Guide Healthcare

Call Center Representative

• Provide friendly, accurate, and timely service to Customers (members/patients, providers, and other stakeholders) through inbound and outbound interactions via phone, email, chat, SMS, video calls, co-browser sessions, and other communication channels.
• Actively listen to understand Customers’ needs and concerns and demonstrate empathy and patience.
• Help Customers navigate internal processes and available resources to achieve their desired results.
• Build rapport and establish trust with Customers to create a positive, personalized experience.
• Go above and beyond to exceed Customer expectations and leave a lasting positive impression.
• Protect Customers’ privacy, dignity, and Personal Health Information (PHI) at all times and comply with HIPAA and all applicable laws and regulations.
• Backup and support other departments (i.e., Claims, UM, Intake, Quality, Care Management, Patient Engagement) and perform a variety of other duties as assigned.
• Answer inquiries regarding benefits, claims, eligibility, provider networks, prior authorizations, preventative health promotion, and other healthcare-related topics.
• Research and resolve complex issues, collaborating with other departments as needed (e.g., Claims, Provider Relations, Utilization Management, Intake, Care Management, Quality, etc.).
• Take ownership of Customer issues, following through to ensure complete resolution and satisfaction.
• Proactively identify and escalate recurring issues or trends to management.
• Document all interactions and resolutions accurately and thoroughly in the appropriate systems.
• Educate Customers on plan benefits, policies, and procedures.
• Clearly and concisely explain complex healthcare information in a way that is easy to understand.
• Conduct outbound enrollment outreach, inviting eligible members/patients to join Guidehealth’s care management and care coordination programs.
• Handle inbound calls from prospective enrollees inquiring about Guidehealth’s care management programs, qualifying interest and guiding them through next steps.
• Clearly articulate the value, features, and benefits of our programs in plain, customer-centered language, helping Customers understand how participation supports their health goals.

Medical Contact Center Representative, Inside Sales

• Provide friendly, accurate, and timely service to Customers (members/patients, providers, and other stakeholders) through inbound and outbound interactions via phone, email, chat, SMS, video calls, co-browser sessions, and other communication channels.
• Actively listen to understand Customers’ needs and concerns and demonstrate empathy and patience.
• Help Customers navigate internal processes and available resources to achieve their desired results.
• Build rapport and establish trust with Customers to create a positive, personalized experience.
• Go above and beyond to exceed Customer expectations and leave a lasting positive impression.
• Protect Customers’ privacy, dignity, and Personal Health Information (PHI) at all times and comply with HIPAA and all applicable laws and regulations.
• Backup and support other departments (i.e., Claims, UM, Intake, Quality, Care Management, Patient Engagement) and perform a variety of other duties as assigned.
• Answer inquiries regarding benefits, claims, eligibility, provider networks, prior authorizations, preventative health promotion, and other healthcare-related topics.
• Research and resolve complex issues, collaborating with other departments as needed (e.g., Claims, Provider Relations, Utilization Management, Intake, Care Management, Quality, etc.).
• Take ownership of Customer issues, following through to ensure complete resolution and satisfaction.
• Proactively identify and escalate recurring issues or trends to management.
• Document all interactions and resolutions accurately and thoroughly in the appropriate systems.
• Research and solve Customer issues and reply to Customer inquiries with friendly, accurate, and timely resolutions.
• Educate Customers on plan benefits, policies, and procedures.
• Clearly and concisely explain complex healthcare information in a way that is easy to understand.
• Encourage the use of our self-service portal and effectively teach Customers how to navigate and use our portal and other available resources.
• Conduct outbound enrollment outreach, inviting eligible members/patients to join Guidehealth’s care management and care coordination programs.
• Conduct outbound clinical quality and wellness outreach, including medication refill reminders, blood pressure check-ins, preventive care reminders, gap-in-care closure, and general wellness check-ins.
• Clearly articulate the value, features, and benefits of our programs in plain, customer-centered language, helping Customers understand how participation supports their health goals.

Healthcare Contact Center Representative, Inside Sales

Medical Assistant

• Working primarily remotely, Healthguides will be working with the patient’s medical practice staff and Guidehealth’s Case Management team, to manage a targeted population of patients.
• Functioning independently and being a highly collaborative team member as an extension of medical practice.
• Assisting the patient in achieving better health outcomes by addressing their questions and concerns, connecting them with the medical practice, partnering in implementing high-impact care plans and closing care gaps, escalating medical issues, and navigating them to the right resources including assisting with referrals to specialty care and community-based organizations (CBOs).
• Accurately documenting patients’ medical history and medical issues in the electronic health record (EHR).
• Understanding the referral and prior authorization process.
• Continuously building a trusting, professional, working relationship with assigned medical practices and within the Guidehealth organization.
• Implementing and meeting assigned Key Performance Indicators to produce a positive patient health outcome, while decreasing medical spend.
• Utilize effective communication modalities (calls, texts, portals, emails) to engage and schedule high-risk patients.
• Appropriately escalating medical issues to the Health Guide Registered Nurse, Primary Care Physician Medical practice or Guidehealth leadership.
• Following all security policies and procedures in order to protect all PHI (Protected Health Information) under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.
• Position may require compensated travel as needed (10-15%) to clinical sites in the Atlanta, GA area for patient and provider engagement and conducting retinal eye exams with paid training provided.

