulatory requirements/audits of the pharmacy benefit.
Consult with clinicians and pharmacists to resolve pharmacy benefit issues.
Review and refine pharmaceutical reimbursement and purchasing procedures.
Develop materials to communicate pharmacy benefit or other information to members, clinicians, and pharmacists.
Experience and/or Education
Required
Graduate of an accredited pharmacy program
Current, unrestricted license as a pharmacist in Oregon
Advanced pharmacy training (PharmD, residency, fellowship, or master's degree in related discipline)
Practical experience as a clinical pharmacist in formulary management or ambulatory care or other clinical setting
Preferred
Previous experience in managed care
Experience with reviewing Prior Authorization requests against plan criteria and making approval or decline decisions
Knowledge, Skills and Abilities Required
Knowledge
Must have comprehensive, clinical pharmaceutical knowledge base
Knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization
Skills and Abilities
Ability to critically evaluate clinical pharmaceutical and medical literature and apply principles of evidence-based medicine
Ability to design and review pharmacy claims analysis/reports according to specific project requirements
Must be highly motivated and have the ability to work independently
Excellent organizational, project management, and time-management skills
Excellent written and verbal communication skills
Excellent customer service skills
Ability to manage multiple tasks
Ability to negotiate, problem-solve, and consensus-build
Basic word processing, spreadsheet, and database skills
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, hear, speak clearly, and perform repetitive finger and wrist movement for at least 6 hours/day
Ability to lift and carry for at least 1-3 hours/day
Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment
Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.
Work Location: Work from home
We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.
We are an equal opportunity employer
CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.
$48k-62k yearly est. Auto-Apply 15d ago
Care Coordinator - Join Our Care Team (Future/Upcoming Roles)
86Borders 3.8
Remote job
Ready to take your career to the next level? 86Borders is always looking for motivated professionals ready to make an impact on the world. Apply for future Care Coordinator positions here! When new roles open, you'll be first in line.
As a Care Coordinator, you are responsible for providing care coordination for Medicaid, Medicare Advantage, and/or Dual Eligible Special Needs Plan (DSNP) members. You will create a positive experience for members by building trusted relationships with each member. This includes helping members access the right care at the right time with the health plan, providers, pharmacies, other vendors, and community-based organizations. You will assess and work with members to address both their medical and social needs (SDOH).
Accepting resumes from the following states: FL, GA, TN, TX, ID, and UT
**Idaho and Utah applicants must be able to work 8:30am to 4:30pm PST or CST, depending on the assigned contract.
About 86Borders
86Borders helps people navigate their healthcare by working with insurance providers to ensure they get the support they need. We focus on individuals who may struggle to access care due to age, financial challenges, or other barriers. Using a combination of real human connection and smart technology, we remind people of important healthcare tasks and assist with issues like transportation or understanding benefits. Our Care Coordinators personally connect with individuals, offering guidance instead of just automated messages. We also use data to track and improve their support, making sure everyone gets the right help at the right time. Simply put, 86Borders makes healthcare easier and less stressful for those who need it most.
Our Team Culture
86Borders is the perfect place for people who want to make a real impact while working with a supportive, mission-driven team. We are committed to breaking down barriers so people can get the care they need. By combining cutting-edge technology with compassionate human connection, we help individuals feel supported, informed, and empowered in their healthcare journey. Our team thrives on innovation, using data to drive real change while fostering a culture of collaboration and inclusivity. As a fast-growing company, we offer exciting opportunities for career growth, where every role makes a difference from day one.
Responsibilities
Conduct outreach to motivate, facilitate, and educate members about the benefits of programs.
Conduct assessments of the member's status and develop a care plan with the member to address their goals. Assessments are conducted by telephone and/or text.
Evaluate individual member care needs and communicate medical information to health care professionals.
Manage a caseload of members to ensure expedient contact is made with each member.
Facilitate coordination of care with providers and schedule appointments as needed. Motivate members to be active and engaged participants in their health and overall well-being.
Identify and help address needs related to Social Determinants of Health.
Coordinate and complete correspondence according to established workflows.
Thoroughly and accurately document actions taken in a care management platform.
Make a high volume of outreaches to members, families, providers, or other recipients as needed to successfully perform the role.
Job Requirements
2+ years of experience in care coordination, case management, CHW work, pharmacy tech, or social services
Experience documenting case notes in a care management or electronic health record platform
Experience working with Medicaid and/or Dual Eligible patients.
