Complex Care Management

Embright and First Choice Health Announce Partnership, Expanding Access and Improving Care for Employees | PR Newswire | 10/1/2020

… each organization’s expertise in managing essential aspects of care at different stages of the patient journey. This approach optimizes the patient experience at every stage, from selecting a provider, understanding an invoice, to supporting complex care management . FCH, a third-party administrator for self-funded employers, also represents the largest independent preferred provider network ( Washington , Oregon , Alaska , Idaho , Montana , Wyoming , North Dakota , and South Dakota ), with more than 116,000 providers …

Cano Health Inaugurates First Medical Center In San Antonio On Saturday, September 26 | PR Newswire | 9/23/2020

… that specialize in primary care for seniors. As part of its care coordination, Cano provides sophisticated, high-touch population health management programs such as home visits, telehealth, transition of care, and high-risk and complex care management . The company’s personalized patient care and proactive approach to wellness and preventive care sets it apart from competitors. Cano Health was recognized in August 2020 by Inc. magazine as the fastest-growing health …

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Clinical Quality Analyst SAS experience Telecommute - UnitedHealth Group - MN, MN | 9/23/2020

… telecommute position - Monday - Friday, days Responsibilities include solutioning, developing, maintaining, and the production / retention of actionable and summary reports for distribution. Scope includes HEDIS, Part D, Stars and clinical quality improvement measures for Optum Complex Care Management and House Calls patients. Includes ownership of clinical/quality reports: design, development, programming, maintaining and publishing reports to support operational / strategic business opportunities. Requires consulting with users to evaluate business & reporting requirements, identify …

Director Clinical Operations Complex Care Management Mid Atlantic Maryland Virginia West Virginia - UnitedHealth Group - Rockville, MD | 9/21/2020

Apply Now Description The Director, Clinical Operations will primarily be accountable for providing leadership and oversight of the performance of managers and/or senior level professional staff. They will work to develop functional market level strategies, plans, productions, and organizational priorities. The DCO identifies and resolves technical, operational, and organizational problems outside of their direct team. This role will be integral in forming internal and external strategic relationships, which support …

Vaya Health expands telehealth services, WAMY to improve housing | 9/16/2020

… receive services that historically couldn’t be provided through telephone or video in that manner,” Smathers said. For the month of July, Vaya Health-funded providers in Avery County served 357 members, 38 members received complex care management and 91 complex care management contacts were made. For Suicide Awareness Month from Sept. 9 to Oct. 15, Vaya Health will be offering crisis intervention training on the second Tuesday of every month …

Chronic Care Management Code Use Increases, But Uptake Still Lagging | RevCycle Intelligence | 9/16/2020

… is not over. First, newer CCM codes represented a minority of services provided, raising questions about the availability of CCM reimbursement, Reddy et al. stated. CPT codes 99487 and 99489 provider higher reimbursement for complex care management compared to the original CCM code, CPT 99490, which reimburses clinicals for up to 20 minutes of non-face-to-care care management activities. The add-on code G0507, which was introduced in …

Cano Health selects Tejano Musician Jay Perez as Ambassador for its San Antonio Medical Centers | PRWeb | 8/29/2020

… that specialize in primary care for seniors. As part of its care coordination, Cano Health provides sophisticated, high-touch population health management programs such as home visits, telehealth, transition of care, and high risk & complex care management . Cano Health’s personalized patient care and proactive approach to wellness and preventive care is what sets it apart from competitors. Cano Health was recently recognized by Inc. magazine for the second consecutive year …

Telehealth Shown to be Successful in Supporting PCP1st During COVID-19 Pandemic | PRWeb | 8/24/2020

… the safety and comfort of their homes.” The onset of the COVID-19 crisis has presented several new challenges for PCP1st, a provider of customized care for high risk patients and those that require complex care management . They need an approach to safely and rapidly extend care for their patients and help them proactively manage COVID-19. PCP1st deployed the COVID-19 Telehealth and Remote Care programs from Wanda Health …

United Health Foundation Pledges $1.7 Million to Health Care Center for the Homeless to Expand Access to Primary Care in Florida | Business Wire | 8/18/2020

