Clinical Care Navigator, After Hours Job at Spring Health

Nurse Practitioner, Transitional Care

The Advanced Practice Provider, Transitions delivers high-touch, high-quality ca...

Location

United States , Indianapolis

Salary:

Not provided

CVS Health

Expiration Date

July 21, 2026

Requirements

Have an active, non-probationary state medical license, including US work authorization, if applicable
1+ years APN experience, preferably with a Medicare population
Experience in home-based care (as RN or APP) preferred
Flexibility to travel throughout service area
Electronic Medical Record experience
Computer skills: Ability to quickly navigate and use multiple computer programs to include, but not limited to: Gmail, MS Word or Google Docs, Excel or Google Sheets, etc.
Additional language proficiency in Spanish, Polish, Russian, or other languages spoken within the communities we serve preferred but not required

Job Responsibility

Provide post-discharge support according to defined pathways within the patient's home
Develop care plans and individualize goals of care with patient, their families, and their providers
Optimize and monitor clinical status, identify and address gaps in care, reconcile medications and address adherence challenges
Collaborate with Transitional Care Managers, home health, social workers, hospitals, SNFs, and specialists
Structure and prioritize scheduling based on clinical complexity for both new and routine patients
Recognize, diagnose, and manage both acute and chronic medical conditions in order to prevent destabilization and readmissions
Provide after-hours and weekend call support, shared with other in-state providers
Facilitate and conduct goals of care and advance care planning discussions with patients and families
Assess and evaluate family/caregiver needs and limitations
Teach patients, caregivers, and others about their health conditions

What we offer

Mission-focused career impacting change and measurably improving health outcomes for Medicare patients
Paid vacation, sick time, and investment/retirement 401K match options
Health insurance, vision, and dental benefits
Opportunities for leadership development and continuing education stipends
New centers and flexible work environments
Opportunities for high levels of responsibility and rapid advancement
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules

Fulltime

Transitional Care Advanced Practice Provider (APP)

The Advanced Practice Provider, Transitions delivers high-touch, high-quality ca...

Location

United States , St. Louis, MO

Salary:

78000.00 - 168714.00 USD / Year

CVS Health

Expiration Date

March 16, 2026

Requirements

Have an active, non-probationary state medical license, including US work authorization, if applicable
1+ years APN experience, preferably with a Medicare population
Experience in home-based care (as RN or APP) preferred
Flexibility to travel throughout service area
Electronic Medical Record experience
Computer skills: Ability to quickly navigate and use multiple computer programs to include, but not limited to: Gmail, MS Word or Google Docs, Excel or Google Sheets, etc.
Additional language proficiency in Spanish, Polish, Russian, or other languages spoken within the communities we serve preferred but not required

Job Responsibility

Provide post-discharge support according to defined pathways within the patient's home
Develop care plans and individualize goals of care with patient, their families, and their providers
Optimize and monitor clinical status, identify and address gaps in care, reconcile medications and address adherence challenges
Collaborate with Transitional Care Managers, home health, social workers, hospitals, SNFs, and specialists
Structure and prioritize scheduling based on clinical complexity for both new and routine patients
Recognize, diagnose, and manage both acute and chronic medical conditions in order to prevent destabilization and readmissions
Provide after-hours and weekend call support, shared with other in state providers
Facilitate and conduct goals of care and advance care planning discussions with patients and families
Assess and evaluate family / caregiver needs and limitations
Teach patients, caregivers, and others about their health conditions

What we offer

Mission-focused career impacting change and measurably improving health outcomes for Medicare patients
Paid vacation, sick time, and investment/retirement 401K match options
Health insurance, vision, and dental benefits
Opportunities for leadership development and continuing education stipends
New centers and flexible work environments
Opportunities for high levels of responsibility and rapid advancement

Fulltime

New

Clinical Care Navigator - After Hours

Our mission: to eliminate every barrier to mental health. At Spring Health, we’r...

