Location: Fully Remote

Schedule: Flexible

Compensation: Up to $85 per hour

Job Type: Full-time, Part-time

About the Role

We’re looking for entrepreneurial, empathetic Registered Dietitians (RDs) and Certified Nutrition Specialists (CNSs) licensed in any state to help us bring medical nutrition therapy (MNT) to all. This role is a fully flexible 1099 role–work only when you’d like to.

Who We Are

Berry Street is tackling America’s most comprehensive health crisis: food. More than half of Americans are struggling with their relationship with food, are clinically overweight, or experience a chronic condition linked to their diet. Nutrition therapy is clinically proven to make a difference, and most commercial health insurance plans cover it at $0 out-of-pocket.

Berry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. We eliminate time-consuming admin so dietitians can focus on providing outstanding client care.

We believe everyone should have access to personalized nutrition therapy covered by insurance. Clinicians should be able to serve the communities they care about, not just those who can afford to pay out of pocket.

Dietitians working with Berry Street are committed to these pillars of high-quality care:

• Evidence-based: We provide quality care based on the latest clinical research. We actively track the quality of care to ensure better health outcomes and behavior change.
• Approachable: Through client education and nutrition therapy, we utilize a realistic, sustainable approach to create behavior change that lasts.
• Personalized: Our care plans are customized for each client based on their individual needs and concerns.
• Compassionate: We approach our work with compassion and empathy, working closely with our clients and their care teams to create meaningful change.
• Relationship-driven: You believe that successful behavior change comes from building deep, long-term relationships with your clients.

What You’ll Do:

• Provide life-changing medical nutrition therapy via remote sessions to clients who fit your areas of specialty.
• Work from anywhere in the U.S. and choose the hours that fit your schedule best. This is a 1099-Contractor position.
• Create personalized, evidence-based nutrition plans tailored to client needs and preferences.
• Provide resources and educational materials to clients to support their health journey.
• Strengthen client relationships to improve retention.
• Use online telehealth tools to track progress, answer client questions, etc.
• Stay current with the latest research and trends in nutrition and wellness.
• Collaborate with other healthcare professionals if applicable to ensure comprehensive care for clients with complex health needs.
• Maintain timely, accurate records of client sessions and progress.

You’ll be a good fit for Berry Street if you’re:

• A self-starter: You know how to take initiative and work independently and tirelessly for your clients and private practice.
• Adaptable: You’re comfortable in changing environments.
• Growth-Oriented: You look to broaden your expertise and confidently support clients beyond your specialty.
• Entrepreneurial: You’re excited to take part in growing your client base and ultimately, a sustainable practice. You’re a pro at marketing yourself (or excited to learn how). You’re willing to invest time to build a relationship (ex. messaging, sharing materials, etc.) because that leads to better outcomes and more money in your pocket.
• Resourceful: You proactively continue your professional education, ask questions, and seek information to overcome hurdles to your work.
• Friendly, empathetic and focused on excellence: You approach every client interaction with empathy and a commitment to delivering an exceptional experience. You work to understand your clients’ unique goals and foster trust.

What You’ll Need:

• Active Registration by the Commission on Dietetic Registration (CDR) OR Board for Certification of Nutrition Specialists (BCNS)

• For RDs: Licensed and in good standing in Nutrition/Dietetics in any state(s)

• For CNSs: Must hold at least one state license

• Licensed and in good standing in Nutrition/Dietetics in any state(s)

• Experience working with clients remotely via telehealth platforms and comfort working with technology

• Permanent residence within the United States

• Ability to build and maintain strong relationships with your clients and Referral partners

• Ability to quickly learn new methods and systems

• A minimum of 8 hours per week of ongoing availability

• Ability to define your own schedule

• Expedited credentialing: See insurance clients in as few as 30 days

• Intake & scheduling support: Simplified booking, onboarding, and eligibility verification

• End-to-end, guaranteed billing: Don’t worry about denials or unpaid claims

• Access to EHR for efficient client management

• Charting Assistant: Time-saving tool that writes notes for you

• Dashboard for practice insights: View your schedule, clients, payouts, and more

• Peer community: Access to our private community of RDs and practice owners

• Dedicated support: Customer service support 7-days a week for you and your clients

• Workshops and professional development: Expert-led workshops on how to self-market your practice and other topics to uplevel your business

• Marketing & referrals: Promote your practice to thousands of potential clients

Location: Fully Remote

Schedule: Flexible

Compensation: Up to $85 per hour

Job Type: Full-time, Part-time

About the Role

We’re looking for entrepreneurial, empathetic Registered Dietitians (RDs) and Certified Nutrition Specialists (CNSs) licensed in any state to help us bring medical nutrition therapy (MNT) to all. This role is a fully flexible 1099 role–work only when you’d like to.

