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Care Coordination jobs near me - 527 jobs

  • Occupational Therapist - Per Diem

    Boldage Pace

    Columbus, OH

    Join BoldAge PACE and Make a Difference! Why work with us? A People First Environment: We make what is important to those we serve important to us. Make an Impact: Enhance the quality of life for seniors. BE PART OF OUR MISSION! Are you passionate about helping older adults live meaningful, independent lives at home with grace and dignity? BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of our participants. Our approach is simple: We listen to our participants and their caregivers to truly understand their needs and desires. Occupational Therapist POSITION SUMMARY: Plans, organizes, and implements Occupational Therapy services for PACE participants as a member of the PACE interdisciplinary team. Responsibilities include but are not limited to assessment; planning, providing treatment; and teaching of participant, caregivers or other appropriate representatives/family to maintain participant support in the community. ESSESNTIAL DUTIES AND RESPONSIBILITIES: Conduct initial and periodic in-person assessments to evaluate participants' functional abilities, home environment, and rehabilitation needs. Recommend and coordinate adaptive equipment, home modifications, and therapy services to promote safety and independence. Develop, implement, and revise individualized treatment plans based on participant progress and IDT collaboration. Deliver OT interventions across settings including the PACE center, clinic, participants' homes, and contracted facilities. Educate participants and caregivers on equipment use, home safety strategies, and ADL programs. Maintain timely, accurate documentation of assessments, treatment, and participant progress per regulatory and organizational standards. Actively participate in daily IDT meetings, contributing to comprehensive care planning and 24-hour care coordination. Supervise Certified Occupational Therapy Assistants (COTAs), including review of care plans, co-signing documentation, and providing ongoing mentorship. Train staff in safe OT practices and equipment use to enhance participant care. Support quality improvement, utilization review, and compliance initiatives. Perform other IDT duties as needed within scope of practice and competencies. Maintain current licensure, certifications, and participation in ongoing professional development. EXPERIENCE AND EDUCATION: Advanced degree in Occupational Therapy from an accredited school of Occupational Therapy Current license to practice Occupational Therapy in the state Two (2) years of experience working on an interdisciplinary team in a hospital, nursing home or community-based setting is preferable. 1 year of experience working with a frail or elderly population preferred. If this is not present, training on working with a frail or elderly population will be provided upon hiring (If applicable for the role). Competency position specific competencies for the Occupational Therapist will be met prior to assuming participant care. PRE-EMPLOYMENT REQUIREMENTS: All Employees - Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance. Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact. Pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen. BoldAge PACE provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. * Match begins after one year of employment
    $63k-81k yearly est. Auto-Apply 2d ago
  • RN Clinical Care Coordinator - Franklin County, OH

    Unitedhealthcare 4.4company rating

    Remote job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. This is a home-office based position with field responsibilities. You will spend approximately 50% to 75% of the time in the field within an assigned coverage area. Candidates must be in Franklin County, OH and willing to commute to surrounding counties. If you reside in Franklin County, OH or surrounding counties, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted independent licensure as a Registered Nurse in Ohio 2+ years of clinical experience as an RN 1+ years of experience with MS Office, including Word, Excel, and Outlook Reliable transportation and the ability to travel up to 75% within Franklin County, OH and surrounding counties in OH to meet with members and providers Reside in Franklin County, OH and surrounding counties Preferred Qualifications: BSN, Master's Degree or Higher in Clinical Field CCM certification 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in Managed Care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly Auto-Apply 3d ago
  • Associate Medical Manager

    Chenmed

    Columbus, OH

    We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Clinical Director will directly supervise and train primary care providers (PCPs) in his/her assigned center. The incumbent in this role is accountable for maximizing overall core model execution, including improving clinical quality, efficiency, outcomes, and clinician/patient satisfaction. In addition to being accountable for the overall clinical outcomes of his/her assigned center, they will have a portion of their time allocated to direct patient care as a PCP and/or other clinical duties (amount dependent on number of direct reports). The remainder of their time is allocated to leadership responsibilities, including PCP performance, engagement, and building a strong clinical-operations synergy and culture. The allocation of time is dependent on several factors, including PCP capacity, market needs, size of centers, patient membership, and Market Clinical Director direction. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Independently provides care for patients with acute and chronic illnesses encountered in older adult patients. Takes full accountability for patient care and outcomes and appropriately seeks consultation from specialists when needed, though will still stay involved in, and be responsible for, the detailed care of the patient. Engages with the hospitalist whenever one of their patients is in the hospital (regardless of whether the hospitalist works for ChenMed or not). Responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination and documentation for patients with acute and complex chronic health needs. Leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the office. For patients that are unable to come to the office-in hospital, SNF, LTC or homebound, engages with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market. Leads Super Huddle (SH) and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager/Center General Manager center clinical leader and/or market clinical leader is not available, based on guidance from Market Chief Medical Officer. Fills in as needed for center clinical leadership needs, including monitoring daily center census as part of joint center accountability for outcomes. Plays an active role in the management of their center and helps cover for other providers who may be out for various reasons. It is also expected that each Clinical Director will take an active role as needed in recruiting patients for the center and recruiting and interviewing additional providers for the company. Managing, mentoring and coaching PCPs in his/her assigned center to deliver outstanding clinical outcomes, including sampling other PCP's daily huddles within their center Leadership rounding with the PCPs (reduced involvement of market clinical leader) Partnering with Center Operations Director/Market General Manager to drive continued improvement of center financial performance, and helping increase center membership Performs other duties as assigned and modified at manager's discretion. KNOWLEDGE, SKILLS AND ABILITIES: Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other applications used in the company Ability and willingness to travel locally as needed in their market, if applicable, nationally for initial training (2 weeks) and then occasionally regionally and nationally for recruiting or training purposes Fluency in English, verbal and written. There may be jobs in some centers that require fluency in other languages, and this will be made known at the time of application. This job requires use and exercise of independent judgment EDUCATION AND EXPERIENCE CRITERIA: MD or DO in Internal Medicine, Family Medicine, Geriatrics, or similar specialty required Current, active MD licensure in State of employment is required A minimum of 1-year clinical experience in geriatric, adult or family practice setting preferred, with Lead PCP ideally being a ChenMed PCP Partner Completion of Chen Medical training, including Masterful Conversations and meeting facilitation, as part of the individual development plan Board certification in Internal Medicine, Family Medicine, Geriatrics or similar specialty is preferred, Board Eligibility is required Once Board certified, PCP will maintain board certification in their terminal specialty by doing necessary MOC, CME and/or retaking board exams as required Must have a current DEA number for schedule II-V controlled substances Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment PAY RANGE: $238,832 - $341,189 Salary EMPLOYEE BENEFITS We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day. Current Employee apply HERE Current Contingent Worker please see job aid HERE to apply
    $238.8k-341.2k yearly 16h ago
  • Licensed Social Worker - Manhattan

    The Jewish Board 4.1company rating

    Remote job

    PURPOSE: The Jewish Board's Community Behavioral Health treatment programs provide compassionate, high quality, evidence-based services to individuals and families in the communities we serve. Our staff use a culturally affirming, person-centered approach to help individuals and theirfamilies develop skills and resources to improve overall functioning, to instill hope, and to strengthen resiliency. Our programs work closely with community partners to address health disparities in our neighborhoods while also celebrating the strengths and resilience of our communities. POSITION OVERVIEW: This position provides clinical services as part of an Article 31 OMH certified outpatient MHOTRS clinic. The clinics are located in diverse communities and provide services to individuals of all ages and their families and support systems. Clinical services are provided using a trauma-informed, evidence-based, racially & culturally affirming approach. Interventions include, but are not limited to, evaluations; individual, group and/or family therapy; care coordination; and crisis interventions. KEY ESSENTIAL FUNCTIONS : • Conduct comprehensive evaluations and psychosocial assessments • Develop treatment plans in collaboration with clients and family members (as appropriate), to identify treatment needs and interventions and review/revise treatment plans to reflect client's treatment progress and changing problems/goals. • Provide individual, group, family, collateral treatment and crisis services/interventions • Be actively self-reflective & self-aware of how clinical and administrative practice impacts clients, families, and the communities we serve • Approach work with an anti-racist lens and open to continuously learning and evolving • Liaise with families, schools, criminal justice, and other community agencies to coordinate care • Participate in clinical meetings, staff meetings, required training, and supervision. • Open and willing to receive constructive feedback • Maintain documentation according to the standards and time frames established by the Jewish Board, regulatory agencies and/or funding sources • Maintain professional behaviors and ethical standards as established by licensing board, relevant professional association and the Jewish Board policies and procedures. • Must have a strong knowledge of OMH Telehealth guidelines and adherence to the requirements of telehealth practice. • Other duties as assigned. ADDITIONAL FUNCTIONS MAY INCLUDE: • Attending case conferences as needed • Maintaining a steady and active caseload • Meeting the minimum expectations for kept visits EDUCATIONAL / TRAINING REQUIRED: • Master's degree in social work or mental health counseling and New York State clinical licensure in social work (LCSW) or mental health counseling (LMHC-DP). Solid clinical skills and knowledge of evidence-based practices. Prior experience in DBT, Trauma Focused CBT, EMDR preferred, but not required. EXPERIENCE REQUIRED / LANGUAGE PREFERENCE: • Experience treating children or adolescents is preferred. • Fluency in a second language is preferred. COMPUTER SKILLS REQUIRED: • Experience with documenting in electronic health records and using Microsoft Office software • Experience with tele mental health platforms a must VISUAL AND MANUAL DEXIERITY: The candidate should be able to read paper and electronic documents and perform significant data entry into various computer programs WORK ENVIRONMENT / PHYSICAL EFFORT Remote work setting. Position entails a schedule of three weekday evening 1pm-9pm or two weekday evening hours and one weekend (Saturday or Sunday 9-5pm) We are an equal opportunity employer that does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, marital status, veteran status, or any other status protected by applicable federal, state, or local law.
    $38k-48k yearly est. 6d ago
  • Legal Counsel