Experience with motivational interviewing
Remote-work readiness with a private home office and reliable internet
Experience working with customers over the phone and by text message
Strong written and verbal communication skills, including strong interpersonal skills, with professional, proactive, and collaborative communication
Strong time-management and problem-solving skills
Strong basic computer literacy (MacBook, Google Workspace, Slack, Zoom)
State location, licensure, or Spanish fluency may be required depending on the contract.
Schedule
8-hour shift during normal business hours, according to the assigned contract. Five days per week, Monday- Friday.
What we offer
Competitive compensation packages starting at $43,800 - $59,200k (depending on experience, location, certification, language, qualifications, etc.)
401(k) with employer matching
Medical, dental, and vision insurance, including a 100% employer-paid option
Paid time off, paid sick time off, and paid holidays
Remote work
Comprehensive training and development
100% employer-paid short-term disability, long-term disability, and basic life insurance
Health Savings Plan with employer contributions
Employee assistance program (EAP)
If you're passionate about helping others, embracing new challenges, and being part of something bigger than yourself, 86Borders is the perfect place for you. Join us and be part of a team that's changing healthcare for the better-one person at a time!
$34k-46k yearly est. 3d ago
Remote Hospitality Coordinator - Reservations & Guest Support
Destination Knot
Remote job
Job Title: Remote Hospitality Coordinator - Reservations & Guest SupportCompany: Destination KnotJob Type: Flexible Schedule | Remote Work About Destination Knot: Destination Knot is a professional travel planning company dedicated to delivering personalized, high-quality travel experiences. We specialize in hotel accommodations, cruises, all-inclusive resorts, and group travel, with a focus on exceptional service and attention to detail.
Position Overview: We are seeking motivated and detail-oriented individuals to join our team as Remote Hospitality Coordinators focusing on reservations and guest support. In this role, you will assist clients with booking travel accommodations, managing reservations, and ensuring a smooth and enjoyable experience from the moment they inquire until the end of their stay.
Key Responsibilities:Coordinate hotel reservations and other travel-related bookings Provide clients with accurate details about accommodations, amenities, and availability Handle changes, modifications, and special requests promptly and professionally Communicate with guests via phone, email, and online platforms in a friendly and helpful manner Maintain accurate booking records and client profiles Collaborate with team members to ensure exceptional guest experiences Stay current on hospitality trends, travel destinations, and supplier offerings
Requirements:Excellent communication and customer service skills Strong organizational abilities with attention to detail Ability to work independently and manage multiple client requests Basic computer proficiency and a reliable internet connection Interest in hospitality and travel services Prior experience in hospitality, customer service, or reservations is a plus but not required
What We Offer:Flexible, fully remote work environment Training and access to industry booking tools and resources Supportive team culture and mentorship Income-earning possibilities based on performance Travel discounts and industry perks Professional development and growth opportunities
Ready to deliver exceptional guest experiences from anywhere? Apply today and join the Destination Knot team!
$40k-56k yearly est. Auto-Apply 15d ago
CHOICES Care Coordinator- Giles and Lawrence Counties
Bluecross Blueshield of Tennessee 4.7
Remote job
Are you a compassionate individual who enjoys helping others achieve their personal health and wellness goals? If so, a career as a CHOICES Care Coordinator might be perfect for you.
As a Care Coordinator, you will make a lasting impact on members' lives by ensuring their safety at home or within a community setting. In this role, you'll travel to member's homes for visits, while managing various demands and requests from both internal and external stakeholders. We're seeking individuals who excel in problem-solving through critical thinking, and who are adept at time management and prioritizing daily tasks. You should be self-motivated, flexible, and thrive in a fast-paced environment. Most importantly, you should have a passion for improving the quality of life for diverse members in their communities.
You will be a great match for this role if you have:
• 3 years of experience in a clinical setting
• Registered nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act; or Masters in Social Work with an active unrestricted license (LCSW, LMSW, or LAPSW).
• Exceptional customer service skills
• Must live within the following counties: Giles and Lawrence Counties
• Available for an 8:00am - 5:00pm EST(no on call) schedule, with the option (upon management approval) to work a compressed work week after 1 year.
Job Responsibilities
Partnering with members and families to identify needed supports and direct services to meet personal goals for good health, employment and independent or community living.
Collaborates with a team of clinical and social support colleagues to meet the physical, behavioral health and long term service needs of each member.
Conduct thorough and objective face-to-face visits with and assess each members situation to determine current status and needs, including physical, behavioral, functional, psycho-social, financial, and employment and independent living expectations.
Utilizing criteria for authorizing appropriate home and community based services and confirm those services are being provided and that members needs are being met.
Valid Driver's License.