… it most.” The $1.7 million, three-year partnership with Health Care Center for the Homeless will create a new clinical fellowship program for post-graduate nurse practitioners to receive on-the-job training in complex care management for underserved populations. The program will train nurse practitioner fellows in integrated behavioral health, pediatric care, wound care, medication therapy management, substance use disorder counseling and other urgently needed services. “Our organization is …

Cano Health is ranked as the fastest growing Primary Care Provider in the US for the second consecutive year with a growth rate of more than 7,000 percent over three years, according to Inc. magazine | PR Newswire | 8/18/2020

… specialize in primary care for seniors. As part of its care coordination, Cano Health provides sophisticated, high-touch population health management programs such as home visits, telehealth, transition of care, and high-risk and complex care management . The company’s personalized patient care and proactive approach to wellness and preventive care is what sets it apart from competitors. Cano Health was first recognized in 2019 by Inc. magazine as the fastest …

Medical Coding Manager - Telecommute - UnitedHealth Group - Columbia, MD | 8/6/2020

Apply Now Description Responsible for the daily operations including planning, organizing, staffing, directing, and controlling all functions of the Clinical Documentation Improvement quality programs supporting OptumCare Complex Care Management division. The CDI Supervisor will manage, oversee, and monitor the process and workflows of coding and quality reviews, and direct, support, and educate the staff, interact with Compliance, QA, and other professional and support staff to ensure quality and consistency of …

Tandigm Health Adds to Leadership Team | Business Wire | 7/9/2020

… business development. An established leader and proven negotiator, Cintron is poised to grow Tandigm’s value-based patient population and refine its account management operations. Dana Pedrick, RN, joins Tandigm as the Senior Director of Complex Care Management (CCM) . As the senior leader for the CCM Program, Dana will be responsible for advancing the Program’s outcomes and expanding their population health impact. She comes to Tandigm from Quality Health Alliance, where …

Healthy Partners Joins Cano Health, Expanding The Company’s Reach To 20 Florida Counties | PR Newswire | 6/30/2020

… that specialize in primary are for seniors. As part of its care coordination, Cano Health provides sophisticated, high-touch population health management programs such as home visits, telehealth, transition of care, and high risk & complex care management . Cano Health’s personalized patient care and proactive approach to wellness and preventive care is what sets it apart from competitors. In 2019, Cano Health was recognized by Inc. magazine as the fastest-growing …

Lessons from Nursing Homes in COVID Hotspots: Secure a Lab Now — and Proceed Carefully on Visitation | 6/24/2020

… careful about reopening for visitation, according to several experts from some of the worst geographical COVID-19 hotspots in the U.S. Advertisement “As a clinician, it makes me nervous,” Karl Dauphinais, medical director of complex care management at the health services firm Optum and the medical director of Autumn Lake Health Care in New Britain, Conn., said on a Skilled Nursing News webinar held Tuesday when asked about visitation. The …

Cano Health Urges COVID-19 Testing For All Patients; Offers In-Home Appointments | PR Newswire | 6/24/2020

… that specialize in primary care for seniors. As part of its care coordination, the enterprise provides sophisticated, high-touch population health management programs such as home visits, telehealth, transition of care, and high risk & complex care management . Cano Health’s personalized patient care and proactive approach to wellness and preventive care sets it apart from competitors. In 2019 Cano Health was recognized by Inc. magazine as the fastest-growing health care …

Bright Health Completes Acquisition of Brand New Day Health Plan Bringing its Groundbreaking Model to California Seniors | PR Newswire | 5/1/2020

… core strengths, we can deliver an even better experience for our members across the country.” Brand New Day was founded in 1983 by the Davis family to improve health outcomes through an emphasis on complex care management , population health and strong relationships between patients and their primary care physicians. Current leadership, including Jeff and Jay Davis , will join the Bright Health Plan leadership team and will continue to lead local …

Sr Java [email protected] Eden prairie, Minnesota | 4/21/2020

… Job Title - Sr Java Developer Location - Eden prairie, Minnesota Duration - 6 months + Position Type - Contract Experience - 10 years + Need Visa Independent only Job Description Pathway is the mission critical integrated care management application for Complex Care Management . It will deliver an improved user experience to approximately 2000 clinical & corporate users enabling comprehensive medical management and clinical documentation, integrated outreach, practice, and revenue cycle management to improve efficiency & effectiveness through increased …