    Medium 4.0company rating

    Remote job

    About Synapticure As a patient and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers, payers, ACOs, health systems, and life sciences organizations-including through CMS' new GUIDE dementia care model-Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases such as Alzheimer's, Parkinson's, and ALS. The Role Synapticure is seeking an experienced and highly capable Legal Counsel to serve as the company's in‑house attorney. In this critical role, you will function as a strategic business partner and trusted advisor to executive and clinical leadership-building and leading a right‑sized compliance program, managing legal risk, and ensuring regulatory alignment across our fast‑growing organization. The ideal candidate brings deep healthcare regulatory expertise, sound business judgment, and the ability to translate complex legal advice into actionable, practical guidance. You will oversee healthcare compliance, contracting, and general legal operations across the enterprise, supporting both the clinical delivery organization and the corporate entity. This is an exciting opportunity to shape the legal and compliance function at a mission‑driven, high‑growth healthcare company that is redefining access to specialized neurological care. Job Duties - What you'll be doing Healthcare Regulatory & Compliance Design, implement, and oversee a scalable healthcare compliance program, including policies, training, and internal monitoring frameworks Provide guidance on federal and state healthcare laws and regulations, including HIPAA, fraud and abuse (Stark and Anti‑Kickback Statute), corporate practice of medicine, and multi‑state telehealth requirements Advise on MSO/PC structures, payer contracting compliance, and corporate practice of medicine guardrails Provide counsel on complex billing, coding, and reimbursement issues, including Medicare and Medicaid participation Anticipate and communicate regulatory trends, advising leadership on both risk and strategic opportunity Oversee internal investigations, audits, and privacy/security initiatives in partnership with technology and clinical operations teams Contracting & Transactions Draft, review, and negotiate a wide range of contracts, including payer, health system, vendor, and technology agreements Support clinical and life sciences partnership agreements while maintaining appropriate corporate and compliance boundaries Develop and maintain contract templates, playbooks, and workflows to streamline review and approvals across the organization Corporate & Operational Legal Support Provide day‑to‑day legal counsel on corporate governance, employment, risk management, and marketing matters Collaborate with business and clinical leaders to translate legal and compliance advice into practical, operational solutions Serve as the primary point of contact for outside counsel, ensuring effective resource use and alignment with company strategy Educate and train internal teams on contracting best practices and healthcare regulatory requirements Support strategic initiatives, corporate development, and special projects as Synapticure continues to scale Requirements - What we look for in you Juris Doctor (J.D.) from an accredited law school and active licensure in at least one U.S. jurisdiction 5-10+ years of legal experience, ideally a blend of law firm and in‑house counsel roles within healthcare or health technology Demonstrated expertise in healthcare regulatory areas including HIPAA, fraud and abuse, corporate practice of medicine, telehealth, payer contracting, and MSO/PC structures Experience designing, managing, or scaling healthcare compliance programs tailored to growth‑stage or technology‑enabled healthcare companies Ability to assess and communicate risk clearly, balancing regulatory compliance with business objectives Strong interpersonal and communication skills, capable of translating complex legal issues into clear, actionable advice for diverse audiences Proven record of working cross‑functionally and collaborating with leadership, operations, and clinical teams Preferred Qualifications Experience in a telehealth or tech‑enabled healthcare environment Familiarity with value‑based care models and payer/provider partnerships Exposure to life sciences collaborations and related regulatory considerations Understanding of data privacy frameworks beyond HIPAA (e.g., CCPA, GDPR) Experience supporting corporate transactions, including fundraising or M&A activities Values Relentless focus on patients and caregivers. We are determined to provide an exceptional experience for every patient we serve, and we put our patients first in everything we do. Embody the spirit and humanity of those living with neurodegenerative disease. Inspired by our founders, families, and personal experiences, we recognize the seriousness of our patients' circumstances and meet that challenge with empathy, compassion, kindness, joy, and hope. Seek to understand, and stay curious. We listen first-to one another, our patients, and their caregivers-communicating authentically while recognizing there's always more to learn. Embrace the opportunity. We act with urgency and optimism, driven by the importance of our mission. Travel Expectations This is a fully remote position. Occasional travel to Synapticure's headquarters in Chicago, IL, or regional clinical team gatherings may be required. Salary & Benefits Competitive compensation based on experience Comprehensive medical, dental, and vision coverage 401(k) plan with employer matching Flexible scheduling and remote‑first work environment Life and disability insurance coverage Generous paid time off and sick leave Opportunities for professional development and advancement within a fast‑growing healthcare organization #J-18808-Ljbffr
    $117k-177k yearly est. 2d ago
  • Staff RN - Accountable Care Uni

    Mount Carmel Health System 4.6company rating

    Columbus, OH

    *Employment Type:* Full time *Shift:* 12 Hour Day Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration * The Accountable Care Unit at Mount Carmel East is expected to open in the Spring of 2022. The ACU, located on 3 Green, will care for patients from acute to intermediate levels of care. These patients will include those who require complex care coordination for greater than 24 hours. The ACU will be managing patients who require services like telemetry monitoring, non-titrating vasoactive drips and stable Bi-pap patients. The ACU will have a high focus on organization and care coordination to decrease length of stay and avoid duplication of services. In accordance with the Mission and Guiding Behaviors; the Staff Registered Nurse, within the scope of the Ohio Nurse Practice Act, will provide care in an atmosphere sensitive to each person's physical, emotional, social and spiritual needs. The Registered Nurse collaborates in the spirit of teamwork is accountable for the delivery of patient care utilizing the Nursing Process within the standards, policies, procedures and guidelines of the Organization. *What You Will Do:* * Assess and evaluate patient care for an assigned group of patients, utilizing evidence-based practice; Assists provider with patient assessment, examinations and treatments; Perform basic medical procedures under the supervision of a provider, including set up of procedures. * Administer medications under the direction of the provider, according to the organization's standards, policies, procedures, and/or guidelines. * Assist in emergency situations under the direction of the provider * Thoroughly educate and explain procedures to patients and family members (diagnosis, disease process etc.). * Document accurately and completely pertinent assessments, interventions and outcomes for patients in accordance with documentation standards, policies, procedures and/or guidelines. * Assume responsibility and accountability for care provided and documented by other licensed and unlicensed care givers as appropriate. *Minimum Qualifications:* * Graduate of a school of nursing * Current license to practice as a Registered Nurse in the State of Ohio * Current BLS/CPR * Demonstrated ability to plan, organize, and manage patient care, including delegation to and supervision of other members of the patient care team * Basic computer skills required; prior experience using an EMR for charting preferred *Position Highlights and Benefits:* * Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one. * Retirement savings account with employer match starting on day one. * Generous paid time off programs. * Employee recognition programs. * Tuition/professional development reimbursement starting on day one. * Relocation assistance (geographic and position restrictions apply). * Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing. * Employee Referral Rewards program. * Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day! * Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups. *Ministry/Facility Information:* Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You! *Our Commitment to Diversity and Inclusion* Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
    $56k-71k yearly est. 8d ago
  • Remote Enrollment Specialist (Certified Medical Assistant)