Medical Assistant – Healthguide

• As a Healthguide, you will be supported by clinical teams in your strengthening of the connection between the patient and their primary care physician/medical practice staff, as well as improving the patient’s health and well-being.
• The Healthguide engages patients and helps them navigate their care, solve their healthcare issues, and improves communication with their medical practice.
• Working primarily remotely, Healthguides will be working with the patient’s medical practice staff and Guidehealth’s Case Management team, to manage a targeted population of patients.
• Functioning independently and being a highly collaborative team member as an extension of medical practice.
• Assisting the patient in achieving better health outcomes by addressing their questions and concerns, connecting them with the medical practice, partnering in implementing high-impact care plans and closing care gaps, escalating medical issues, and navigating them to the right resources including assisting with referrals to specialty care and community-based organizations (CBOs).
• Accurately documenting patients’ medical history and medical issues in the electronic health record (EHR).
• Understanding the referral and prior authorization process.
• Continuously building a trusting, professional, working relationship with assigned medical practices and within the Guidehealth organization.
• Implementing and meeting assigned Key Performance Indicators to produce a positive patient health outcome, while decreasing medical spend.
• Utilize effective communication modalities (calls, texts, portals, emails) to engage and schedule high-risk patients.
• Appropriately escalating medical issues to the Health Guide Registered Nurse, Primary Care Physician Medical practice or Guidehealth leadership.
• Following all security policies and procedures in order to protect all PHI (Protected Health Information) under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.
• Position may require compensated travel as needed (10-15%) to clinical sites in the Atlanta, GA area for patient and provider engagement and conducting retinal eye exams with paid training provided.

Recruitment

• Own full-cycle recruitment for a broad range of clinical and non-clinical roles, from creative talent pipeline development and sourcing through interview coordination, offer negotiation, offer acceptance, pre-boarding and onboarding.
• Quickly build a strong understanding of Guidehealth’s business, operating model, workforce needs, and People processes to develop and execute effective, role-aligned recruiting strategies.
• Partner closely with hiring managers, clinical leaders, and business stakeholders to define candidate profiles, align on hiring priorities, and execute search plans that support business goals.
• Develop and execute creative, investigative, and data-informed sourcing strategies using LinkedIn, job boards, referrals, networking, market outreach, and talent communities.
• Deliver a high-touch, empathy-driven candidate experience that reflects Guidehealth’s patient-centered mission and values, clinical culture, and commitment to people at every touchpoint before and after hire, including regular new-hire check-ins to support a strong onboarding transition.
• Manage pre-boarding activities for hired candidates, including background checks, credential verification, licensure review, and pre-hire documentation, while ensuring strict adherence to employment law, healthcare credentialing regulations, state licensure requirements, and internal compliance standards.
• Proactively identify, escalate, and resolve compliance gaps, hiring risks, bottlenecks, and candidate experience concerns, while maintaining meticulous documentation to support audit readiness and to reduce liability.
• Apply a healthcare-informed lens to candidate assessment, using structured interviews, behavioral-based questions, assessment tools, and sound judgment to evaluate technical capability, interpersonal warmth, ethical grounding, patient-first values, and long-term fit consistently and equitably.
• Perform AI-assisted sourcing, screening, scheduling, and leverage assessment tools with accountability for data integrity, candidate equity, process transparency, and human oversight in consequential hiring decisions.
• Utilize applicant tracking systems, assessment tools, reporting platforms, and recruiting technologies to support efficient workflows, while tracking and analyzing recruiting metrics, market insights, and hiring outcomes to drive continuous improvement.
• Educate hiring managers on staffing best practices, structured, behavioral interviewing, candidate assessment, and equitable hiring practices.
• Navigate ambiguity, rapid organizational change, and shifting priorities with resilience, professionalism, and accountability, modeling change agility and a high standard of excellence for hiring partners and team members.
• Collaborate with People Operations and business leaders to support seamless hiring and onboarding, identify internal talent for new or evolving roles, contribute to employer branding and hiring manager capability building, and support broader Talent Acquisition and People Team initiatives as needed.
• Promote Guidehealth’s mission, values, and culture to candidates and external partners, and contribute to reducing regrettable early turnover through strong assessment, onboarding alignment, and hiring quality.