Location

United States

Salary:

33.33 - 42.31 USD / Hour

Spring Health

Expiration Date

Until further notice

Requirements

LCSW, LMFT, LPC, or licensed psychologist
Minimum of 2+ years of direct clinical care experience
Crisis assessment and safety planning experience required
Knowledge of crisis support, CBT, motivational Interviewing, mindfulness, and solution-focused clinical interventions
Excellent listening, written and verbal communication skills
Acknowledge and embrace diversity and inclusion
Motivated to go above and beyond for members to provide a high-touch experience
Tech-savvy: must be comfortable using various computer platforms and learning new systems, and efficient in tech-related tasks
Able to multi-task and context switch

Job Responsibility

Provide in-the-moment clinical support, psycho education, and connection to appropriate referrals and resources while answering calls on a clinical phone queue
Utilize skills such as active listening, motivational interviewing, and solution-focused approaches to collaboratively engage with members seeking help with mental health, substance use, or family/relationship concerns
Assess for risks and provide crisis support, safety planning, and follow up with high risk members to ensure safety and timely connection to care
Recommend a plan of action based on clinical presentation and coordinate connection to appropriate care and services (Spring Health therapists, coaches, physicians, or external resources)
Use effective written skills to complete professional documentation and to interact with members and providers through email
Follow care management outreach protocols and utilize good clinical judgment to identify and problem-solve barriers or disruptions to care
Promote effective care by coordinating closely with Spring Health care providers and the Provider Operations team
Interact and problem-solve with multi-disciplinary teams such as Care Support, Benefits/Billing, and Product to ensure a smooth member experience
Participate in staff meetings, case consultations, and trainings
Assist with onboarding and mentoring new team members

What we offer

stock options and benefits

Fulltime

New

Clinical Care Navigator

Our mission: to eliminate every barrier to mental health. At Spring Health, we’r...

Location

Salary:

33.33 - 42.31 USD / Hour

Spring Health

Expiration Date

Until further notice

Requirements

LCSW, LMFT, LPC, or licensed psychologist
Minimum of 2+ years of direct clinical care experience
Expertise in crisis assessment and safety planning
Knowledge of crisis support, CBT, motivational Interviewing, mindfulness, and solution-focused clinical interventions
Fully engaged and free from interruptions for the duration of shift
Excellent listening, written and verbal communication skills
Approach all interactions with cultural awareness, empathy, and respect for individual identities
Motivated to go above and beyond for members to provide a high-touch experience
Tech-savvy: must be comfortable using various computer platforms and learning new systems, and efficient in tech-related tasks
Able to multi-task and context switch

Job Responsibility

Provide in-the-moment clinical support, psycho education, and connection to appropriate referrals and resources on a clinical phone queue
Utilize skills such as active listening, motivational interviewing, and solution-focused approaches to collaboratively engage with members seeking help with mental health, substance use, or family/relationship concerns
Assess for risks and provide crisis support, safety planning, and follow up with high risk members to ensure safety and timely connection to care
Recommend a plan of action based on clinical presentation and coordinate connection to appropriate care and services (Spring Health therapists, coaches, physicians, or external resources)
Provide after hours support to members and leaders seeking services or connection to the Global team, Management Consultation team, and Spring Internal team
Use effective written skills to complete professional documentation and to interact with members and providers through email
Follow care management outreach protocols and utilize good clinical judgment to identify and problem-solve barriers or disruptions to care
Promote effective care by coordinating closely with Spring Health care providers and the Provider Operations team
Interact and problem-solve with multi-disciplinary teams such as Care Support, Benefits/Billing, and Product to ensure a smooth member experience
Participate in staff meetings, case consultations, and trainings

What we offer

Health, Dental, Vision benefits start on your first day
Access to One Medical accounts
HSA and FSA plans available, with Spring contributing up to $1K for HSAs
Employer sponsored 401(k) match of up to 2%
A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents
Competitive paid time off policies including vacation, sick leave and company holidays
At 6 months tenure, parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents
Access to Noom, a weight management program
Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses
Access to Wellhub for fitness, mindfulness, nutrition, and sleep

Fulltime

Rare Condition Manager

To support high-quality, cost-effective care by coordinating services for member...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
Associate’s Degree in general field of study or Post High School Nursing Diploma
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
Intermediate PC proficiency
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
Intermediate skill in word processing, spreadsheet, and database software
Maintain confidentiality and privacy
Advanced and current clinical knowledge
Practice interpersonal and active listening skills to achieve customer satisfaction
Interpret and translate policies, procedures, programs, and guidelines

Job Responsibility

Perform assessments, condition management education, training, and other clinically-based activities to coordinate care among providers, members, and family to implement the care plan
Make and answer a diverse and high volume of condition management-related member calls on a daily basis
Identify holistic member needs considering whole-person health, to include condition-specific needs, behavioral health needs, and social drivers of health needs
Analyze medical records, claims data, and other information sources
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, BCBSAZ programs, provider networks, etc
Present status reports on cases to the manager/supervisor and, when indicated, to the medical director
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
Maintain complete and accurate records per department policy

Fulltime

Medical Appeals/Grievance Specialist II - Registered Nurse

Responsible for utilizing clinical acumen and managed care expertise related to ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