    Medsien

    Remote job

    Enrollment Specialist Are you a Certified Medical Assistant looking to continue in healthcare from a remote position? While still helping patients? Look no further, Medsien is a leading provider of Chronic Care Management and Remote patient monitoring services to medical practices across the United States. Medsien is a leading provider of scalable remote care management, enabling healthcare practices to enhance patient engagement, improve outcomes, and optimize operational efficiency. Hundreds of organizations trust Medsien's unparalleled technology solutions to implement exceptional remote care management programs, personalize every interaction, and improve the lives of those who need it most. We are committed to innovation, collaboration, and delivering exceptional service to our clients and their patients. Based in San Francisco and venture-backed by top-tier investors, Medsien was founded to reimagine remote care management. Our company is committed to improving the lives of patients living with chronic health conditions. We prioritize compassion, integrity, and excellence in all our interactions and operations. Here at Medsien, our Certified Medical Assistants are able to take their clinical experience, knowledge, insight, and empathy to improve patients' health care, experiences, and outcomes. Comprehensive chronic care management benefits patients with 24/7 access to physicians and clinical staff who can meet their urgent and ongoing needs. CCM also benefits practices by electronically capturing all patient interactions for real-time continuity of care. Patient enrollment is the first step in helping our patients and providers manage their chronic conditions more effectively. If patients aren't taking advantage of our Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) programs, they are missing out on a key tool in managing their Chronic illnesses. Our Enrollment Specialists (Certified Medical Assistants) use their training and knowledge to help patients understand the value of utilizing our CCM and RPM programs. Once they understand that enrollment in these programs allows the providers and our team to make real-time, data-driven decisions, they are eager to participate. Improving patient care and clinical outcomes is what we strive to accomplish every day. Medsien's personalized approach to patient care is unparalleled in the industry. Our goal is for patients to feel as comfortable with us as they do when visiting their provider's office. We prioritize compassionate quality care. As an Enrollment Specialist you will educate and enroll eligible patients from our established clinic partnerships. You will connect with eligible patients through outbound calls, resulting in enrollments to achieve your weekly goals. You will help patients navigate and enroll in these programs to better their health and achieve their wellness goals. As an Enrollment specialist you'll receive competitive pay including paid training. Fully remote capabilities (Within US only) and better work life balance. Company Values: Our company is committed to improving the lives of patients living with chronic health conditions. We prioritize compassion, integrity, and excellence in all our interactions and operations. If you are passionate about making a meaningful difference in the lives of patients and are eager to embark on a rewarding career in healthcare, we encourage you to apply for this Enrollment Specialist position. Join us in our mission to provide high-quality care and support to those who need it most. Key Responsibilities: Patient Outreach: Initiate contact with potential CCM and RPM patients Conduct initial assessments to determine eligibility for CCM/RPM services based on established criteria. Education and Information Sharing: Clearly and compassionately explain the benefits of enrolling in a CCM/RPM program to patients and their families. Provide detailed information about the program's services, including remote monitoring, care coordination. Enrollment and Documentation: Assist eligible patients with the enrollment process, ensuring that all necessary forms and documentation are completed accurately. Maintain meticulous records of patient interactions, enrollment status, and program details. Compliance and Regulatory Knowledge: Stay up-to-date with the latest regulations and compliance standards related to CCM/RPM services. Ensure all patient enrollments adhere to legal and ethical standards. Performance Tracking: Monitor and track your enrollment performance, striving to meet or exceed enrollment goals. Qualifications: National Certification in Medical Assisting Residence in the US Strong communication skills, both written and verbal. Empathy and the ability to connect with patients and their families. Basic knowledge of chronic health conditions and their management. Comfortable using technology for documentation and communication. Attention to detail and strong organizational skills. Ability to work independently and as part of a team. Sales or customer service experience is a plus but not required. Please note that having national certification in Medical Assisting from AAMA, NHA, NCCT, NAHP or similar is a hard job requirement and any single-state certifications, diplomas or completion certificates do not qualify. Training and Development: You will receive comprehensive training on CCM/RPM program details, enrollment processes, and communication techniques to ensure you are well-prepared for the role. If you are passionate about making a meaningful difference in the lives of patients and are eager to embark on a rewarding career in healthcare, we encourage you to apply for this Enrollment Specialist position. Join us in our mission to provide high-quality care and support to those who need it most. Please don't forget to attach your Medical Assistant certificate. This is a 1099 role and does not come with benefits Monday - Friday Our Process We will review your application along with all the others we receive and pick the top profiles for a screening call. In many cases due to time constraints and our candidate volume, only the short-listed candidates are contacted but we do consider each application carefully. If you have been selected as a short-listed candidate, we will contact you for a short screening call to get to know you better. If you don't get a call, please don't be disappointed! We receive many applications for each role and must prioritize who we speak to. Employment at Medsien is based solely on a person's merit and qualifications. We are committed to providing equal employment opportunity regardless of sex, age, race, color, national or ethnic origin, religion, marital status, pregnancy, sexual orientation, gender identity or expression, disability, age, citizenship, veteran or military status, and other legally protected characteristics. Thank you for taking the time to apply for a position at Medsien!
    $24k-56k yearly est. Auto-Apply 52d ago
  • Lead Care Manager (LCM)

    Heritage Health Network 3.9company rating

    Remote job

    The Bilingual Lead Care Manager partners with Care Team Operations, Clinical Operations, Compliance, Community Health Workers, Behavioral Health staff, and external providers (medical, housing, and social services) to ensure seamless, culturally responsive, member-centered care coordination. The bilingual LCM additionally supports members with limited English proficiency by facilitating communication, translation, and cultural interpretation as needed. Responsibilities Serve as the primary point of contact for assigned members, building trust and maintaining active engagement through consistent outreach, relationship-based strategies, and a trauma-informed approach. Provide all communication in the member's preferred language. Conduct comprehensive assessments (physical, behavioral, functional, social) and develop person-centered care plans that reflect the member's goals, risks, preferences, cultural needs, and social determinants of health. Implement, monitor, and update care plans following transitions of care, significant changes in condition, or required reassessments; ensure timely and compliant submission of all care plans. Coordinate services across the continuum-including medical, behavioral health, housing, transportation, social services, and community programs-to reduce fragmentation and remove barriers to care. Conduct required in-person home or community visits based on member need and risk stratification and maintain a compliant monthly visit structure. Utilize motivational interviewing, coaching, and health education to promote behavioral change, self-management, and long-term member stability. Identify gaps in care, service delays, lapses in benefits, unmet needs, and environmental risks; collaborate with internal and external partners to resolve issues quickly and effectively. Maintain accurate, timely, audit-ready documentation of all interactions, assessments, and interventions using required HHN platforms, including eClinicalWorks (ECW), Google Suite, RingCentral, PowerBI dashboards, and payer portals. Meet or exceed HHN and payer productivity standards, including encounter metrics, outreach requirements, documentation timelines, and quality measures. Actively participate in multidisciplinary case reviews, team huddles, care conferences, and escalations with nurses, behavioral health staff, CHWs, care operations, and compliance. Coordinate and schedule appointments with primary care, specialists, behavioral health providers, and community partners; manage referrals, transportation, and follow-ups to ensure continuity of care. Support hospital discharge (TOC) planning through follow-up scheduling, care transitions, medication reconciliation support, and education on discharge instructions. Assist members in navigating plan eligibility, redeterminations, documentation, social service applications, housing resources, and crisis interventions. Maintain active and professional communication with members and care partners through HHN-approved channels, including RingCentral, secure messaging, SMS workflows, and phone. Participate in HHN's continuous quality improvement efforts, identifying workflow gaps, documenting barriers, sharing insights, and contributing to best-practice development. Uphold confidentiality and adhere to all HIPAA and payer regulatory requirements across all areas of care delivery. Open to seeing patients in their home or their location of preference. Provide real-time interpretation and translation support (verbal and written) for members and families with limited English proficiency. Help bridge cultural gaps that may impact communication, trust, adherence, or engagement. Skills Required Fluency in English and another language (Spanish preferred); ability to read, write, and speak at a professional level. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Bilingual Communication (interpretation + translation) Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field preferred; equivalent experience considered. Licensure: Not required; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $36k-47k yearly est. 4d ago
  • Case Manager Social Worker

    Virginpulse 4.1company rating

    Remote job

    Overview Ready to Transform Lives Through Comprehensive Care Coordination and Advocacy?We're seeking a compassionate social work professional who can telephonically manage cases while addressing the full spectrum of patient needs-physical, psychosocial, emotional, spiritual, environmental, and financial. As our Case Manager, you'll develop treatment plans for standard and catastrophic cases while advocating for patients, facilitating quality care delivery, and implementing cost management strategies that achieve optimal outcomes.Responsibilities What makes this role different✓ Holistic assessment: Conduct thorough evaluations addressing physical, psychosocial, emotional, spiritual, environmental, and financial needs✓ Complex case management: Develop treatment plans for both standard and catastrophic cases in collaboration with patients, caregivers, and multidisciplinary teams✓ Cost management expertise: Negotiate and implement strategies that affect quality outcomes while documenting cost avoidance and intervention effectiveness✓ Advocacy focus: Champion patient needs by facilitating quality care delivery and providing emotional support and guidance throughout care continuum What You'll Actually Do Manage comprehensive cases: Telephonically coordinate cases on long- or short-term basis per established guidelines, policies, and healthcare industry standards.Conduct holistic assessments: Complete thorough patient evaluations including physical, psychosocial, emotional, spiritual, environmental, and financial needs assessment.Develop treatment plans: Create collaborative treatment plans for standard and catastrophic cases with patients, caregivers, family, community resources, and multidisciplinary healthcare providers.Monitor and evaluate outcomes: Track interventions and evaluate treatment plan effectiveness promptly while reporting measurable outcomes that record intervention success.Maintain care coordination: Initiate and sustain contact with patient/family, providers, employers, and multidisciplinary teams throughout continuum of care.Advocate for patients: Facilitate delivery of quality patient care while assisting in reducing overall costs and providing emotional support and guidance to patients and families.Implement cost strategies: Negotiate and execute cost management strategies to affect quality outcomes, reflecting data in monthly case management reviews and cost avoidance reports.Build strategic relationships: Establish and maintain working relationships with healthcare providers, clients/groups, and patients to provide comprehensive support.Maintain comprehensive documentation: Record detailed case information in Eldorado and UM Web, maintain confidential site-specific files, and prepare reports at 30-day intervals per HIPAA requirements.Qualifications What You Bring to Our Mission The social work foundation: Graduation from accredited college with degree in Social Work required License in Social Work preferred Must apply for certification in case management after one year at Personify Health Minimum 2 years acute healthcare experience including 2 years case management experience, or equivalent combination of education and experience The technical competencies: Basic computer literacy with ability to work on multiple screens and proficient typing skills Proficiency in Microsoft Word, Microsoft Excel, and Outlook Knowledge of medical claims and ICD-10, CPT, HCPCS coding Ability to work independently and utilize written resources to problem-solve The professional competencies: Excellent verbal and written communication skills for upward and downward conversations Ability to speak clearly and convey complex or technical information in understandable manner Capability to understand and interpret complex information from others Ability to meet productivity, quality, and turnaround time requirements daily, weekly, and monthly Evidence of innovative thinking with ability to assist with department operations and implementations The compliance standards: Ability to pass external audits including URAC and NCQA Maintain HIPAA compliance per company policies and procedures Maintain confidentiality and minimum requirement rules Complete all required yearly training per company's expected timeframe Additional training, certification, or degree outside of company preferred No candidate will meet every single desired qualification. If your experience looks a little different from what we've identified and you think you can bring value to the role, we'd love to learn more about you! Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $23-$29. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits. We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing. #WeAreHiring #PersonifyHealth #TPA #HPA #Selffunded Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to **************************. All of our legitimate openings can be found on the Personify Health Career Site. Application Deadline: Open until position is filled.
    $23-29 hourly Auto-Apply 2d ago
  • Technical Implementation Partner - AI Operational Assistants (Patient Care Coordination)