Who We Are

Berry Street is tackling America’s most comprehensive health crisis: food. More than half of Americans are struggling with their relationship with food, are clinically overweight, or experience a chronic condition linked to their diet. Nutrition therapy is clinically proven to make a difference, and most commercial health insurance plans cover it at $0 out-of-pocket.

Berry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. We eliminate time-consuming admin so dietitians can focus on providing outstanding client care.

We believe everyone should have access to personalized nutrition therapy covered by insurance. Clinicians should be able to serve the communities they care about, not just those who can afford to pay out of pocket.

Dietitians working with Berry Street are committed to these pillars of high-quality care:

• Evidence-based: We provide quality care based on the latest clinical research. We actively track the quality of care to ensure better health outcomes and behavior change.
• Approachable: Through client education and nutrition therapy, we utilize a realistic, sustainable approach to create behavior change that lasts.
• Personalized: Our care plans are customized for each client based on their individual needs and concerns.
• Compassionate: We approach our work with compassion and empathy, working closely with our clients and their care teams to create meaningful change.
• Relationship-driven: You believe that successful behavior change comes from building deep, long-term relationships with your clients.

What You’ll Do:

• Provide life-changing medical nutrition therapy via remote sessions to clients who fit your areas of specialty.
• Work from anywhere in the U.S. and choose the hours that fit your schedule best. This is a 1099-Contractor position.
• Create personalized, evidence-based nutrition plans tailored to client needs and preferences.
• Provide resources and educational materials to clients to support their health journey.
• Strengthen client relationships to improve retention.
• Use online telehealth tools to track progress, answer client questions, etc.
• Stay current with the latest research and trends in nutrition and wellness.
• Collaborate with other healthcare professionals if applicable to ensure comprehensive care for clients with complex health needs.
• Maintain timely, accurate records of client sessions and progress.

You’ll be a good fit for Berry Street if you’re:

• A self-starter: You know how to take initiative and work independently and tirelessly for your clients and private practice.
• Adaptable: You’re comfortable in changing environments.
• Growth-Oriented: You look to broaden your expertise and confidently support clients beyond your specialty.
• Entrepreneurial: You’re excited to take part in growing your client base and ultimately, a sustainable practice. You’re a pro at marketing yourself (or excited to learn how). You’re willing to invest time to build a relationship (ex. messaging, sharing materials, etc.) because that leads to better outcomes and more money in your pocket.
• Resourceful: You proactively continue your professional education, ask questions, and seek information to overcome hurdles to your work.
• Friendly, empathetic and focused on excellence: You approach every client interaction with empathy and a commitment to delivering an exceptional experience. You work to understand your clients’ unique goals and foster trust.

What You’ll Need:

• Active Registration by the Commission on Dietetic Registration (CDR) OR Board for Certification of Nutrition Specialists (BCNS)

• For RDs: Licensed and in good standing in Nutrition/Dietetics in any state(s)

• For CNSs: Must hold at least one state license

• Licensed and in good standing in Nutrition/Dietetics in any state(s)

• Experience working with clients remotely via telehealth platforms and comfort working with technology

• Permanent residence within the United States

• Ability to build and maintain strong relationships with your clients and Referral partners

• Ability to quickly learn new methods and systems

• A minimum of 8 hours per week of ongoing availability

• Ability to define your own schedule

• Expedited credentialing: See insurance clients in as few as 30 days

• Intake & scheduling support: Simplified booking, onboarding, and eligibility verification

• End-to-end, guaranteed billing: Don’t worry about denials or unpaid claims

• Access to EHR for efficient client management

• Charting Assistant: Time-saving tool that writes notes for you

• Dashboard for practice insights: View your schedule, clients, payouts, and more

• Peer community: Access to our private community of RDs and practice owners

• Dedicated support: Customer service support 7-days a week for you and your clients

• Workshops and professional development: Expert-led workshops on how to self-market your practice and other topics to uplevel your business

• Marketing & referrals: Promote your practice to thousands of potential clients

Location: Fully Remote

Schedule: Flexible

Compensation: Up to $85 per hour

Job Type: Full-time, Part-time

About the Role

We’re looking for entrepreneurial, empathetic Registered Dietitians (RDs) and Certified Nutrition Specialists (CNSs) licensed in any state to help us bring medical nutrition therapy (MNT) to all. This role is a fully flexible 1099 role–work only when you’d like to.