1 year experience in clinical and health insurance or other healthcare related field
3 years experience in clinical and health insurance or other healthcare related field AND 1 year Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
5 years experience in clinical and health insurance or other healthcare related field AND 2 years Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
8 years experience in clinical and health insurance or other healthcare related field AND 3 years above satisfactory job performance in the managed care environment with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
Associate’s Degree in a healthcare field of study or Nursing Diploma
Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) or a compact state as a Registered Nurse (RN), a Physical Therapist (PT) or a Licensed Master Social Worker LMSW.
Intermediate PC proficiency
Intermediate skill using office equipment, including copiers, fax machines, scanner and telephones
Maintain confidentiality and privacy
Advanced clinical knowledge

Job Responsibility

Perform in-depth analysis, clinical review and resolution of provider appeals/inquiries, corrected claims and subscriber reconsiderations, member appeals, corrected claims and provider grievances for all lines of business
Identify, research, process, resolve and respond to customer inquiries primarily through written / verbal communication.
Respond to a diverse and high volume of health insurance appeal related correspondence on a daily basis.
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of appeal, grievance and reconsideration requests.
Maintain complete and accurate records per department policy.
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
Demonstrate ability to apply plan policies and procedures effectively.
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
Attend staff and interdepartmental meetings.
Participate in continuing education and current developments in the fields of medicine and managed care.

Fulltime

Patient Engagement Coordinator

Allara is seeking an enthusiastic and engaging Patient Engagement Coordinator to...

Location

United States

Salary:

20.00 USD / Hour

Allara Health

Expiration Date

Until further notice

Requirements

1+ years of experience in a patient coordination, care management, or care navigation role
Strong verbal and written communication skills, with the ability to build rapport and navigate complex conversations
Ability to problem-solve creatively, ensuring smooth coordination of patient requests
Strong technical skills, comfortable navigating multiple systems, and working with sensitive data
A quiet, private workspace with reliable internet to support confidential patient communications
Ability to dedicate 30 weekly hours

Job Responsibility

Engage patients in Allara care programs through omnichannel inbound and outbound campaigns (phone, SMS, and live video call)
Provide empathetic, patient-centric support via phone, email, and in-app messaging, ensuring timely and accurate responses
Assist patients with scheduling, telehealth services, and general inquiries about their care plans and Allara’s offerings
Offer personalized assistance, helping patients navigate their healthcare journey with compassion and professionalism
Ensure accuracy in relaying patient information between providers, patients, and internal teams
Stay informed about Allara’s clinical and operational workflows and processes to provide seamless patient support

What we offer

A collaborative, mission-driven culture focused on improving patient care

Parttime

Transitional Care Advanced Practice Provider

The Advanced Practice Provider, Transitions delivers high-touch, high-quality ca...

Location

United States , Rockford

Salary:

87035.00 - 206206.00 USD / Year

CVS Health

Expiration Date

May 16, 2026

Requirements

Genuine passion for reaching vulnerable patients
strong clinical skills focused on older adults with complex disease states
comfort navigating visits in patient homes
demonstrated ability to collaborate effectively in a team setting
willingness to learn and be accountable for visit documentation and workflows
excellent communication, follow-up, teamwork, and problem-solving skills
desire to be a part of a fast-paced, innovative, quality-driven organization
have an active, non-probationary state medical license, including US work authorization
1+ years APN experience, preferably with a Medicare population
experience in home-based care (as RN or APP) preferred

Job Responsibility

Provide post-discharge support according to defined pathways within the patient's home
develop care plans and individualize goals of care with patient, their families, and their providers
optimize and monitor clinical status, identify and address gaps in care, reconcile medications and address adherence challenges
collaborate with transitional care managers, home health, social workers, hospitals, SNFs, and specialists
structure and prioritize scheduling based on clinical complexity for both new and routine patients
recognize, diagnose, and manage both acute and chronic medical conditions in order to prevent destabilization and readmissions
provide after-hours and weekend call support, shared with other in-state providers
facilitate and conduct goals of care and advance care planning discussions with patients and families
assess and evaluate family/caregiver needs and limitations
teach patients, caregivers, and others about their health conditions

What we offer

Mission-focused career impacting change and measurably improving health outcomes for Medicare patients
paid vacation, sick time, and investment/retirement 401K match options
health insurance, vision, and dental benefits
opportunities for leadership development and continuing education stipends
new centers and flexible work environments
opportunities for high levels of responsibility and rapid advancement
affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
no-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
benefit solutions that address the different needs and preferences of colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Fulltime

Clinical Care Navigator, After Hours

Spring Health

Location:
United States

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 18, 2026

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