    Qventus 4.1company rating

    Remote job

    On this journey for over 12 years, Qventus is leading the transformation of healthcare. We enable hospitals to focus on what matters most: patient care. Our innovative solutions harness the power of machine learning, generative AI, and behavioral science to deliver exceptional outcomes and empower care teams to anticipate and resolve issues before they arise. Our success in rapid scale across the globe is backed by some of the world's leading investors. At Qventus, you will have the opportunity to work with an exceptional, mission-driven team across the globe, and the ability to directly impact the lives of patients. We're inspired to work with healthcare leaders on our founding vision and unlock world-class medicine through world-class operations. #LI-JB1 About the Role We're looking for an experienced Technical Implementation Partner - Patient Care Coordination to join our Delivery team. In this role, you will leverage your expertise in end-to-end delivery of technical features and functions to ensure successful and timely enterprise-scale software deployments. You'll work cross-functionally with key leaders and users in the hospital including the OR, PAT teams, nurses, and IT Teams to shape solutions that deliver measurable value. This is a high-impact role that will influence our Patient Care Coordination solution, strengthen customer outcomes, and shape our company's growth trajectory. Key Responsibilities Define and manage the timeline for enterprise-wide, multi-module deployments, with an initial focus on the Qventus Patient Care Coordination solution. Work with Data Integration Specialists, Clinical Operation Consultants, and Product Specialists throughout each deployment to identify and implement solutions that deliver client value. Collaborate with external client teams to understand evolving requirements/needs and communicate potential approaches to address them. Leverage deep functional PAT and Periop expertise to create and sustain buy-in from core users, executives, and surgeons around workflows and tool adoption Provide technical project leadership to manage the full deployment lifecycle from internal project kickoff to go-live by prioritizing tasks, identifying dependencies, and ensuring deliverables are met. Build and manage relationships at multiple levels of client organizations, from frontline staff to C-suite stakeholders. Identify and mitigate risks and advise Delivery team leaders on project opportunities and risks, driving any issues to resolution. Identify process improvement opportunities and create structured approaches to close gaps. Serve as the owner and accountable team member for assigned accounts/customers with limited oversight. Effectively lead complex engagements with matrixed teams (technical and operational). Articulate Qventus' value proposition and create value for customers by establishing clearly defined business outcomes. Leverages deep functional expertise in order to sustain buy-in from core users and executives around workflows and tool adoption. Creates a customer base who is excited about Qventus and serves as a reference for prospective customers. A passion for fixing our healthcare system. What We're Looking For 5+ years of experience in project/program management experience with a comprehensive understanding of the business requirements and technical capabilities needed for an enterprise-wide SaaS implementation. 5+ years professional experience working at a top healthcare consulting firm, digital health company, or health system.5+ years working cross-functionally with multiple teams, both internally & externally, to manage end-to-end project lifecycles and to drive project milestones to completion. Proven track record in applying strong quantitative and analytical skills in prior hospital systems (eg. EHR implementations) and project management with complex implementations in the provider-side health setting Deep domain knowledge in PAT perioperative metrics, processes, challenges, and solutions;ability to engage in strategic/operational discussions with hospital leaders and surgeons Strong communicator with the ability to influence and collaborate across all levels Hands-on experience and proficiency with tools such as data validation dashboards, interpreting JAVA/SQL code, complex Excel functions, etc. A systems thinker who balances big-picture vision with attention to detail Passion for real-world impact and solving meaningful problems Ability to travel up to 25%-50% Bonus Points For Experience with writing SQL queries (highly desired) Experience with Epic/Cerner EHR instances Experience working with clinical and/or process consultants PMP Certification Compensation for this role is based on market data and takes into account a variety of factors, including location, skills, qualifications, and prior relevant experience. Salary is just one part of the total rewards package at Qventus. We also offer a range of benefits and perks, including Open Paid Time Off, paid parental leave, professional development, wellness and technology stipends, a generous employee referral bonus, and employee stock option awards. Salary Range$120,000-$150,000 USD Qventus values diversity in its workforce and proudly upholds the principles of Equal Opportunity Employment . We welcome all qualified applicants and ensure fair consideration for employment without discrimination based on any legally protected characteristics, including, but not limited to: veteran status, uniformed service member status, race, color, religion, sex, sexual orientation, gender identity, age, pregnancy (including childbirth, lactation and related medical conditions), national origin or ancestry, citizenship or immigration status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law (collectively, "protected characteristics"). Our commitment to equal opportunity employment applies to all persons involved in our operations and prohibits unlawful discrimination by any employee, including supervisors and co-workers. Qventus participates in the E-Verify program as required by law and is committed to providing reasonable accommodations to individuals with disabilities in compliance with Americans with Disabilities Act (ADA). In compliance with the California Consumer Privacy Act (CCPA), Qventus provides transparency into how applicant data is processed during the application process. Candidate information will be treated in accordance with our candidate privacy notice. *Benefits and perks are subject to plan documents and may change at the company's discretion. *Employment is contingent upon the satisfactory completion of our pre-employment background investigation and drug test.
    $26k-41k yearly est. Auto-Apply 2d ago
  • Remote Call Center Representative - Part 4

    Insight Global

    Remote job

    We are building the future of healthcare. Through our digital health platform, we empower our partners to deliver world-class patient experiences. With nearly five million prescriptions shipped, we've been included on Forbes '"Next Billion-Dollar Startup" list and are proud to work with many of the world's largest healthcare organizations. We never settle for how it's done today. We invent how it will be done tomorrow. None of this is possible without the right team driving us forward. We are committed to creating an environment focused on racial and gender equality, inclusion, empowerment and respect. We believe that when our teams feel supported and inspired, they turn that creativity into innovation. The type of innovation that benefits all of our people, our partners and our patients. We encourage our team members to expand their horizons and bring their passion and curiosity to work, every day. Come join us. Let's build something great together. Post Discharge: This program makes phone outreaches to Medicare members who are discharged from the Emergency Department/Emergency Room (ED/ER). The Care Team will make outreaches to these members and offer a no-cost telephonic consultation with a Call Center Representative. Concerns that may be addressed may include, but are not limited to, issues surrounding the member's understanding of diagnoses, providing resources for hot meals, transportation, and local urgent care or Telehealth options, and making other recommendations for resources that may benefit their care, and discuss other follow-up needs. Responsibilities: * Primary work will come from outbound calls and some inbound calls from people calling back (high volume, fast-paced environment) * You will perform typical front office and back-office responsibilities, including patient education, medication requests, handling patient questions, and supporting provider needs * Assist with patient support such as answering patient emails, patient phone calls, processing medical records, provide patient care coordination * Work collaboratively with team members and our provider network to maintain an excellent model focused on patient care and high-quality service * Become an expert with our software solutions, including but not limited to, Zendesk, Truepill EMR, and Five9. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements * 2+ years of call center experience, needs to include high volume call center experience * 6+ months remote call center experience * Needs to be tech savvy: experience working with technology, computers, electronic medical records, etc. * High School Diploma or GED equivalent * A great communicator - both written and verbal * Must have strong internet connection because this is a remote role * Outbound call center experience * Knowledge of the healthcare / medical field * Experience working at a startup (fast paced, changing environment) * Experience with any customer service software (such as Zendesk, Freshdesk, TalkDesk, Salesforce, etc.) * Bachelor's Degree
    $32k-42k yearly est. 14d ago
  • Program Presenter-On-Call