Who We Are

Berry Street is tackling America’s most comprehensive health crisis: food. More than half of Americans are struggling with their relationship with food, are clinically overweight, or experience a chronic condition linked to their diet. Nutrition therapy is clinically proven to make a difference, and most commercial health insurance plans cover it at $0 out-of-pocket.

Berry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. We eliminate time-consuming admin so dietitians can focus on providing outstanding client care.

We believe everyone should have access to personalized nutrition therapy covered by insurance. Clinicians should be able to serve the communities they care about, not just those who can afford to pay out of pocket.

Dietitians working with Berry Street are committed to these pillars of high-quality care:

• Evidence-based: We provide quality care based on the latest clinical research. We actively track the quality of care to ensure better health outcomes and behavior change.
• Approachable: Through client education and nutrition therapy, we utilize a realistic, sustainable approach to create behavior change that lasts.
• Personalized: Our care plans are customized for each client based on their individual needs and concerns.
• Compassionate: We approach our work with compassion and empathy, working closely with our clients and their care teams to create meaningful change.
• Relationship-driven: You believe that successful behavior change comes from building deep, long-term relationships with your clients.

What You’ll Do:

• Provide life-changing medical nutrition therapy via remote sessions to clients who fit your areas of specialty.
• Work from anywhere in the U.S. and choose the hours that fit your schedule best. This is a 1099-Contractor position.
• Create personalized, evidence-based nutrition plans tailored to client needs and preferences.
• Provide resources and educational materials to clients to support their health journey.
• Strengthen client relationships to improve retention.
• Use online telehealth tools to track progress, answer client questions, etc.
• Stay current with the latest research and trends in nutrition and wellness.
• Collaborate with other healthcare professionals if applicable to ensure comprehensive care for clients with complex health needs.
• Maintain timely, accurate records of client sessions and progress.

You’ll be a good fit for Berry Street if you’re:

• A self-starter: You know how to take initiative and work independently and tirelessly for your clients and private practice.
• Adaptable: You’re comfortable in changing environments.
• Growth-Oriented: You look to broaden your expertise and confidently support clients beyond your specialty.
• Entrepreneurial: You’re excited to take part in growing your client base and ultimately, a sustainable practice. You’re a pro at marketing yourself (or excited to learn how). You’re willing to invest time to build a relationship (ex. messaging, sharing materials, etc.) because that leads to better outcomes and more money in your pocket.
• Resourceful: You proactively continue your professional education, ask questions, and seek information to overcome hurdles to your work.
• Friendly, empathetic and focused on excellence: You approach every client interaction with empathy and a commitment to delivering an exceptional experience. You work to understand your clients’ unique goals and foster trust.

What You’ll Need:

• Active Registration by the Commission on Dietetic Registration (CDR) OR Board for Certification of Nutrition Specialists (BCNS)

• For RDs: Licensed and in good standing in Nutrition/Dietetics in any state(s)

• For CNSs: Must hold at least one state license

• Licensed and in good standing in Nutrition/Dietetics in any state(s)

• Experience working with clients remotely via telehealth platforms and comfort working with technology

• Permanent residence within the United States

• Ability to build and maintain strong relationships with your clients and Referral partners

• Ability to quickly learn new methods and systems

• A minimum of 8 hours per week of ongoing availability

• Ability to define your own schedule

• Expedited credentialing: See insurance clients in as few as 30 days

• Intake & scheduling support: Simplified booking, onboarding, and eligibility verification

• End-to-end, guaranteed billing: Don’t worry about denials or unpaid claims

• Access to EHR for efficient client management

• Charting Assistant: Time-saving tool that writes notes for you

• Dashboard for practice insights: View your schedule, clients, payouts, and more

• Peer community: Access to our private community of RDs and practice owners

• Dedicated support: Customer service support 7-days a week for you and your clients

• Workshops and professional development: Expert-led workshops on how to self-market your practice and other topics to uplevel your business

• Marketing & referrals: Promote your practice to thousands of potential clients

About Solace Healthcare in the U.S. is fundamentally broken. The system is so complex that 88% of U.S. adults do not have the health literacy necessary to navigate it without...

