Personify Health

The nurse will telephonically coordinate wellness and disease management for conditions like diabetes, asthma, and hypertension, comparing patient care against national guidelines. Key duties include developing individual care plans, assisting patients with provider access and referrals, and documenting all interventions.

Sales Executive at WellnessIQ promoting wellness programs

Sales Associate at Wellness IQ promoting wellness initiatives and services

The Case Manager Nurse RN provides telephonic case management, contacting patients to complete thorough assessments covering physical, psychosocial, emotional, spiritual, environmental, and financial needs. Responsibilities include developing collaborative treatment plans, monitoring interventions, negotiating cost management strategies, and performing Utilization Review for assigned members.

We’re looking for a bold, data-driven leader to transform how millions of members engage with our Wellbeing platform. You will define strategies that activate, retain, and guide members while directly influencing health outcomes and cost savings. This is a rare opportunity to s...

The Utilization Review Nurse will provide professional assessments and review for the medical necessity of treatment requests and plans, including first-level review for pre-certification and post-service reviews. Duties also involve working with hospital staff for discharge planning, processing appeals, and referring potential cases to various internal programs.

The Utilization Review Nurse will provide professional assessments and review for the medical necessity of treatment requests and plans, including first-level review for pre-certification and post-service reviews. Duties also involve working with hospital staff for discharge planning, processing appeals, and referring potential cases to various internal programs.

This specialist ensures regulatory and quality compliance across clinical operations by conducting independent evaluations, audits, and improvements of clinical systems and processes. A major component involves training clinical staff on regulatory requirements, quality standards, and department objectives using evidence-based materials.

The Utilization Review Nurse will provide professional assessments and review for the medical necessity of treatment requests and plans. The standard work schedule is Monday through Friday, 8:00 AM–5:00 PM Pacific Standard Time, with rotating weekend coverage as required. Provi...

The Care Management Operations Analyst serves as a subject matter expert and process leader, optimizing non-clinical workflows across CM, CDM, and UM programs while advancing standardization, system improvements, and operational performance. Analyze and support end-to-end non-cli...