    MSU Careers Details 3.8company rating

    Remote job

    Michigan State University actively promotes a dynamic research and learning environment in which qualified individuals of differing perspectives and cultural backgrounds pursue academic goals with mutual respect and shared inquiry. The MSU School of Social Work, within the College of Social Science, is dedicated to educating students for ethical, competent, responsive, and innovative social practice, and to conducting and disseminating high quality research that improves the well-being of the most vulnerable in society. Our teaching, research, and outreach synergistically promote social justice, positive change, and solutions to the problems facing broad cross section individuals, families, groups, organizations, and communities. More than 600 students are enrolled in our CSWE- accredited BASW and MSW programs, and our PhD program. The Health and Aging Certificate program prepares MSW students to serve aging and medically vulnerable populations. This specialization emphasizes interdisciplinary care, policy and systems engagement, and chronic illness and end-of-life issues. Students may be placed that include aging services, integrated health care, hospice, long-term care, and community-based health initiatives. Field Liaisons play a key role in helping students translate this specialized knowledge into practice through targeted integrative field seminars, individual support, and structured communication with agency field instructors. This is a project paid position. Primary Functions of this role include: - Conduct agency visits in health or aging-related settings - Facilitate student learning through required field seminars with a focus on aging and health care systems - Maintain regular contact with students and agency instructors to support learning and identify concerns - Guide students in setting and evaluating goals within the Health and Aging Certificate competencies - Collaborate with field instructors to align placement activities with academic and certificate objectives - Complete field documentation and assessments by required deadlines Equal Employment Opportunity Statement All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, age, disability or protected veteran status. Required Degree Masters -Social Work Minimum Requirements - LMSW with a minimum of 3 years post-MSW clinical or macro experience in health or aging-related services by the date of employment - Strong knowledge of aging populations, chronic illness, care coordination, or gerontological frameworks - Experience in mental health, behavioral health, or integrative care settings - Experience facilitating small groups - Excellent professional verbal and written communication skills Desired Qualifications - Previous experience as a field instructor, liaison, or clinical/community supervisor - Expertise in aging-related policy, interdisciplinary care, or trauma-informed care - Experience in interprofessional collaboration within health and aging systems - Familiarity with adult learning principles and supervision practices Required Application Materials Interested candidates should send: Cover Letter Current resume or Curriculum Vitae Special Instructions Review of applications will begin on 10/24/2025 and will be filled on an as-needed basis. Work Hours This is an on-call project pay position. Review of Applications Begins On 10/24/2025 Remote Work Statement MSU strives to provide a flexible work environment and this position has been designated as remote-friendly. Remote-friendly means some or all of the duties can be performed remotely as mutually agreed upon. Website www.socialwork.msu.edu MSU Statement Michigan State University has been advancing the common good with uncommon will for more than 160 years. One of the top research universities in the world, MSU pushes the boundaries of discovery and forges enduring partnerships to solve the most pressing global challenges while providing life-changing opportunities to a diverse and inclusive academic community through more than 200 programs of study in 17 degree-granting colleges.
    $37k-48k yearly est. 60d ago
  • Director, HEDIS Business Operations

    Clover Health

    Remote job

    At Clover Health, we are dedicated to improving the lives of seniors through high-quality, data-driven physician enablement technology. Initially scaled within our own Medicare Advantage provider network, we have built an innovative technology platform, designed to put actionable clinical insights into the hands of physicians at the point of care. In 2024, Clover's PPO plan achieved an industry leading 4.94 stars in HEDIS, with significant impact driven by its innovative technology - Counterpart Assistant. Read more about how CA drove this improvement in our case study here. As the Director of HEDIS Business Operations, you will serve as the connector across Clover's clinical, analytic, and operational teams to deliver measurable HEDIS impact. You will design and manage the programs, ranging from incentives to member engagement, that directly drive numerator closure, while partnering with HEDIS Operations to ensure seamless alignment from program design through abstraction, audit, and submission. Ultimately, you will design programs to ensure members of Clover's Medicare Advantage plan are always provided with the industry's leading clinical quality. As a Director, HEDIS Business Operations you will: Lead the business strategy and execution for HEDIS outcomes, focusing on programs that ultimately yield success in closing care gaps for members across the various interaction channels available - ranging from provider incentive programs, call center outreach, mailing lab testing kits, to chart chase and abstraction. Establish and manage incentive structures and provider engagement models that directly drive numerator closure. Develop and oversee cross-functional initiatives that translate measure logic into actionable programs across the organization. Partner with HEDIS Operations to ensure business programs align with abstraction and submission workflows, creating a seamless end-to-end process. Own scenario-planning for HEDIS measure cutpoints and Stars implications, guiding the organization toward the interventions that will drive results. Anticipate and prepare for measure evolution (hybrid to admin, admin to digital, display to official), ensuring Clover is strategically positioned for future changes and always ahead of the industry changes. Track and communicate performance outcomes, highlighting risks, opportunities, and ROI of interventions to senior leadership. Success in this role looks like: Building high-functioning programs across provider, call center, and care coordination teams that directly contribute to numerator closure and improved Stars ratings. Clear ownership of business levers tied to HEDIS outcomes, complementing the abstraction and audit work of the HEDIS Operations teams. Proactive adaptation of programs to reflect evolving NCQA, CMS, and industry changes. Strong alignment between Stars strategy and HEDIS programs, ensuring organizational resources are focused on the highest-impact measures. You should get in touch if: You have 7+ years of experience in healthcare program management and strategy. You have led cross-functional programs that align multiple stakeholders toward a common outcome. You are highly analytical, able to interpret performance data and translate it into effective interventions. You understand the HEDIS and Stars landscape and are motivated by the business and programmatic levers that deliver results. You thrive in a dynamic, high-stakes environment where success is measured in outcomes, not activity. Benefits Overview: Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions. Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare. Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location. Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews. Additional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities Reimbursement for office setup expenses Monthly cell phone & internet stipend Remote-first culture, enabling collaboration with global teams Paid parental leave for all new parents And much more! About Counterpart Health: In 2018, Clover Health set out to do something unprecedented: build a clinically intuitive, AI-enabled solution that fits within physicians' workflows to help support the earlier diagnosis and management of chronic conditions. Years later, that vision is a reality, with thousands of practitioners using Counterpart Assistant during patient visits to improve disease management, reduce medical expenses, and drive success in value-based care. With an exceptional team of value-based care and technology experts, Counterpart Health is driving value-based care at the speed of software. Counterpart Health is a subsidiary of Clover Health. From Clover's inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one's identity. All of our employee's points of view are key to our success, and inclusion is everyone's responsibility. #LI-Remote Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company. A reasonable estimate of the base salary range for this role is $176,000 to $200,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant's education, work experience, certifications, etc.
    $176k-200k yearly Auto-Apply 8d ago
  • Legal Counsel

    Synapticure, Inc.

    Remote job

    About Synapticure As a patient and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers, payers, ACOs, health systems, and life sciences organizations-including through CMS' new GUIDE dementia care model-Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases such as Alzheimer's, Parkinson's, and ALS. The Role Synapticure is seeking an experienced and highly capable Legal Counsel to serve as the company's in‑house attorney. In this critical role, you will function as a strategic business partner and trusted advisor to executive and clinical leadership-building and leading a right‑sized compliance program, managing legal risk, and ensuring regulatory alignment across our fast‑growing organization. The ideal candidate brings deep healthcare regulatory expertise, sound business judgment, and the ability to translate complex legal advice into actionable, practical guidance. You will oversee healthcare compliance, contracting, and general legal operations across the enterprise, supporting both the clinical delivery organization and the corporate entity. This is an exciting opportunity to shape the legal and compliance function at a mission‑driven, high‑growth healthcare company that is redefining access to specialized neurological care. Job Duties - What you'll be doing Healthcare Regulatory & Compliance Design, implement, and oversee a scalable healthcare compliance program, including policies, training, and internal monitoring frameworks Provide guidance on federal and state healthcare laws and regulations, including HIPAA, fraud and abuse (Stark and Anti‑Kickback Statute), corporate practice of medicine, and multi‑state telehealth requirements Advise on MSO/PC structures, payer contracting compliance, and corporate practice of medicine guardrails Provide counsel on complex billing, coding, and reimbursement issues, including Medicare and Medicaid participation Anticipate and communicate regulatory trends, advising leadership on both risk and strategic opportunity Oversee internal investigations, audits, and privacy/security initiatives in partnership with technology and clinical operations teams Contracting & Transactions Draft, review, and negotiate a wide range of contracts, including payer, health system, vendor, and technology agreements Support clinical and life sciences partnership agreements while maintaining appropriate corporate and compliance boundaries Develop and maintain contract templates, playbooks, and workflows to streamline review and approvals across the organization Corporate & Operational Legal Support Provide day‑to‑day legal counsel on corporate governance, employment, risk management, and marketing matters Collaborate with business and clinical leaders to translate legal and compliance advice into practical, operational solutions Serve as the primary point of contact for outside counsel, ensuring effective resource use and alignment with company strategy Educate and train internal teams on contracting best practices and healthcare regulatory requirements Support strategic initiatives, corporate development, and special projects as Synapticure continues to scale Requirements - What we look for in you Juris Doctor (J.D.) from an accredited law school and active licensure in at least one U.S. jurisdiction 5-10+ years of legal experience, ideally a blend of law firm and in‑house counsel roles within healthcare or health technology Demonstrated expertise in healthcare regulatory areas including HIPAA, fraud and abuse, corporate practice of medicine, telehealth, payer contracting, and MSO/PC structures Experience designing, managing, or scaling healthcare compliance programs tailored to growth‑stage or technology‑enabled healthcare companies Ability to assess and communicate risk clearly, balancing regulatory compliance with business objectives Strong interpersonal and communication skills, capable of translating complex legal issues into clear, actionable advice for diverse audiences Proven record of working cross‑functionally and collaborating with leadership, operations, and clinical teams Preferred Qualifications Experience in a telehealth or tech‑enabled healthcare environment Familiarity with value‑based care models and payer/provider partnerships Exposure to life sciences collaborations and related regulatory considerations Understanding of data privacy frameworks beyond HIPAA (e.g., CCPA, GDPR) Experience supporting corporate transactions, including fundraising or M&A activities Values Relentless focus on patients and caregivers. We are determined to provide an exceptional experience for every patient we serve, and we put our patients first in everything we do. Embody the spirit and humanity of those living with neurodegenerative disease. Inspired by our founders, families, and personal experiences, we recognize the seriousness of our patients' circumstances and meet that challenge with empathy, compassion, kindness, joy, and hope. Seek to understand, and stay curious. We listen first-to one another, our patients, and their caregivers-communicating authentically while recognizing there's always more to learn. Embrace the opportunity. We act with urgency and optimism, driven by the importance of our mission. Travel Expectations This is a fully remote position. Occasional travel to Synapticure's headquarters in Chicago, IL, or regional clinical team gatherings may be required. Salary & Benefits Competitive compensation based on experience Comprehensive medical, dental, and vision coverage 401(k) plan with employer matching Flexible scheduling and remote‑first work environment Life and disability insurance coverage Generous paid time off and sick leave Opportunities for professional development and advancement within a fast‑growing healthcare organization #J-18808-Ljbffr
    $96k-161k yearly est. 4d ago
  • SR Data Integrity Analyst, Revenue Cycle