UpLift – Redefining Access to Mental Healthcare At UpLift, we believe mental health is just as important as physical health — and we’re rethinking the mental healthcare model. UpLift is...

Apollo Applied Research is a virtual medical clinic offering its patients an accessible path to medical cannabis treatment.

SummaryPerforms medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines.

Our culture and people are what set us apart from other post-acute care providers.

Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and medical necessity reviews and appeals within an NCQA-compliant UM program.

Salary: $60,000.00/annual

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

The UM Nurse’s responsibilities include but are not limited to:

• Perform pre-service and post service UM authorization reviews utilizing federal and state mandates, plan benefit language and NCDs/LCDs as criteria for medical necessity reviews
• Work with non-clinical team to obtain additional clinical information, as needed
• Approve requests that meet eligibility, benefit, and medical necessity criteria
• Refer cases to the Medical Director that do not meet medical necessity criteria
• Refer cases to independent consultants or IROs, when necessary
• Communicate outcomes of UM authorization reviews, both verbally and in writing
• Process administrative and clinical appeals and refer as needed to the Medical Director
• Maintain compliance with all accrediting agency standards such as NCQA, CMS and State agencies
• Strong organizational skills, ability to adapt quickly to change and desire to work in a fast-paced environment
• Team oriented and self-motivated with a positive attitude
• Performs other duties as assigned

EDUCATION: Active, Licensed Vocational Nurse, or Licensed Practical Nurse license

EXPERIENCE:

• Minimum of 3 years of nursing in an acute or outpatient setting
• Minimum of 2 years of UM experience in a managed care, payor environment
• Experience with Medicare and Medicaid (not required, but highly desirable)
• Experience with UM authorizations and appeals for DMEPOS (not required, but highly desirable)
• Experience with Medical Necessity Criteria including but not limited to InterQual, CMS guidelines, health plan medical policies, etc.
• Experience writing denial letters is preferred
• Verbal and written communication skills to convey information clearly and consistently

Benefits Offered

• Competitive compensation and annual bonus program
• 401(k) retirement program with company match
• Company-paid life insurance
• Company-paid short term disability coverage (location restrictions may apply)
• Medical, Vision, and Dental benefits
• Paid Time Off (PTO)
• Paid Parental Leave
• Sick Time
• Paid company holidays and floating holidays
• Quarterly company-sponsored events
• Health and wellness programs
• Career development opportunities

Remote Opportunities

We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.

Our Story

Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.

With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.

Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Interact is a leading provider of allied health, occupational health and safety, and injury management services to the regions of New South Wales.

Included Health is seeking a Remote Psychiatrist to join our team of dedicated mental health clinicians, under the guidance of a Medical Director. This is a 1099 Independent Contractor position. This role offers the opportunity to help redefine healthcare by providing compassionate, high-quality virtual care to patients across their healthcare journey.

You will use video-based visits to diagnose and treat a wide variety of mental, emotional and behavioral disorders. You will provide Psychotropic medication management to assist patients with problems ranging from short-term interpersonal issues to severe, chronic conditions. By using medical and psychiatric data, psychiatrists will aid in the development of treatment plans, monitor the effects of medications, and collaborate with primary care physicians, psychologists, therapists and other healthcare professionals to help patients restore their optimal mental health.

Responsibilities:

• Assess patients through a video-based encounter
• Perform virtual comprehensive mental health evaluations, compile patient medical data, including health history and mental status examination findings
• Psychotropic medication management including evaluation of patient medical history, and medication response, adherence and tolerability for each individual patient treated
• Develop and implement behavioral health treatment plans, evaluate results of mental health assessments, and provide medication management to patients
• Collect, record and maintain sensitive patient information such as examination results, medical history and reports
• Conduct monthly chart reviews as part of our peer review QA process, as assigned

Qualifications and Requirements:

• Active and unrestricted M.D. or D.O. medical license in the state of residence required
• Graduate of ACGME-accredited psychiatry residency program
• Keep up-to-date with continuing medical education
• Comfortability navigating video-conferencing platforms and willingness to learn new technology, such as Athena
• Experience with technology and an understanding of digital tools and platforms

The United States compensation for this Independent Contractor Position is $206 per visit hour. Your recruiter will share more about the compensation for this role during the hiring process.