TB Skin Test (applies to coordinators that work in the field).
Position requires 24 months in role before eligible to post for other internal positions.
Various immunizations and/or associated medical tests may be required for this position.
Job Qualifications
Experience
2 years - Clinical experience required
Skills\Certifications
PC Skills required (Basic Microsoft Office and E-Mail)
Effective time management skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
License
Registered nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act; or Masters in Social Work with an active unrestricted license (LCSW, LMSW, or LAPSW).
Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver's license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.
Number of Openings Available
0
Worker Type:
Employee
Company:
VSHP Volunteer State Health Plan, Inc
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
$37k-49k yearly est. Auto-Apply 10d ago
Care Coordinator
Honeydew
Remote job
Mission 💪
Our mission is to ensure that no one in the world has to suffer from a treatable skin disease because of an access issue ever again.
👋
Honeydew is building a platform for hundreds of millions of people globally to access expertise and science-backed skin treatments, from prescription to retail.
Our tech-forward dermatology experience helps people with chronic skin conditions access licensed specialists, FDA-approved treatment, and ongoing support in record time (24 hours vs an industry average of 6 months).
Honeydew is the future of skin health - digitally native, scientifically rooted, integrated end-to-end (evaluation + treatments + lab tests), and powered by AI.
About the Role
Start Being The Reason Someone Finally Feels Seen.
As a Care Coordinator at Honeydew, you'll be the thoughtful voice during someone's treatment - the person who crafts messages that make patients feel heard, supported, and confident in their skincare journey. This isn't just customer service, it's healthcare.
You know that feeling when someone
actually
listens to your healthcare concerns? When you're not just another ticket number or appointment slot? That's what you'll create every single day at Honeydew - one message at a time.
If you join us, you'll be central to our mission as a trusted guide helping people navigate one of the most frustrating parts of modern life: getting healthcare that works.
Your Day-to-Day
You'll be the empathetic problem-solver behind the screen:
Master the art of written communication - crafting clear, warm, professional messages via app chat that make patients feel supported (this is 99% of your patient interaction)
Turn healthcare chaos into clarity through thoughtful, detailed written responses that anticipate questions before they're asked
Coordinate directly with pharmacies and labs via phone to troubleshoot prescription issues, insurance hiccups, and delivery problems
Connect with dermatology providers as needed to ensure care plans stay on track
Keep meticulous records because details matter when it's someone's health on the line
Bridge the gap between patients, providers, and insurance companies through strategic communication across channels
Partner with medical teams to communicate care plans that actually fit into people's real lives
Monitor patient progress through ongoing messaging, troubleshoot obstacles, and celebrate wins along their journey
Important to Keep in Mind about the Schedule
Honeydew is open, serving patients between 9am and 10pm Eastern every day, and Care Coordinators can choose the structure of their workday on their own. However, Care Coordinators have a responsibility to respond to patients within 4 hours on weekdays and within 6 hours on weekends. Abiding by these response times is crucial to success.
As part of the initial onboarding and training process, Care Coordinators are expected to be available 7 days a week in order to ramp up to a full-time (35+ hours/week) schedule.
You Might Be Our Person If…
You genuinely like people, even when they're frustrated and it's coming through in ALL CAPS
You're comfortable with async communication
You can read tone and emotion in written messages and respond appropriately
You find satisfaction in solving problems that don't have obvious solutions
You like to be proactive in offering advice, rather than just following a template
You believe healthcare should be accessible to everyone, not just the privileged few
You find joy in doing work that matters
What We're Looking For...
The Non-Negotiables:
High school diploma or equivalent
You're an exceptional writer and speaker - clear, warm, professional across every channel
You type at least 40 WPM
You're comfortable with Gmail and Chrome (or similar)
Rock-solid internet and a private workspace - HIPAA compliance isn't optional, and dropped connections aren't an option
You have a customer service mentality but understand healthcare isn't retail - empathy and professionalism are your baseline, not your ceiling
You thrive working independently - no one's looking over your shoulder, and you don't need them to
You're coachable and collaborative - you take feedback as fuel, not criticism, and communicate openly with the team
We're Looking For At Least Two Of These:
Customer service experience - you've turned "difficult customers" into your happiest ones
Healthcare or clinical support background - you speak the language and understand the stakes
Remote work experience - you've already figured out how to stay focused when Netflix is two clicks away
The Nice-to-Haves (But Honestly, You'll Pick These Up Fast):
Comfortable with Slack and Zoom - if you're not, no stress, you'll be fluent in a week
What You Get
Full remote flexibility
Direct impact you can measure
Ability to grow within the company
$100 monthly tech stipend
Free Honeydew membership
Direct access to new dermatology treatments
20% off Honeydew products
Bi-monthly get togethers
Peer-to-peer recognition through Motivosity
Full-time employees also get:
Health insurance & HSA match
401(k) retirement savings with employer match
Unlimited time off
Hourly pay: $15/hour (or the applicable state or local minimum wage, if higher)
Our Process
Application
Skills assessment (async) - max 30 minutes
Screening interview - 20-30 minutes
Team Lead interview - 30 minutes
CEO interview - 30 minutes
Offer
Candidates must be authorized to work for any employer in the US. This role is not eligible for visa sponsorship.