    Ohiohealth 4.3company rating

    Remote job

    We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position supports the System-wide Enterprise Master Patient Index (EMPI), chart corrections, duplicate merges, overlays, and other Data Integrity Analyst functions for all OhioHealth entities on Epic (Care Connect). In addition, this position may support all EMPI functions related to Community Connect entities. These tasks require effective critical thinking skills to analyze regulatory requirements, state and federal laws, including Joint Commission, the 21st Century Cures Act and HIPAA. The Senior Data Integrity Analyst must apply this knowledge when evaluating and working multiple inbaskets and interface error queues requiring deductive reasoning for the purpose of ensuring accurate documentation in the patient's EHR. This role requires excellent written and verbal communication skills. The position also requires working independently with little to no supervision. Data abstraction and computer skills are essential to this role along with excellent customer service skills. Excellent organizational skills with attention to detail are necessary to perform this role successfully. This position is responsible for training, process and workflow assessment, recommendations for improvement, implementing changes to workflows, reporting, GEMBA board, tracking and analyzing statistics, leading huddles and assisting with team engagement. May also assist with more duties and responsibilities requiring advanced critical thinking and analysis skills. The position must work independently with little to no supervision. This associate must also be able to perform other duties as assigned by HIM Leadership. Responsibilities And Duties: 40% Assists with various functions in Data Integrity/EMPI to include, but not limited to duplicate merges, chart corrections and overlays as assigned. • Troubleshoots data integrity issues by ensuring each patient has one medical record number, including performing necessary changes in all Ohio Health systems as needed. • Monitors overlay reports and potential duplicate patient work queues, researches and performs maintenance required to validate patient identity utilizing established department guidelines / processes in addition to personal discretion and judgement. • Monitors assigned chart correction cases (document corrections, amendment requests, etc) or tasks on a routine basis and follows up with all members assigned within the case to ensure timely resolution. • Utilize internal and external resources as needed to aid in the necessary research to resolve duplicates, overlays, and other chart correction issues. Utilize various applications and validate documents such as clinical and registration notes, physician orders, prescriptions, medications, and other data fields/resources. • Search for and analyze demographic and clinical data applying critical thinking skills to discern correct patient information in accordance with established processes and procedures. • Manage multiple critical tasks and assignments simultaneously with speed and accuracy in a fast paced and evolving environment. 40% • Uses logic and reasoning to identify corrective measures, process improvements, approaches to solving problems, and alternate solutions, as necessary. • Notify all downstream systems/departments and/or support staff external to department of data integrity or medical record number (MRN) changes in a timely fashion to keep systems synchronized. • Reviews and processes inbound messages or tasks into the Ohio Health electronic medical record for patient care coordination, privacy/security, and integrity of the patient's protected health information. • Responds to questions from external facilities/practices regarding the operation and support of our health information exchange (HIE) and completes processes and tasks related to the HIE. • Manage multiple critical tasks and assignments simultaneously with speed and accuracy while under pressure. • Leads cross training and new hire onboarding • Prepare documentation and guidelines as assigned. • Generates reports and analyzes data for distribution to other areas or for the team as assigned. • Participates with task forces, project teams or committees as assigned. • Leads department huddles and GEMBA board preparation and presentation. • Maintains positive behavior and adapts to a changing environment. 10% • Understand and present complex information and respond to questions about patient chart/data integrity issues from all departments across the organization • Work both independently and collaboratively with others in a professional manner within and externally to the department with minimal supervision / guidance. • Assumes responsibility for professional growth and development by completing training/recertification designed to maintain and increase job knowledge. 10% • May be required to provide afterhours/on-call support for urgent requests and coverage. • Attends meetings as required. •Other duties and projects as assigned Minimum Qualifications: Associate's Degree, Bachelor's DegreeRHIA - Registered Health Information Administrator - American Health Information Management Association, RHIT - Registered Health Information Technician - American Health Information Management Association Additional Job Description: Data Integrity/EMPI Data Experience of 2 years or greater. Work Shift: Day Scheduled Weekly Hours : 40 Department Corporate HIM Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment Remote Work Disclaimer: Positions marked as remote are only eligible for work from Ohio.
    $42k-54k yearly est. Auto-Apply 1d ago
  • Director, Womens Services

    Cottonwood Springs

    Remote job

    Director of Nursing - Women's Services Full-Time | Raleigh General Hospital | Beckley, WV The Director of Nursing - Women's Services provides strategic and operational leadership for all aspects of the Women's and Children's Department. This role directs departmental activities, manages resources, and ensures the highest quality of patient-centered care for women, infants, and pediatric populations. The Director is responsible for aligning departmental goals with organizational objectives, driving continuous improvement, and fostering a culture of excellence and professional growth. Essential Functions To perform this role successfully, an individual must be able to carry out each essential function satisfactorily, with or without reasonable accommodation: Strategic Leadership: Develop and implement departmental goals, plans, and standards that meet the clinical, administrative, legal, and ethical requirements of the organization. Operational Oversight: Direct and evaluate Women's & Children's Services, including labor & delivery, postpartum, nursery, NICU, and pediatric care. Ensure optimal patient outcomes, satisfaction, and quality performance. Staffing & Development: Oversee hiring, orientation, evaluations, corrective actions, and continuing education. Cultivate a supportive environment that encourages professional growth and staff engagement. Financial Management: Prepare, monitor, and evaluate departmental budgets, ensuring compliance with allocated funding. Lead and support internal and external audits. Quality & Safety: Integrate evidence-based nursing practices into protocols and ensure compliance with healthcare regulations (HIPAA, Joint Commission, and other accrediting bodies). Collaboration: Partner with physicians, advanced practice providers, and hospital leadership to enhance care coordination, patient experience, and service delivery. Other Duties: Maintain regular and reliable attendance and perform additional responsibilities as assigned. Supervisory Responsibilities Manage nursing leadership and staff within Women's & Children's Services. Plan, assign, and review work while ensuring adherence to quality standards. Lead recruitment, retention, training, performance reviews, and corrective actions. Knowledge, Skills & Abilities Education & Licensure: Registered Nurse (RN) license in West Virginia required. Bachelor's degree in nursing or healthcare administration preferred (equivalent experience considered). Certifications: BLS, PALS, and NRP required. Advanced certifications in obstetrics, pediatrics, or neonatal care strongly preferred. Core Competencies: Strong leadership skills in maternal-child health nursing. Ability to manage complex clinical and operational situations with sound judgment. Skilled in communication, motivation, and conflict resolution. Proficient in technology (EHR, data systems, spreadsheets, presentations). Expertise in budgeting, staffing models, and regulatory compliance. Physical & Mental Demands Ability to sit or stand for extended periods with occasional lifting of up to 20 lbs. Frequent use of computer systems. Visual acuity required for patient care and documentation. Work Environment & Travel Primarily hospital-based within Women's & Children's Services units. Potential exposure to bloodborne pathogens, contagious illnesses, and biohazardous materials requiring safety precautions. Minimal overnight travel (up to 10%). Why Join Us At Raleigh General Hospital, people are our passion and purpose. As a leader in Women's and Children's Services, you will directly impact the care of mothers, infants, and children while guiding a team of skilled professionals dedicated to excellence. We offer: Comprehensive Health, Dental, and Vision Insurance 401(k) with employer contributions Generous Paid Time Off and Extended Illness Bank Tuition & Educational Assistance for ongoing professional development Employee Assistance Programs supporting mental, physical, and financial wellness And more… Equal Opportunity Employer Raleigh General Hospital is proud to be an Equal Opportunity and Affirmative Action Employer. We value diversity and inclusion and welcome applicants of all backgrounds.
    $26k-44k yearly est. Auto-Apply 60d+ ago
  • I/DD Care Manager, QP (Gaston/Cleveland/Rutherford NC)-Mobile