SR. JAVA DEVELOPER - EDEN PAIRIE, MN | 4/20/2020

… Sr. Java Developer Work Location: Eden Prairie, MN Rate: C2C or W2 all-inclusive Client: Pathway - CCM Years of experience: 10+ Project: Pathway - CCM. Pathway is the mission critical integrated care management application for Complex Care Management . It will deliver an improved user experience to approximately 2000 clinical & corporate users enabling comprehensive medical management and clinical documentation, integrated outreach, practice, and revenue cycle management to improve efficiency &  effectiveness through …

Senior Salesforce Developer…Minimum 11-12 Years…Urgent Req | 4/9/2020

Hi, We have this below position open. Please let me know if you have anyone available for this role. Eden Prairie, MN Long Term Description: Required Skills: Salesforce, APEX, Visual Force, Healthcare experience Project: Pathway is the mission critical integrated care management application for Complex Care Management . It will deliver an improved user experience to approximately 2000 clinical & corporate users enabling comprehensive medical management and clinical documentation, integrated outreach, practice …

Senior Capability Analyst for Care Services - Eden Prairie, MN - UnitedHealth Group - Eden Prairie, MN | 3/26/2020

Share Description As the Senior Capability Analyst for Care Services (HouseCalls and Complex Care Management ), this supporting role serves as a trusted voice to the Capability Strategy leader and the Business Enablement & Technology (BET) team to articulate and support the intake engagement process, capability roadmap(s), strategies and tactics related to our business partners’ vision. Capability analysis requires alignment to business and/or product strategy, effective design and development, and …

Vaya’s Cox appointed to NCCDD | 3/25/2020

… Asheville, serves Jackson County, managing Medicaid and other public funds for mental health, substance use disorder and intellectual/developmental disability services in 22 Western North Carolina counties. At Vaya, Cox is responsible for all complex care management and integrated care functions, member services, provider network operations and utilization management. Cox has more than 20 years of experience in managing behavioral health and IDD services. She is a firm believer that …

Vaya Health executive leadership member appointed to statewide developmental disabilities council | 3/18/2020

… Vaya, based in Asheville, manages Medicaid and other public funds for mental health, substance use disorder and intellectual/developmental disability services in 22 western North Carolina counties. At Vaya, Cox is responsible for all complex care management and integrated care functions, member services, provider network operations and utilization management. Cox has more than 20 years of experience in managing behavioral health and IDD services. She is a firm believer that …

Charter Health Group Acquires Hospices in Nevada and Arizona - Hospice News | 3/17/2020

… Arizona Select Hospice for an undisclosed sum. Both of those providers were part of the VeraCare Hospice system. California-based Charter provides a range of post-acute care services that include hospice, home health, complex care management and palliative care services. Pharos first invested in Charter in Oct. 2018. The company serves an average census of 3,000 patients in six counties. These transactions mark their entry into the Arizona and …

Cano Health issues guidance for its patients in response to Coronavirus; Urges those presenting symptoms to call the company’s 24x7 Support Line | PR Newswire | 3/17/2020

… for older adults. As part of its care coordination, the enterprise provides sophisticated, high-touch population health management programs including patient-centric programs such as home visits, telehealth, transition of care, and high-risk & complex care management . Cano Health’s personalized patient care and proactive approach to wellness and preventive care sets them apart. For more information visit www.canohealth.com . SOURCE Cano Health, LLC Related Links http://www.canohealth.com …

Cano Health issues guidance for its patients in response to Coronavirus; Urges those presenting symptoms to call the company’s 24x7 Support Line | PR Newswire | 3/17/2020

… for older adults. As part of its care coordination, the enterprise provides sophisticated, high-touch population health management programs including patient-centric programs such as home visits, telehealth, transition of care, and high-risk & complex care management . Cano Health’s personalized patient care and proactive approach to wellness and preventive care sets them apart. For more information visit www.canohealth.com . SOURCE Cano Health, LLC Related Links http://www.canohealth.com …

Telehealth

Telehealth Shown to be Successful in Supporting PCP1st During COVID-19 Pandemic | PRWeb | 8/24/2020