Candidates residing in the following states will be considered for this role: AL, AZ, DC, FL, GA, ID, MD, MI, MO, NJ, NY, NC, OH, PA, TX, UT, VA, WA, WI
$15 hourly Auto-Apply 20d ago
Remote Triage Nurse (Full-Time)
Diana Health
Remote job
Diana Health is a network of modern women's health practices working in partnership with hospitals to reimagine the maternity and women's healthcare experience. We are restructuring the traditional approach to care to create an experience that is good for patients and good for providers. We do that by combining a tech-enabled, wellness-focused care program that women love with a clinical system that helps us drive continuous quality improvement and ensure work-life balance for our care team. We work with clients across all life stages to empower and support them to live happier, healthier, more fulfilling lives. With strong collaborative care teams; passionate administrators and a significant investment in operational support, Diana Health providers are well-supported to bring their very best to the work they love.
We are an interdisciplinary team joined together by our shared commitment to transform women's health. Come join us!
Description
We are looking for a full-time LPN passionate about all aspects of women's health to provide direct patient care as part of an interdisciplinary care team and to serve as the first line of communication with patients in our clinical phone and messaging triage during office hours. The ideal candidate thrives in a busy practice, loves women's health and building relationships with patients, is an excellent problem-solver and communicator, and is able to multi-task easily. Bilingual skills preferred with a preference for Spanish language, open to other languages.
What you'll do
Patient Care
Act as the first line of call in clinical communications for patients, within guidelines/protocols
Administer injections and medications
Provide direct clinical care as needed for minor check in visits or lab draws
Provide supporting paperwork and education for patients
Support clinic visits as appropriate and per training when needed
Administrative
Support the everyday flow of clinic acting as back up support for MA
Maintaining logs
Cleaning of rooms as needed and sterilization of instruments
Obtaining and transcribing patient medical records
Additional workflow items as the need arises
Qualifications
Current certification as a Tennessee Licensed Practical Nurse
2+ years of experience in an outpatient preferred
Excellent communication, interpersonal, and organizational skills
Strong computer skills and familiarity with EMRs
Lactation certification (IBCLC, CLC, CLE) preferred, but not required
Bilingual, Spanish skills preferred
Benefits
Competitive compensation
Health; dental & vision, with an HSA/FSA option
401(k) with employer match
Paid time off
Paid parental leave
Diana Health Culture
Having a growth mindset and striving for continuous learning and improvement
Positive, can do / how can I help attitude
Empathy for our team and our clients
Taking ownership and driving to results
Being scrappy and resourceful
$52k-79k yearly est. Auto-Apply 9d ago
Bilingual Triage Nurse
Firsthand Part Time Nurse Practitioner
Remote job
firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health. firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI. We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job-it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.
The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is primarily a day-shift role (8 hours/day, 8:30-4:30 PST or 8:30-4:30 PST), with occasional potential for nights or weekends. When not managing acute issues, Triage Nurses focus on care coordination, training, and related administrative tasks.
Responsibilities of a Triage Nurse include:
Triage and Escalation: Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately and escalate emergencies immediately.
Collaboration: Work closely with peer mental health workers, social workers, and APPs to address acute issues comprehensively.
Coordination: Coordinate care with patients' other providers to ensure seamless health management.
Training: Develop and deliver training on basic medical topics for peer mental health workers and social workers
Triage Nurses should have:
Strong triage and prioritization skills, with the ability to rapidly assess and determine the appropriate level of care.
Problem-solving expertise with a creative, patient-centered approach.
Ability to provide condition-specific patient education and self-management guidance.
Adaptability to varying team cultures and processes.
Empathy, compassion, and approachability in patient and team interactions.
Required experience includes:
Active RN license through a Nurse Licensure Compact (NLC) state and willingness to obtain licensure in non-compact states.
Bachelor of Science in Nursing (BSN).
