Role Description You love helping women feel confident and supported during pregnancy, especially when navigating challenges like gestational diabetes. You just don’t love doing it all alone. If you’ve ever run or dreamed of running your own private practice, you know what it takes. The marketing, the scheduling, the billing, the insurance headaches, the empty calendar days, the tech issues, and the isolation. At Simplex Health, you get the best parts of private practice, including autonomy, flexibility, and deep one-on-one relationships with patients, without the burnout or business stress. Here, you get to focus on what you do best: helping women through pregnancy, gestational diabetes (GDM), and hormone-related conditions using an integrative and functional nutrition approach. Qualifications - Passionate about women’s health, pregnancy, and gestational diabetes (GDM) - Integrative and functional nutrition approach to care - Thrive in a collaborative, growth-minded environment - At least 2 years of experience in outpatient or clinical care - Experience or strong interest in prenatal nutrition, GDM, or hormone-related conditions - Current registration with CDR - Minimum of 15 hours of weekly availability required, with flexibility and opportunity to increase hours over time - Credentialed or open to being credentialed with insurance companies - No active private practice or independent nutrition counseling business to avoid conflicts of interest Requirements - Availability for evening appointments strongly preferred - CDCES (Certified Diabetes Care and Education Specialist) strongly preferred - IFNA Certified (IFNCP credential a plus); candidates actively enrolled in IFNA training welcome - Prior experience supporting pregnant patients or managing gestational diabetes - PA license and completion of major insurance credentialing required before start Role Responsibilities - Provide telehealth medical nutrition therapy using a functional and integrative approach, focusing on pregnancy and gestational diabetes (GDM) - Assess nutritional health of patients/clients with attention to prenatal needs, blood sugar regulation, and hormone-related conditions - Monitor and review daily blood glucose logs for GDM patients, providing timely feedback, adjustments, and ongoing support - Educate and train patients on proper use of glucose meters and blood sugar monitoring techniques - Develop and modify individualized nutrition care plans, focusing on glycemic control during pregnancy - Coordinate care and communicate effectively with referring physicians and healthcare providers - Implement Simplex Health protocols and materials in patient care - Document all new and follow-up appointments in the Healthie platform with strong attention to detail - Respond to all patient communications in a timely and supportive manner - Communicate openly and effectively to resolve work-related issues or conflicts - Proactively contribute to team collaboration and support team decisions and outcomes - Adhere to all company policies and procedures - Stay current and forward-thinking with emerging research in women’s health, prenatal nutrition, and diabetes care - Manage a full and consistent patient caseload, ensuring timely follow-ups, continuity of care, and optimal patient outcomes - Maintain a minimum of 15 hours of weekly availability, with opportunity to grow into a higher-hour or full-time schedule Benefits - Flexible Scheduling: Set your availability with the ability to build and adjust your schedule based on your preferences and patient demand - Supplement Commissions: Earn 12.5% of MSRP on supplements purchased through Fullscript - 401(k) (after 90 days) - Discretionary Holiday Break: Office closed between Christmas and New Year’s - Fitness Allowance: Partial reimbursement for gym memberships, fitness classes, or wellness activities - Simplex Wellness on Demand: Free access to virtual fitness programs Key Intangible Characteristics of the Ideal Candidate - Called: A passion for our mission and a sense that this role and company are a strong fit for your gifts, talents, passions, and experiences. - Servant Leadership: A commitment to serving others, both internal and external customers. - Learning and Adaptive: An appetite for learning and skill improvement in a startup environment. - Grit, Resourcefulness & Entrepreneurial Spirit: Ability to be resourceful and resilient in overcoming challenges. - Organizational Skills: Capacity for being open to change and discerning better processes. - Chemistry Fit: Ability to fit into a unique and fun culture. - High Character: Integrity, honesty, compassion, and diligence are essential. - Energy & Enthusiasm: Bringing joy and passion for work to the job. - Multitasking: Ability to juggle and adjust in a dynamic environment. - Project Management: Keeping an eye on deadlines and critical dependencies. Company Description If you’ve ever wished you could combine the freedom of private practice with the camaraderie and stability of a larger organization, this is where you belong. Apply today and rediscover the joy of patient care without the grind of running a business.