About Included Health

Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.

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Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.

Included Health uses AI-assisted tools at select stages of the hiring process to enhance efficiency, consistency, and communication. AI does not make hiring decisions—final decisions are made exclusively by our recruiting and hiring teams.

You could be the one who changes everything for our 28 million members.

The Medical Scientific Liaison (MSL) is primarily responsible for external medical stakeholder engagement, with the role focused on field-based scientific exchange.

AthenaPsych is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges. We specialize in individual and group...

DescriptionRemote | 1099 Independent Contractor | Flexible Commitment MEDvidi is seeking experienced Physicians (MD/DO) to serve as Collaborating / Supervising Physicians for our growing team of Psychiatric Mental Health Nurse Practitioners (PMHNPs).

Maven Clinic is the world’s largest virtual clinic for women and families on a mission to make healthcare work for all of us. Through Maven Enterprise, the company partners with more than 2,300 employers and health plans to provide end-to-end women’s and family health programs spanning fertility and family building, maternity and newborn care, parenting and pediatrics, and menopause and midlife — improving clinical outcomes, reducing healthcare costs, and expanding equitable access to high-quality care at scale. Through its consumer platform, Maven provides direct access to virtual care across 30+ specialties, as well as dedicated hormone and GLP-1 care programs purpose-built for women. Founded in 2014 by CEO Kate Ryder, Maven Clinic has raised more than $425 million from leading healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. Recognized for innovation and industry leadership, Maven has been named to the TIME100 Most Influential Companies, CNBC Disruptor 50, Fast Company’s Most Innovative Companies, and FORTUNE Best Places to Work. Learn more at mavenclinic.com

An award-winning culture working towards an important mission –  Maven Clinic is a recipient of over 30 workplace and innovation awards, including:

• TIME 100 Most Influential Companies (2023, 2026)
• Fortune Change the World (2024)
• CNBC Disruptor 50 List (2022, 2023, 2024)
• Fortune Best Workplaces for Millennials (2024)
• Fortune Best Workplaces in Health Care (2024)
• Fast Company Most Innovative Companies (2020, 2023)
• Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)

About the Role:

We are looking for a mission-driven health coach to join our team to provide world-class care delivery services to Maven members. Our Care Delivery team consists of care coaches and care advocates who help our members navigate digital care and access the tools to unlock their best experience and outcomes. Our team works to continuously learn more about members and ourselves, and you’ll move fast to adapt and grow as we implement data-driven strategies for improving the lives of our members through a shared coaching model. As a Care Coach, you’ll coordinate care for our members beyond the digital space. Through goal setting and program opt-in, you’ll drive behavior change and improved outcomes for higher risk members.

Our Care Delivery team works remotely and supports Maven members 24/7/365. We are currently hiring for the following shifts:

• Tuesday - Saturday: 7am - 3:30pm EST ; 11am-7:30pm EST; 3pm-11:30pm EST
• Sunday - Thursday: 11am-7:30pm EST

What You’ll Do:

• Drive program engagement by clearly communicating the value of Maven’s care coaching model, optimizing opt-in rates, and supporting long-term behavior change
• Co-create SMART goals with members and own their progress by tracking adherence, adjusting care plans, and course-correcting within Maven’s clinical program design
• Manage a caseload of members and engage with them through ongoing messaging, video appointments, and outreach
• Adhere to clinical program guidelines and protocols while utilizing motivational interviewing skills and behavior modification techniques to remove barriers, influence sustained behavior change, and promote optimal health outcomes for members
• Move fast to assess member knowledge and barriers and provide personalized health education to members across varying ages, backgrounds, cultures, and literacy levels
• Collaborate with providers on members’ care teams to translate clinical recommendations into actionable next steps
• Lead with data by remotely monitoring member health data and platform activity to identify risks early and follow established protocols and procedures to take appropriate action
• Remove barriers to care by coordinating seamlessly across Maven’s digital network, in-person provider networks, and external partners as needed
• Embrace a continuous-learning mindset by participating in and leading efforts to improve quality of care and clinical outcomes
• Act as a team player by providing coverage to ensure that all members across the Maven platform receive appropriate care and timely responses when needed