At least 3 (three) years of clinical care experience in an Emergency Department.
Experience working with populations facing challenges such as behavioral health and/or substance use disorders.
Care management and coordination experience.
Bilingual in Spanish
Bonus Points for:
Certification in Psychiatric-Mental Health Nursing (PMH-BC)
Washington state RN license
Base salary range:$75,000-$75,000 USD
We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to begin getting to know you.
Benefits
For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.
Vaccination Policy Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law. New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed.
Unfortunately, we are not able to offer sponsorship at this time.
$75k-75k yearly Auto-Apply 24d ago
Remote Triage Nurse
Medcor 4.7
Remote job
Medcor is looking to hire a full-time Registered Nurse for our remote 24/7 Occupational Health triage call center! The hours for this position include 8-hour or 10-hour shifts between the hours of 12pm and 2am CST.
Job Type: Full-time - 40 hours per week
Salary: $28 per hour with additional shift differential pay available for evenings, nights & weekends.
By joining our nursing team, you will be helping thousands of employers better manage their workplace injuries and improve the quality of healthcare for their employees. Nurses who are successful in this position must be able to talk on the phone for long periods while typing and navigating through various software applications simultaneously. Our nurses must be able to visualize an injury while on the phone and clarify details about the injury while following our propriety algorithms to guide the triage of the injured worker.
Training:
Training for this role will last 5-6 weeks, with 2.5 weeks of classroom instruction and 2.5 weeks of precepting. These first 5-6 weeks of training are held Monday through Friday, from 8a-4p CST. The training schedule is non-negotiable, and all training must be successfully completed within the 6-week time frame. Following training, you will transition to your permanent schedule between the hours of 12p and 2a CST with an every-other-weekend requirement and holiday rotation. Changes to the permanent schedule are not allowed within the first 12 months of employment.
A typical day in the life of a Medcor Triage RN:
Manage a rapid flow of incoming telephone calls from Medcor customers in a call center environment
Document each call efficiently and accurately
Monitor and track individual as well as call center goals, productivity metrics, and statistics
Reflect all shift activities using the phone system and be responsible for personal schedule adherence
Provide superior customer service to Medcor s clients and employees
Complete accurate assessment of symptoms and/or concerns utilizing Medcor s Triage Algorithms
Follow HIPAA Compliance Policies
You Must
Be bilingual, fluent in both the English and Spanish language
Have a valid RN license and current BLS (CPR) certification
Be able to handle a high volume of consecutive calls
Have strong technological skills as well as a typing speed of at least 30 WPM
Work a major U.S. holiday rotation
Work every other weekend
Have effective written, verbal, and interpersonal communication skills. Ability to read, analyze, and interpret triage tools and information along with care instructions to injured employees and their managers.
Be able to talk and/or hear. You are required to sit and use your hands. Specific vision abilities required by this job include close vision for computers and written work with the ability to adjust focus
Be able to work on a computer for long periods
Have a private space in your home with 4 walls and a door for patient privacy
Have access to high-speed internet (no satellite) within your primary residence
Be able to receive and apply feedback
It's a Plus If
You have call center experience
You have occupational health experience
At Medcor, we re passionate about caring for our advocates as much as you are passionate about caring for your patients! Join our team and receive the support you need to be successful in your practice and to focus on your patients. In addition to a collaborative work environment, we offer great pay and benefits and emphasize your wellness.
Here s why people love working for Medcor:
Stability! We ve been around since 1984.
Potential for retention and performance incentives
Opportunities galore! Medcor has a lot more to offer than just this job. There are opportunities to move vertically, horizontally, and geographically. Annually, 20% of our openings are filled by internal employees. The fact is, opportunity exists here!
Training! We believe in it and we ll train and support you to be the best you can be. We feel we offer more training than most other companies.
We have an open-door policy. Do you have something to say? Speak your mind! We encourage it and we look forward to how you can help our organization.
Benefits
We don t just advocate for our clients and our patients; we also advocate for ourselves. Our benefits include paid time off, health and dental insurance, 401K with match, education reimbursement, and more.
To learn more about Medcor s Culture click
here
.
Medcor Philosophy
Medcor embraces a set of simple, interconnected practices that everyone can tailor to their own life and work. To preserve our pioneering, entrepreneurial spirit, we impart our values through the ongoing Better@Medcor campaign: encouraging our advocates to make a conscious choice to practice our values, to celebrate and recognize each other via our peer recognition program, and to support one another during tough times.
Medcor is a tobacco-free and smoke-free workplace!
EOE/M/F/Vet/Disability
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.