Telehealth Shown to be Successful in Supporting PCP1st During COVID-19 Pandemic Share Article Case study on how the proactive use of telehealth during the COVID-19 pandemic successfully identifies high-risk patients and improves … customized care for high risk patients and those that require complex care management. They need an approach to safely and rapidly extend care for their patients and help them proactively manage COVID-19. PCP1st deployed …

Cano Health Acquires Primary Care Physicians of Hollywood (PCP); Significantly Expands its Footprint in Florida | PR Newswire | 1/28/2020

… telehealth, transition of care, and high risk & complex care management. Cano Health’s personalized patient care and proactive approach to wellness and preventive care is what sets them apart. For more information visit www.canohealth.com . SOURCE Cano Health, LLC Related Links https://canohealth.com …

Population Health

Tandigm Health Adds to Leadership Team | Business Wire | 7/9/2020

WEST CONSHOHOCKEN, Pa.- Tandigm Health , a leading population health services organization, today announced several additions to its leadership team: Kevin M. Fosnocht, MD, FACP, Vice President of High Value Networks; Doron Schneider, MD, Vice President … Dana Pedrick, RN, joins Tandigm as the Senior Director of Complex Care Management (CCM) . As the senior leader for the CCM Program, Dana will be responsible for advancing the Program’s outcomes and expanding their population …

Tandigm Health Adds to Leadership Team | Business Wire | 7/9/2020

WEST CONSHOHOCKEN, Pa.–(BUSINESS WIRE)–Jul 9, 2020– Tandigm Health , a leading population health services organization, today announced several additions to its leadership team: Kevin M. Fosnocht, MD, FACP, Vice President of High Value Networks … Dana Pedrick, RN, joins Tandigm as the Senior Director of Complex Care Management (CCM) . As the senior leader for the CCM Program, Dana will be responsible for advancing the Program’s outcomes and expanding their population …

Behavioral Health

Care-coordination firm Grand Rounds embraces larger role with Walmart | MedCity News | 10/7/2019

behavioral health needs and other complex medical issues. The program will be available first to Walmart employees in Colorado, Minnesota and Wisconsin. Grand Rounds will be providing a referral network and complex care management as part of the program, Snow said. In addition to its headquarters in San Francisco, Grand Rounds has offices in Reno, Nevada, and Lewiston, Maine. The Maine office, which opened in 2016, has been adding employees …

Carisk Partners Welcomes Eric Wunderlich as Senior Vice President, Sales | Business Wire | 4/26/2019

… He joins Carisk after eight years at Paradigm Outcomes where he was responsible for increasing revenue in the workers’ compensation complex care management business. In his role with Carisk, Wunderlich will be responsible for sales … the company’s expansion efforts,” says Wunderlich. “The suite of managed behavioral health and risk-transfer solutions is most intriguing to me as I fundamentally believe we can positively impact complex workers’ compensation cases being managed …

Health Management

(USA) Chief Medical Officer- CareAllies (A Cigna Company) | 8/30/2019

… consider candidates on a full time remote basis. Travel will be up to 50%. SUMMARY: CareAllies is an innovative population health management services company focused on helping physicians groups and delivery systems navigate the transition … models. Recently, CareAllies welcomed Alegis Care, and innovative, home-based complex care management company into the organization. Today, over 1000 employees strong, CareAllies brings the best of these organizations to market with deep expertise and …

Cano Health Ranks No. 1 on the 2019 Inc. 5000 list as the fastest-growing healthcare Company - and No. 6 overall with three-year revenue growth of 14,000 percent | PR Newswire | 8/27/2019

Health Management Programs including patient-centric programs such as home visits, telehealth, transition of care, and high risk and complex care management. For more information visit www.canohealth.com . More about Inc. and the Inc. 5000 Methodology The 2019 Inc. 5000 is ranked according to percentage revenue growth when comparing 2015 and 2018. To qualify, companies must have been founded and generating revenue by March 31, 2015 . They had to be U.S …

UnitedHealth Group

Director, Complex Care Management - Sugar Land, TX - UnitedHealth Group - Sugar Land, TX | 12/6/2019