Talent Acquisition Specialist

Talent Acquisition Specialist, Talent Integration

Talent Acquisition and Integration Specialist

IT Support

• Conducting Medicare Annual Wellness Visits via telehealth in accordance with CMS guidelines, ensuring all required assessments and screenings are completed.
• Virtually reviewing and updating patient medical histories, including medication lists, immunization records, and family history.
• Assessing patients’ current health status, including vital signs when available, cognitive function, and risk factors for chronic diseases, utilizing remote monitoring tools when applicable.
• Providing patient education on preventive measures, lifestyle changes, and available community resources to promote overall health and well-being through virtual consultations.
• Developing and updating personalized prevention plans based on individual patient needs and physician guidance.
• Collaborating with the supervising physician to ensure accurate documentation and follow-up on any identified health concerns using electronic health record systems.
• Identifying any HCC codes requiring recapture reporting to CMS.
• Maintaining comprehensive and accurate patient records in compliance with HIPAA and organizational standards, particularly in a remote environment.
• Facilitating virtual referrals to appropriate healthcare services and specialists as needed.
• Monitoring patient progress and adherence to personalized prevention plans, providing support and making adjustments as necessary through telehealth follow-ups.
• Staying current on Medicare guidelines, telehealth best practices, preventive care practices, and chronic disease management strategies.
• Participating in virtual team meetings, training sessions, and continuing education to maintain and enhance clinical skills.

Registered Nurse, Telehealth Medicare Annual Wellness Visit Specialist

Registered Nurse – Telehealth Medicare Annual Wellness Visit Specialist – PRN

Pharmacist

• Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures.
• Analyze medication adherence data, identify gaps in care, and implement targeted interventions to improve adherence rates.
• Collaborate with healthcare providers, care managers, and other stakeholders to develop and implement strategies that promote adherence to prescribed therapies.
• Conduct medication therapy management (MTM) sessions to address barriers to adherence, provide patient education, and ensure understanding of medication regimens.
• Work directly with patients to identify and resolve issues related to medication adherence.
• Utilize motivational interviewing techniques to encourage patients to adhere to their prescribed medication regimens.
• Monitor and track HEDIS performance metrics, generating reports to assess the effectiveness of interventions and programs.
• Use electronic health records (EHR) and pharmacy data to identify patients at risk of non-adherence and develop action plans.
• Serve as a medication adherence subject matter expert (SME) within the organization.

Clinical Pharmacist – HEDIS Medication Adherence

• Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures, including but not limited to adherence to antihypertensive, cholesterol-lowering, and diabetes medications.
• Analyze medication adherence data, identify gaps in care, and implement targeted interventions to improve adherence rates.
• Collaborate with healthcare providers, care managers, and other stakeholders to develop and implement strategies that promote adherence to prescribed therapies.
• Conduct medication therapy management (MTM) sessions to address barriers to adherence, provide patient education, and ensure understanding of medication regimens.
• Work directly with patients to identify and resolve issues related to medication adherence, including cost, side effects, and complex dosing schedules.
• Utilize motivational interviewing techniques to encourage patients to adhere to their prescribed medication regimens.
• Monitor and track HEDIS performance metrics, generating reports to assess the effectiveness of interventions and programs.
• Use electronic health records (EHR) and pharmacy data to identify patients at risk of non-adherence and develop action plans.
• Provide regular updates to leadership on progress towards HEDIS goals and make recommendations for improvement.
• Serve as a medication adherence subject matter expert (SME) within the organization.
• Provide training and support to other pharmacists, care managers, and clinical staff on best practices in medication adherence.
• Participate in cross-functional teams focused on quality improvement, population health management, and value-based care initiatives.

• Lead efforts to improve HEDIS medication adherence and other pharmacy quality measures, including but not limited to adherence to antihypertensive, cholesterol-lowering, and diabetes medications.
• Analyze medication adherence data, identify gaps in care, and implement targeted interventions to improve adherence rates.
• Collaborate with healthcare providers, care managers, and other stakeholders to develop and implement strategies that promote adherence to prescribed therapies.
• Conduct medication therapy management (MTM) sessions to address barriers to adherence, provide patient education, and ensure understanding of medication regimens.
• Work directly with patients to identify and resolve issues related to medication adherence, including cost, side effects, and complex dosing schedules.
• Utilize motivational interviewing techniques to encourage patients to adhere to their prescribed medication regimens.
• Monitor and track HEDIS performance metrics, generating reports to assess the effectiveness of interventions and programs.
• Use electronic health records (EHR) and pharmacy data to identify patients at risk of non-adherence and develop action plans.
• Provide regular updates to leadership on progress towards HEDIS goals and make recommendations for improvement.
• Serve as a medication adherence subject matter expert (SME) within the organization.
• Provide training and support to other pharmacists, care managers, and clinical staff on best practices in medication adherence.