    Partners Behavioral Health Management 4.3company rating

    Remote job

    which will work primarily out in the assigned communities.** Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Location: Available for Gaston, Cleveland, Rutherford NC locations; Mobile/Remote position Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Intellectual and Developmental Disabilities (I/DD) Care Manager is responsible for providing Tailored Care Management and/or care coordination to members/recipients with I/DD to help secure and coordinate a variety of physical health, developmental disability, behavioral health and long-term services and support (LTSS) services. The I/DD Care Manager actively engages with members/ recipients through comprehensive assessment, care planning, health promotion, and comprehensive transitional care. Tailored Care Management is comprehensive and longitudinal for members with Medicaid coverage. Recipients with no Medicaid receive Tailored Care Management based on specified triggers and for a duration not to exceed ninety (90) days. Travel is an essential function of this position. Role and Responsibilities: Duties of the I/DD Care Manager include, but are not limited to, the following: Comprehensive Care Management Provide assessment and care management services aimed at the integration of primary, behavioral and specialty health care and community support services, using a comprehensive person-centered care plan which addresses all clinical and non-clinical needs and promotes wellness and management of chronic conditions in pursuit of optimal health outcomes Complete a care management comprehensive assessment within required timelines and update as needed Develop a comprehensive Individual Support Plan and update as needed Provide diversion activities to support community tenure Care Coordination Facilitate access to and the monitoring of services identified in the Individual Support Plan to manage chronic conditions for optimal health outcomes and to promote wellness. Facilitate communication and regularly scheduled interdisciplinary team meetings to review care plans and assess progress. Monitors services for compliance with state standards and Medicaid regulations, including home and community-based standards for 1915i services Verify that services are delivered as outlined in ISP and addresses any deviations in services Individual and Family Supports Provide education and guidance on self-management and self-advocacy Provide information about rights, protections, and responsibilities, including the right to change providers, the grievance and complaint resolution process, and fair hearing processes Educate members and recipients about the Registry of Unmet Needs, with referral as indicated Utilize person centered planning methods/strategies to gather information and to get to know the members supported Ensure that members/legally responsible persons are informed of services available, service options available, processes (e.g. requirements for specific service), etc. Promote prevention and health through education on the member's chronic conditions and/or disabilities for the member, family members, and their caregivers/support members Promote culturally competent services and supports. Health Promotion Educate and engage the member/recipient and caregivers in making decisions that promote his/her maximum independent living skills, good health, pro-active management of chronic conditions, early identification of risk factors, and appropriate screening for emerging health problems Closely coordinate care with the member's I/DD, behavioral health, and physical health providers, including in person visits to Emergency Departments and Skilled Nursing Facilities Support medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment Transitional Care Management Proactive and intentional care management when the member/recipient is experiencing care transitions (including, but not limited to transitions related to hospitalization, nursing facility, rehabilitation facility, community-based group home, etc.), significant life changes including, but not limited to loss of primary caregiver, transition from school services, etc.) or when a member/recipient is transitioning between health plans. Create and implement a 90-day transition plan as an amendment to the ISP that outlines how services will be maintained or accessed and includes a process to transition to the new care setting and integrate into his or her community. Referral to Community/Social Supports Provide information and assistance in referring members/recipients to community-based resources and social support services, regardless of funding source, which can meet identified needs Provide comprehensive assistance securing health-related services, including assistance with initial application and renewal with filling out and submitting applications and gathering and submitting required documentation, including in-person assistance when it is the most efficient and effective approach. Time-Limited Care Coordination for Member Excluded from Receiving Tailored Care Management Assist member who are receiving care management from other entities (e.g., CCNC, CAP/C, CAP/DA) with referral/linkage to I/DD services available through the Tailored Plan or Medicaid Direct contract Provide transitional care management Participate in weekly conference with CCNC, as needed, to share information on high-risk members, including members with a behavioral health transitional care need and members with special health care needs, who are receiving care coordination and care management from both entities or require referrals Coordinate with each member's care manager to the extent the member is engaged in care management through another entity (e.g. PCCM Vendor, Skilled Nursing Facility, CAP/C or CAP/DA, etc.) Share the results of the any assessments completed, the member's person-centered plan, and the member's Care Plan (to the extent one exists) with entity providing care management Notify the member's care manager that the member is undergoing a transition and engage the member's assigned care manager to assist with transitioning the member into the community, including in the development of the ninety (90) day post-discharge transition plan to the extent there are items within the care manager's scope. With the assistance of the care management entity, encouraging, supporting, and facilitating communication between primary care providers and the Partners network providers regarding medication management, shared roles in care transitions and ongoing care, the exchange of clinically relevant information, annual exams, coordination of services, case consultation, and problem-solving as well as identification of a medical home for persons determined to have need. Other: Assist state-funded recipients apply for Medicaid Coordinate Medicaid deductibles, as applicable, with the member/legally responsible person and provider(s) Proactively monitor documentation/billing to ensure that issues/errors are resolved as quickly as possible Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency and Medicaid requirements Maintain medical record compliance/quality, as demonstrated by ≥90% compliance on Qualitative Record Reviews Recognizes and reports critical incidents Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues Collaborates with providers to ensure accurate/timely submission of authorization requests for all Tailor Plan-funded services/supports Document within the grievance system any expression of dissatisfaction/concern expressed by member/recipient supported or others on behalf of the member/recipient supported Ensure strong leadership to care team for each member/recipient, including effectively communicating with and providing direction to Care Management extenders Knowledge, Skills, and Abilities: Demonstrated knowledge of the assessment and treatment of I/DD needs, with or without co-occurring physical health, mental health or substance use disorder needs Ability to develop strong, person-centered plans Exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts and established processes Demonstrated ability to collaborate and communicate effectively in team environment Ability to maintain effective and professional relationships with member/recipients, family members and other members of the care team Problem solving, negotiation and conflict resolution skills Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) Detail oriented Ability to learn and understand legal, waiver and program practices/requirements and apply this knowledge in problem-solving and responding to questions/inquiries Ability to independently organize multiple tasks and priorities and to effectively complete duties within assigned timeframes Ability to manage and uphold integrity and confidentiality of sensitive data Sensitivity and knowledge of different cultures, ethnicities, spiritual beliefs and sexual orientation. Education/Experience Required: Bachelor's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area and two (2) years of full-time experience with I/DD population OR Bachelor's degree in a field other than human services and four (4) years of full-time experience with I/DD population OR Master's degree in human services and one (1) year of full-time experience with I/DD population OR Licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with I/DD AND Two (2) years of prior Long-Term Services and Supports (LTSS)and/or Home and Community Based Services (HCBS) coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working with I/DD population described above AND Must reside in North Carolina Must have ability to travel regularly as needed to perform job duties Education/Experience Preferred: Experience working with member/recipients with co-occurring physical health and/or behavioral health needs preferred. Licensure/Certification Requirements: If a Registered Nurse (RN), must be licensed in North Carolina.
    $69k-82k yearly est. Auto-Apply 60d+ ago
  • Provider Relations Specialist

    Synapticure Inc.

    Remote job

    About SynapticureAs a patient- and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers and health plans, including CMS' new GUIDE dementia care model, Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases like Alzheimer's, Parkinson's, and ALS. The RoleSynapticure is seeking a Provider Relations Manager to serve as a trusted relationship-builder and key account manager for our provider partners. This remote-first position focuses on nurturing long-term relationships with primary care and neurology practices, driving program adoption, and ensuring ongoing engagement and satisfaction. While the majority of your work will be conducted remotely, you'll travel approximately 30% of the time to meet with provider groups, attend key events, and support local engagement efforts. Some door-to-door practice outreach (10-20%) may be required to introduce Synapticure programs to new clinics and strengthen relationships in the field.This role is ideal for a relationship-driven professional with experience in healthcare account management, provider engagement, or field sales who thrives on connecting virtually and in-person to expand access to quality neurodegenerative care. Job Duties - What You'll Be Doing Build and manage strong relationships with provider partners, practice managers, and clinical leadership across assigned territories Serve as Synapticure's relationship owner, ensuring ongoing satisfaction and sustained adoption of programs Conduct virtual and in-person meetings to communicate Synapticure's mission, capabilities, and impact Identify provider needs and use a consultative approach to deliver tailored solutions that improve workflow and patient experience Track and report provider engagement activities, progress toward goals, and insights gathered from the field Coordinate with internal teams (Clinical Operations, Implementation, and Product) to resolve issues and improve program delivery Support new program rollouts through remote and in-person training sessions, onboarding, and troubleshooting Execute strategic outreach campaigns, including limited door-to-door provider engagement when introducing new markets or services Collaborate with leadership to develop growth plans and identify new opportunities for partnership Represent Synapticure at regional meetings and healthcare networking events as needed In person outreach to members Requirements - What We Look For In You 5+ years of experience in healthcare account management, provider relations, or field engagement Demonstrated success managing provider or client relationships remotely with periodic travel Excellent written and verbal communication skills; confident engaging both clinical and administrative audiences Highly organized, proactive, and adaptable to changing priorities Comfortable using CRM tools and virtual collaboration platforms (Zoom, Salesforce, etc.) Understanding of healthcare delivery models and practice operations preferred Familiarity with neurodegenerative care, behavioral health, or telehealth models is a plus Willingness to travel ~30% and perform in-person outreach (10-20%) We're founded by a patient and caregiver, and we're a remote-first company where empathy and excellence guide every interaction: Relentless focus on patients and caregivers. We are determined to deliver exceptional care and support to every individual we serve. Empathy and humanity. We meet every challenge with compassion, understanding, and hope. Curiosity and adaptability. We listen first, learn continuously, and evolve based on the needs of patients and partners. Optimism and action. We move with urgency and positivity to make meaningful change. Travel ExpectationsThis is a remote position with approximately 30% travel to provider sites, conferences, and community events. Most travel is regional and planned in advance, though limited door-to-door outreach may be required for new practice introductions.
    $39k-63k yearly est. Auto-Apply 60d+ ago
  • Nutrition Assistant - Full-Time (Remote - PST)