What You’ll Bring:

• 1- 2+ years experience in health coaching or clinical work (e.g., nursing, behavioral health, or related field) with focus on patient education, motivational interviewing, and driving clinical outcomes
• Demonstrated experience working with the maternity population and/or individuals navigating family planning or fertility care (trying to conceive, undergoing fertility treatment)
• Training and experience coaching individuals to achieve specific health outcomes (ie, medication management, nutrition and exercise goals, managing blood pressure)
• Ability to remain flexible with changes, work efficiently to meet member demand and have a growth mindset
• Ability to communicate with patients empathetically in writing and verbally, and passionate about creating a positive member experience with optimal outcomes
• Experience achieving KPIs relevant to patient outcomes, including but not limited to opt-in rates, follow-up adherence and member satisfaction
• Demonstrated ability to quickly learn and adapt to new digital health tools and platforms, with comfort operating in a fast-changing tech environment
• Embrace AI tools as part of daily workflows to enhance efficiency and improve member outcomes
• Strong telehealth competency, including comfort in conducting phone outreach and video calls. Reliable access to high-speed internet
• Health coaching certification (NBC-HWC or ICF) is preferred, not required
• Experience in a start-up or fast-paced environment with ability to navigate systems quickly and adapt to change is preferred, not required
• Experience coaching across multiple modalities such as video, text/chat, and phone; adapting communication style to fit member need is preferred, not required
• Comfort with technology tools like Google suite, CRM platforms, EHRs, and Zendesk is preferred, not required

The base salary range for this role is $62,000 - $73,000 per year. You will also be entitled to receive equity and benefits. Individual pay decisions are based on a number of factors, including qualifications for the role, experience level, and skillset.

This role requires active work authorization in the US.

Maven embraces a flexible and inclusive work environment. This role is open to candidate in: AZ, DC, DE, FL, GA, HI, IL, KS, MA, MD, ME, MI, MN, MO, NC, NJ, NM, NV, NY, OH, OR, PA, SC, TN, TX, VA, VT, WI. Maven is committed to supporting remote team members with the tools and collaborative culture needed to thrive regardless of location. This policy reflects our belief that great work can happen anywhere and that flexibility enables our team to do their best work.

At Maven we believe that a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in all of the areas detailed above, we hope that you will share your unique background with us in your application and how it can be additive to our teams.

Benefits That Work For You

Our benefits are designed to support your health, well-being and career development, helping you thrive both personally and professionally. We remain focused on providing a competitive benefits package for our employees. On top of standards such as employer-covered health, dental, and insurance plan options, we offer an inclusive approach to benefits:

• Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics.
• Whole-self care through wellness partnerships
• Hybrid work, in office meals, and work together days
• 16 weeks 100% paid parental leave and new parent stipend (for Mavens who’ve been with us for 1 year+)
• Annual professional development stipend and access to a personal career coach through Maven for Mavens
• 401K matching for US-based employees, with immediate vesting

These benefits are applicable to Maven Clinic Co., US-based, full-time employees only. 1099/Contract Providers are ineligible for these benefits.

Maven is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Maven is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Maven Clinic interview requests and job offers only originate from an @mavenclinic.com email address (e.g jsmith@mavenclinic.com). Maven Clinic will never ask for sensitive information to be delivered over email or phone. If you receive a scam issue or a security issue involving Maven Clinic please notify us at: security@mavenclinic.com. For general and additional inquiries, please contact us at careers@mavenclinic.com.

At Clover Health, we provide high-quality, affordable, and easy-to-understand healthcare for America’s seniors. Through the Clover Assistant, we combine data, technology, and preventive care to give physicians a more complete view of each member’s health—helping improve outcomes while lowering costs.

The Utilization Management (UM) team supports members throughout their care journey by combining clinical expertise with evidence-based decision-making. Working closely with providers and care partners, the team ensures timely, appropriate care while maintaining compliance with CMS guidelines.

