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Job DescriptionCompany Description 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 Description As 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. Qualifications WHAT YOU'LL NEED TO HAVE • Current and active IL Registered Nurse License. Temporary licenses or licenses that are under consideration with the Board of Nursing are not acceptable. (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., • Certification in Case Management preferred but not required Additional Information The salary range for this role is between $80,000.00 and $83,500 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. 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. 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.

Job Description UNITE HERE HEALTH serves over 200,000 workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Director of Care Navigation & Medical Cost Management leads a multidisciplinary team of Navigators focused on improving member outcomes and reducing healthcare costs. This role drives strategic initiatives that address high-cost conditions (including diabetes and end-stage renal disease), reduce emergency room utilization, and enhance care coordination across the network. The Director collaborates with internal departments, providers, vendors, and health centers to implement data-driven, member-centered programs that support value-based care and health equity. ESSENTIAL JOB FUNCTIONS AND DUTIES • Lead and manage Health Navigator and Nurse Navigator teams to ensure effective care coordination and cost mitigation strategies., • Develop and oversee programs targeting high-cost members, providers, and chronic conditions, with a focus on diabetes and ESRD., • Collaborate with utilization management (UM) vendors and internal teams to optimize site-of-care decisions and prior authorization protocols., • Partner with Claims, Analytics, and Healthcare Delivery teams to analyze medical and pharmacy claims data and identify actionable cost drivers., • Support network management efforts by guiding members to in-network providers and reducing unnecessary emergency room visits., • Work with health centers, providers, and community organizations to promote coordinated care and reduce healthcare disparities., • Monitor program effectiveness through ROI metrics, member outcomes, and cost trend analyses., • Ensure compliance with HIPAA, payer guidelines, and internal policies., • Provide strategic input on benefit design and policy development based on cost and utilization trends., • Communicate program goals, outcomes, and opportunities to executive leadership and key stakeholders., • Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints, • Supervises, leads, and delegates work and coaches, mentors, develops employees, • Analyzes problems, identifies, and develops alternative solutions, projects consequences of proposed actions, and implements recommendation/solutions, • Recommends hires and promotions, directs, and evaluates employment decisions for all assigned positions, • Assists with developing and coordinating policies and procedures, • Responsible for the oversight of continued employee training requirements, safety, and quality initiatives ESSENTIAL QUALIFICATIONS • 7 ~ 10 years of SELECT DIRECT OR RELATED experience minimum, • Bachelor’s Degree in Nursing (BSN) required; Master’s Degree in Healthcare Administration (MHA), Public Health (MPH), or Business Administration (MBA) preferred., • Active Registered Nurse (RN) license required, • Minimum of 7 years of experience in medical cost management, care coordination, or utilization management., • Strong knowledge of managed care principles, value-based care, and healthcare cost-containment strategies., • Understanding of self-funded health plans., • Experience with chronic disease management programs, especially diabetes and ESRD., • Proficiency in healthcare analytics platforms and data interpretation., • Excellent leadership, communication, and strategic planning skills., • Familiarity with EHR systems, payer platforms, and UM software., • Experience working with union populations or in a labor health fund environment is a plus., • Bilingual language skills preferred., • Remote position with occasional travel for provider meetings, member outreach, and strategic planning sessions. Salary range for this position: Salary $156,600 - $195,900. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule (may vary to meet business needs): Monday thru Friday, 7.5 hours per day (37.5 hours per week) as a flexible hybrid employee. We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #LI-HYBRID

Data Entry Clerk - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Data Entry Clerk experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • High school diploma or it’s equivalent, • $75-$150 (per 1 hour session) If you are a data entry clerk, admin assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call centre employee or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.

Administrative Assistant - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Administrative Assistant experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • $75-$150 (per 1 hour session) If you are a data entry clerk, administrative assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call centre employee or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.

Data Entry Clerk - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Data Entry Clerk experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • High school diploma or it’s equivalent, • $75-$150 (per 1 hour session) If you are a data entry clerk, admin assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call centre employee or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.

Data Entry Clerk - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Data Entry Clerk experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • High school diploma or it’s equivalent, • $75-$150 (per 1 hour session) If you are a data entry clerk, admin assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call centre employee or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.

Data Entry Clerk - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Data Entry Clerk experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • High school diploma or it’s equivalent, • $75-$150 (per 1 hour session) If you are a data entry clerk, admin assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call centre employee or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.

Data Entry Clerk - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Data Entry Clerk experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • High school diploma or it’s equivalent, • $75-$150 (per 1 hour session) If you are a data entry clerk, admin assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call centre employee or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.

Call Center Representative Agent - Remote Work From Home Focus Group Panelist - Full Time / Part Time Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. We need participants on the following topics: • Child Related (individuals with children 18 yrs or younger), • Cell Phones (Apple, Android, or Windows...Prepaid or Contract), • Entertainment (TV shows, movies, and video games), • Food (If you buy fast food, casual dining, or upscale dining), • Sports (Casual viewers and die-hard fans), • Electronics (Tell us which devices you prefer and why), • Pets (Animal lovers needed! Dogs, cats, and other pets), • Automobiles (Do you own, make payments, or lease your vehicle?), • Show up at least 10 minutes prior to discussion start time., • Participate by completing written and oral instructions., • Complete written survey provided for each panel., • MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to meeting date., • Must have either a smart phone with working camera or webcam on desktop/laptop., • Must have access to a reliable internet connection, • Desire to fully participate in one or several of the above topics, • Ability to read, understand, and follow oral and written instructions., • Call Center Representative Agent experience is not necessary but helpful, • Flexibility to take part in discussions online or in-person., • No commute needed if you choose to work from home., • No minimum hours. You can do this part-time or full-time, • Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products., • You get to review and use new products or services before they are launched to the public., • $75-$150 (per 1 hour session) If you are a data entry clerk, administrative assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse, call center representative, call center agent or anyone who is looking for a flexible part time remote work from home job, this is a great position to supplement your income.