    Equip Health

    Remote job

    About Equip Equip is the leading virtual, evidence-based eating disorder treatment program on a mission to ensure that everyone with an eating disorder can access treatment that works. Created by clinical experts in the field and people with lived experience, Equip builds upon evidence-based treatments to empower individuals to reach lasting recovery. All Equip patients receive a dedicated care team, including a therapist, dietitian, physician, and peer and family mentor. The company operates in all 50 states and is partnered with most major health insurance plans. Learn more about our strong outcomes and treatment approach at ***************** Founded in 2019, Equip has been a fully virtual company since its inception and is proud of the highly-engaged, passionate, and diverse Equisters that have created Equip's culture. Recognized by Time as one of the most influential companies of 2023, along with awards from Linkedin and Lattice, we are grateful to Equipsters for building a sustainable treatment program that has served thousands of patients and families. Working Hours: Full-Time - Monday - Friday, 8 AM to 5 PM Pacific Time. About the Role The Nutrition Assistant is a member of the Care Delivery team who is responsible for ensuring that Equip patients and their families have adequate support to meet their nutritional goals. The Nutrition Assistant delivers complementary tools, resources, and live support that help patients implement the nutrition recommendations made by their Equip Registered Dietitians. The Nutrition Assistant also engages in administrative tasks that assist the Registered Dietitian in providing timely and accurate patient care. Responsibilities Meal Support: Provide direct meal supervision (group or 1:1), offer meal support via messaging, and support meal feedback in consultation with Registered Dietitians. Menu Building: Perform quality assurance on patient menus and process personalized menu updates. Meal Planning: Conduct one-on-one meal planning sessions. Cooking Support: Lead one-on-one cooking sessions and generate content for cooking videos. Administrative Support: Complete administrative tasks for Registered Dietitians, including growth chart review, supplement insurance letters, external care coordination, and message triaging/response. Meetings & Training: Participate in team meetings, supervision, and required training. Adhere to HIPAA rules and regulations. Perform other duties as assigned. Qualifications 2+ years of experience providing nutritional services (e.g. meal support or supervision) to patients in a clinical setting or actively pursuing a degree in Nutrition and Dietetics. Experience working in an eating disorder program or mental health preferred. Passion for evidence-based care and treatment as well as an ability to learn, practice, and continuously develop skills in Nutrition and Dietetics. Ability to maintain patient confidentiality. Ability to connect with a range of diverse patients with varying diagnoses and degrees of acuity. Attention to detail. Comfortable working with and learning new technologies. Comfortable working in a remote environment, including the requirement to be on camera. Comfortable with ambiguity and able to think critically to quickly and accurately work through challenges in a fast-paced, fluid environment. Compensation & Benefits Package Compensation: Hourly Range: $20 to $24/Per Hour Consists of Hourly Pay + 15% Annual Performance-Based Bonus Potential Time Off: Flex PTO policy (3-5 wks/year recommended) + 11 paid company holidays. Generous Parental Leave. Core Benefits: Competitive Medical, Dental, Vision, Life, and AD&D insurance. Equip pays for a significant percentage of benefits premiums for individuals and families. Maven, a company paid reproductive and family care benefits for all employees. Employee Assistance Program (EAP), a company-paid resource for mental health, legal services, financial support, and more! 401k Retirement Plan. Other Benefits Loan Repayment: $500/quarter for employees under a year of tenure. $1,000/quarter for employees over a year of tenure. Continuing Education: For therapists and medical providers, unlimited online courses through NetCE. Up to $1,000/year stipend for continuing education. Opportunities to attend team onsites and conferences at various locations throughout the US. Work From Home Additional Perks: $50/month stipend added directly to an employee's paycheck to cover home internet expenses. Initial work-from-home stipend of up to $500. Reload of $200 on the home office stipend at the 3-year mark and then every other year after that (year 5, year 7, etc.). Company Laptop. Physical Demands Work is performed 100% from home with no requirement to travel. This is a stationary position that requires the ability to operate standard office equipment and keyboards as well as to talk or hear by telephone. Sit or stand as needed. At Equip, Diversity, Equity, Inclusion and Belonging (DEIB) are woven into everything we do. At the heart of Equip's mission is a relentless dedication to making sure that everyone with an eating disorder has access to care that works regardless of race, gender, sexuality, ability, weight, socio-economic status, and any marginalized identity. We also strive toward our providers and corporate team reflecting that same dedication both in bringing in and retaining talented employees from all backgrounds and identities. We have an Equip DEIB council, Equip For All; also referred to as EFA. EFA at Equip aims to be a space driven by mutual respect, and thoughtful, effective communication strategy - enabling full participation of members who identify as marginalized or under-represented and allies, amplifying diverse voices, creating opportunities for advocacy and contributing to the advancement of diversity, equity, inclusion, and belonging at Equip. As an equal opportunity employer, we provide equal opportunity in all aspects of employment, including recruiting, hiring, compensation, training and promotion, termination, and any other terms and conditions of employment without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, gender expression, familial status, age, disability, weight, and/or any other legally protected classification protected by federal, state, or local law. Our dedication to equitable access, which is core to our mission, extends to how we build our "village." In line with our commitment to Diversity, Equity, Inclusion, and Belonging (DEIB), we are dedicated to an accessible hiring process where all candidates feel a true sense of belonging. If you require a reasonable accommodation to complete your application, interview, or perform the essential functions of a role, we invite you to reach out to our People team at accommodations@equip.health. #LI-Remote
    $20-24 hourly Auto-Apply 12d ago
  • Clinical Intern - Pharmacy

    Navitus 4.7company rating

    Remote job

    Company Navitus About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at ************************************ to be considered for internal opportunities. Pay Range USD $17.78 - USD $20.91 /Hr. STAR Bonus % (At Risk Maximum) 0.00 - Ineligible Work Schedule Description (e.g. M-F 8am to 5pm) M-Th between 8:30am to 7pm and F 8:30am-5pm Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview Navitus Health Solutions is seeking a Clinical Intern to join our team! The Clinical Intern will be a key contributor to the success of our Clinical Engagement Center focused on improving member's health and wellness via tele-pharmacy and wellness coaching. Under the supervision of a clinician, this individual is responsible for the delivery of the Medication Therapy Management (MTM) services for commercial and Medicare members. In addition, the Clinical Intern will assist in the development and execution of additional clinical outreach programs to exceed client expectations. The MTM program will include telephonic and/or video chat outreach with members to complete an analysis of a member's medication regimen for prescription, OTC, herbal and supplement medications. The assessment will include the development of a personalized Medication Action Plan in partnership with the member as required by CMS. Is this you? Find out more below! Responsibilities How do I make an impact on my team? Conduct medication therapy management (MTM) and expanded clinical programs in accordance with the Centers for Medicare & Medicaid Services (CMS). Develop appropriate clinical algorithms, pathways and call scripts to support pharmacy staff in delivering MTM services. Review and update all algorithms and call scripts with updated clinical guidelines. Develop documentation standards for clinical outreach. Collaborate with other CEC staff to develop and maintain a high quality and consistent MTM product. Assist CEC leadership to develop programs to support STAR ratings outreach. Provide clinical outreach to members, prescribers, and pharmacy providers in order to enhance care coordination. Develop a full understanding of Navitus' Clients' member experience and how the engagement center contributes to improved health and wellness. Adhere to compliance and HIPAA regulations. Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives. Other duties as assigned Qualifications What our team expects from you? Education: In DPH-2 or DPH-3 year. CPhT Preferred. Experience: Must be 18 years or older. Experience working in Microsoft Office suite, particularly Word, Excel, and PowerPoint preferred. The intern role is considered a learning opportunity and as such, no specific experience is required. Preference may be given to candidates with work experience or education paths determined desirable by the department each intern supports. Participate in, adhere to, and support compliance program objectives. The ability to consistently interact cooperatively and respectfully with other employees. Participate in, adhere to, and support compliance program objectives The ability to consistently interact cooperatively and respectfully with other employees What can you expect from Navitus? Top of the industry benefits for Health, Dental, and Vision insurance 20 days paid time off 4 weeks paid parental leave 9 paid holidays 401K company match of up to 5% - No vesting requirement Adoption Assistance Program Flexible Spending Account Educational Assistance Plan and Professional Membership assistance Referral Bonus Program - up to $750! #LI-Remote Location : Address Remote Location : Country US
    $17.8-20.9 hourly Auto-Apply 5d ago

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