The Registered Nurse (RN) Lead, Home Health Utilization Management, will split time between direct utilization management reviews (50%) and leading the Home Health UM nursing team (50%). You’ll ensure timely, high-quality medical necessity determinations while providing clinical leadership, mentoring reviewers, and partnering with UM leadership, Medical Directors, Quality, Operations, and Contracting to drive consistency, compliance, and continuous improvement.

As a Registered Nurse (RN) Lead, Home Health Utilization Management, you will:

Clinical Review Responsibilities (Approximately 50%)

• Review Home Health prior authorization requests using CMS regulations, Medicare Benefit Policy, NCD/LCD criteria, and Clover guidelines.
• Complete initial and concurrent medical necessity reviews for Home Health services.
• Maintain an active review workload while meeting quality, productivity, and turnaround expectations.
• Apply sound clinical judgment and escalate complex cases to Medical Directors as needed.
• Collaborate with providers, home health agencies, case managers, and internal teams to obtain clinical documentation.
• Accurately document determinations in UM systems and electronic medical records.
• Identify opportunities to optimize care and appropriate Home Health utilization.

Leadership Responsibilities (Approximately 50%)

• Provide day-to-day clinical leadership and support to the Home Health UM nursing team.
• Serve as the primary resource for complex cases, CMS policy interpretation, and clinical guidance.
• Conduct quality audits and reviewer calibration to ensure consistent, compliant decisions.
• Perform monthly quality reviews and maintain greater than 90% reviewer concordance.
• Monitor productivity, quality, turnaround times, and workload distribution.
• Identify utilization trends, perform root cause analyses, and implement process improvements.
• Mentor and coach reviewing nurses through case reviews and ongoing feedback.
• Train reviewers on episodic and per-visit Home Health authorization methodologies.
• Support onboarding, competency validation, and ongoing staff education.
• Partner with Home Health agencies to review utilization trends and strengthen collaboration.
• Work with Contracting to evaluate agency performance and support a high-quality provider network.
• Collaborate with cross-functional partners to improve workflows, consistency, and member outcomes.
• Support implementation of new CMS guidance, internal policies, and UM initiatives.
• Serve as the clinical escalation point before Medical Director review, when appropriate.
• Foster a collaborative, accountable, and high-performing team culture.

Success in this role looks like:

First 30 Days

• Complete onboarding and become proficient in Clover’s UM systems, Home Health clinical guidelines, CMS regulations, and internal workflows. Begin independently reviewing Home Health authorizations, participate in quality reviews, and build strong relationships with reviewing nurses, Medical Directors, Contracting, and key cross-functional partners.

First 6 Months

• Confidently balance an active review caseload with leadership responsibilities while serving as a trusted resource for the Home Health UM team. Consistently deliver high-quality, timely reviews, conduct monthly quality audits and reviewer calibration, coach and mentor team members, identify utilization trends, and partner with internal stakeholders and Home Health agencies to improve consistency, compliance, and operational performance.

Future State

• Be recognized as the clinical leader for Home Health Utilization Management, driving best practices, reviewer development, and continuous process improvement. Lead initiatives that enhance quality, efficiency, and member outcomes while maintaining strong partnerships across Clinical, Medical Directors, Contracting, and provider organizations. Foster a high-performing, collaborative team culture and help shape the future direction of Clover’s Home Health UM program

You should get in touch if you:

• Hold a current Compact Registered Nurse (RN) license (required).
• Have 5+ years of clinical nursing experience in Home Health, Utilization Management, Case Management, or Medicare Advantage (required).
• Have 2+ years of Home Health medical necessity review experience using CMS criteria (required).
• Have experience leading, mentoring, coaching, or developing clinical staff (preferred).
• Demonstrate expertise in CMS regulations, the Medicare Benefit Policy Manual, and NCD/LCD criteria.
• Have experience with quality reviews, performance calibration, or clinical education (preferred).
• Are organized, analytical, and comfortable balancing leadership with direct clinical review responsibilities.
• Are proficient with electronic medical records and utilization management systems.
• Thrive in a collaborative, fast-paced environment focused on improving member outcomes.

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 Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we’ve created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.

We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.

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.

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.

A reasonable estimate of the base salary range for this role is:

$130,800—$170,000 USD

Who are we, and why should you join us? ADHDAdvisor.

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