WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAt Guidehealth, we’re reimagining how healthcare works — making great care affordable, accessible, and equitable through data-driven insights and human-centered design. As Senior Director of Financial Reporting, you’ll be leading the accuracy, integrity, and scalability of our financial reporting as we continue growing and innovating.
What You’ll Be Doing
Overseeing all accounting and financial reporting functions to ensure accuracy, compliance, and insight.Partnering with the CFO and VP of Finance & Accounting to be delivering transparent and actionable reporting.Leading monthly, quarterly, and annual close processes while ensuring GAAP compliance.Building scalable systems, policies, and internal controls that support growth and audit readiness.Driving continuous improvement through automation and process enhancement.Interpreting complex accounting standards and implementing clear, consistent policies.Mentoring and developing accounting staff while fostering collaboration and accountability.Collaborating cross-functionally with Finance, Operations, and Technology to ensure data integrity and system alignment.Serving as the primary liaison with external auditors and ensuring audit readiness throughout the year.Coordinating with tax partners to ensure accurate and timely filings and compliance.QualificationsWHAT YOU'LL NEED FOR SUCCESS
CPA required; Bachelor’s in Accounting, Finance, or related field.10–15 years of progressive accounting and reporting experience spanning public accounting (Big 4 or mid-tier) and private industry.Deep knowledge of U.S. GAAP, internal controls, and financial statement preparation.Proven success leading consolidated reporting in multi-entity or growth-stage organizations.Experience implementing and optimizing ERP and reporting systems.Advanced Excel and data analysis skills with strong communication and presentation ability.Prior experience in healthcare, health services, or payer/provider environments strongly preferred.Demonstrating leadership, ownership, and a hands-on approach to improving financial processes.The salary range for this position is between $170,000.00 and $178,000.00 based upon experience and skillset.
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job DescriptionAs a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals.
This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCQA standard, and company policies and procedures. This position is part of the Value Based Care Services team.
WHAT YOU’LL BE DOING
Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. QualificationsWHAT YOU'LL NEED TO HAVE
Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings.Highly experienced in Case Management and Chronic Condition Management.Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience.Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing.Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages.WHAT WE'D LOVE FOR YOU TO HAVE
Certification in Case Management preferred but not requiredThe salary range for this role is between $80,000.00 and $85,000.00
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test here to confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Job DescriptionAs outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs.
WHAT YOU’LL BE DOING
Work in a fully remote environment and virtually engage with company and team in your daily work.Subject Matter Expert (SME) on entire scope of Medicare Advantage STAR measures, services, customers and quality initiatives under various commercial and governmental payers.Conduct proactive patient outreach initiatives to identify and address quality gaps, engaging with patients to educate them on preventive care measures, schedule necessary screenings or appointments, and facilitate adherence to treatment plans and medications, thereby contributing to improved health outcomes and closing quality gapsCollect quality data using various methods of data sourcing-EMR, claims, provider / patient outreach.Manage daily work using multiple systems and applications-EMR systems, payer portals, vendor platforms, Guidehealth applications, Microsoft 365 for Excel, Word and PowerPoint, Microsoft Outlook and Teams for messaging and meetings.Work with patient lists, gap lists, sourced health data and medical records in your daily work.Leverage all quality related resources to ensure accuracy and completeness of work-measure/project instructions, NCQA/HEDIS® specifications, coding documents, quick reference guides.Prioritize daily work to meet various quality reporting deadlines and requirements.Communicate quality performances, barriers and improvement strategies both internally and with customers.Follow all established policies and procedures for various QI workflows to ensure overall success.Collaborate w/ customers, payers, co-workers to accomplish daily work.Participate in all departmental and payer sponsored webinars/trainings/support calls throughout the year.Communicate professionally and develop positive relationships with co-workers, customers, providers and providers’ support staff.Qualifications
WHAT YOU'LL NEED TO HAVE
Associate degree or greater in related fieldMinimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction via EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding.Minimum 2 years’ experience in Medicare Advantage Quality data abstraction and patient outreachTech savvy in managing the technical side of this position-working with health data, working in excel and PowerPoint, navigating multiple systems and applications.Highly skilled in verbal and written communications.Strong attention to detail, organized and ability to meet hard deadlines.Ability to collaborate w/ others and work effectively with management, co-workers, and customers.WOULD LOVE FOR YOU TO HAVE
Certified/licensed professional-CMA, LPNKnowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers.Extensive experience with quality database entries and reporting.Experience in interpreting and reporting quality information, as well as training staff.Proficiency in Electronic Medical Record (EMR) software and cloud platformSThe base pay range for this role is between $28-$30 per hour paid bi-weekly
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.
We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test here to confirm your internet connection meets these requirements.