… reports. It’s important for this candidate to be located near Houston, Sugarland area. Primary Responsibilities: Responsible for executing disease management, complex care management, and designated required state assessments for the STAR+PLUS, STAR Kids, STAR … your life’s best work. SM Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion …

Market Medical Director CCM North Florida - UnitedHealth Group - FL, FL | 9/14/2019

Share Description Medical Director Careers at UnitedHealth Group (UHG) are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that’s driving the health care … a member of the Senior Leadership Team (SLT) for Optum Complex Care Management (CCM). They will work with the FL SLT to develop and drive the business strategy, growth, and clinical operations and help to …

UnitedHealth

Director, Complex Care Management - Sugar Land, TX - UnitedHealth Group - Sugar Land, TX | 12/6/2019

… reports. It’s important for this candidate to be located near Houston, Sugarland area. Primary Responsibilities: Responsible for executing disease management, complex care management, and designated required state assessments for the STAR+PLUS, STAR Kids, STAR … data sets and making data-driven analytical decisions Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most amazingly talented …

Market Medical Director CCM North Florida - UnitedHealth Group - FL, FL | 9/14/2019

Share Description Medical Director Careers at UnitedHealth Group (UHG) are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that’s driving the health care … a member of the Senior Leadership Team (SLT) for Optum Complex Care Management (CCM). They will work with the FL SLT to develop and drive the business strategy, growth, and clinical operations and help to …

Optum

Market Medical Director CCM North Florida - UnitedHealth Group - FL, FL | 9/14/2019

Optum Complex Care Management (CCM). They will work with the FL SLT to develop and drive the business strategy, growth, and clinical operations and help to ensure that the highest level of quality care is being delivered to the residents of our partner nursing homes. This individual will work collaboratively with the site’s advanced practice clinicians (APCs), and will serve as a clinical resource when needed. As the North Florida …

Actuarial Consultant, Optum Complex Care Management - Eden Prairie, MN - UnitedHealth Group - Eden Prairie, MN | 9/7/2019

… care industry Proficient in Microsoft Office At least a basic level of proficiency with SAS (Statistical Analysis System) and/or SQL (Structured Query Language) Experience in Medicare Advantage and/or Medicaid Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information …

Remedy Partners

Iris Dorbian wrote a new post, New Mountain-backed Signify Health and Remedy Partners to merge, on the site PE Hub | 8/21/2019

New Mountain-backed Signify Health and Remedy Partners to merge August 21, 2019 New Mountain Capital portfolio companies Signify Health and Remedy Partners have agreed to merge. No financial terms were disclosed. The newly combined … clinician and social services networks, the company provides evaluative services, complex care management, social determinants of health, and outcomes-based pharma services in the home and community. With an extensible network of up to 9,000 …

Signify Health and Remedy Partners Merge | 8/21/2019

Remedy Partners , both portfolio companies of New Mountain Capital LLC, have signed a definitive agreement to merge. Signify Health partners with health plans, healthcare providers, and life sciences companies to improve quality of life by providing comprehensive clinical and social care. Via a logistics and clinical workflow technology platform, data set, and national clinician and social services networks, the company provides evaluative services, complex care management, social determinants of health …

Bright Health

Bright Health Completes Acquisition of Brand New Day Health Plan Bringing its Groundbreaking Model to California Seniors | PR Newswire | 5/1/2020

MINNEAPOLIS , May 1, 2020 /PRNewswire/ – Today, Bright Health, a diversified consumer-focused healthcare company, announced it has closed on the acquisition of California -based Universal Care Inc. (d.b.a. Brand New Day ) health plan. This transaction … Davis family to improve health outcomes through an emphasis on complex care management, population health and strong relationships between patients and their primary care physicians. Current leadership, including Jeff and Jay Davis , will join the …

Bright Health to Expand into California through Planned Acquisition of Brand New Day Health Plan | PR Newswire | 1/8/2020

MINNEAPOLIS , Jan. 8, Today, Bright Health, a diversified consumer-focused healthcare company, announced it has signed an agreement to acquire California -based Universal Care (d.b.a. Brand New Day ) health plan. The transaction will combine Brand … Davis family to improve health outcomes through an emphasis on complex care management, population health and strong relationships between patients and their primary care physicians. Current leadership, including Jeff and Jay Davis , will join the …