Role Description You love helping people heal. You just don’t love doing it all alone. If you’ve ever run (or dreamed of running) your own private practice, you know what it takes — the marketing, the scheduling, the billing, the insurance headaches, the empty calendar days, the tech issues, the isolation… At Simplex Health, you get the best parts of private practice — the autonomy, the flexibility, the deep 1:1 relationships with patients — without the burnout or business stress. Here, you get to focus on what you do best: helping patients transform their health through integrative and functional nutrition. Qualifications - Passionate about integrative and functional nutrition - Thrive in a collaborative, growth-minded environment - At least 2 years of experience in outpatient or clinical care - Hold active certification as a Certified Nutrition Specialist (CNS) or Registered Dietitian (RD/RDN) - Credentialed or open to being credentialed with insurance companies - Minimum of 12 hours of weekly availability required, with flexibility and opportunity to increase hours over time based on preferences and schedule - Desire to spend more time with patients and less time running a business Requirements - Availability for evening appointments strongly preferred to meet patient demand - CDCES (Certified Diabetes Care and Education Specialist) strongly preferred - IFNA Certified (IFNCP credential a plus); candidates actively enrolled in IFNA training welcome - PA license and completion of major insurance credentialing required before start; this process may take 3–6 months Role Responsibilities - Provide telehealth medical nutrition therapy using a functional and integrative approach - Implement Simplex Health protocols, tools, and educational materials in patient care - Assess the nutritional health of patients/clients and develop personalized, root-cause care plans - Create and modify individualized nutrition interventions based on patient needs and goals - Document all new and follow-up appointments in the Healthie platform with strong attention to detail - Respond to patient communications in a timely, professional, and supportive manner - Collaborate with team members through case discussions, meetings, and shared learning opportunities - Communicate openly and effectively to resolve work-related issues and support team outcomes - Contribute to a positive, collaborative team environment and ongoing clinical initiatives - Adhere to all company policies, procedures, and clinical standards - Stay current with emerging research and best practices in nutrition and health - Maintain a consistent and engaged patient schedule, ensuring timely follow-ups and continuity of care - Maintain a minimum of 12 hours of weekly availability, with opportunity to grow into a higher-hour or full-time schedule Benefits - Flexible Scheduling: Set your availability with the ability to build and adjust your schedule based on preferences and patient demand - Supplement Commissions: Earn 12.5% of MSRP on supplements purchased through Fullscript, paid quarterly - 401(k) (after 90 days) - Discretionary Holiday Break: Office closed between Christmas and New Year’s — guaranteed time off from patient appointments & administrative work - Fitness Allowance: Partial reimbursement for gym memberships, fitness classes, or wellness activities - Simplex Wellness on Demand: Free access to virtual fitness programs

The UM Clinical Reviewer Senior Analyst promotes quality and cost-effective medical services through clinical review, applying Cigna clinical policies, national guidelines, and decision-support tools to determine authorizations. The role ensures timely completion of reviews to meet regulatory and contractual requirements while representing Cigna professionally. Core Responsibilities: - Conduct utilization management reviews for medical necessity, appropriateness, and benefit coverage. - Apply Cigna medical policies, MCG, ASAM, URAC standards, and clinical judgment. - Identify cases requiring physician review and coordinate with Medical Directors. - Initiate Case Management referrals as appropriate. - Maintain compliance with HIPAA, regulatory rules, and internal quality standards. - Participate in team meetings, quality audits, training, and workflow improvements. - Support departmental initiatives, documentation accuracy, and performance metrics. Qualifications: - Registered Nurse (RN) with multistate license in good standing. - BSN preferred. - Minimum 3 years RN experience in managed care, UM, or prior authorization preferred. - Previous in-patient or outpatient experience preferred. - Strong analytical, communication, and decision-making skills. - Proficiency with Windows, Word, care management platforms, and documentation systems. - Ability to manage multiple tasks, meet deadlines, and adapt to a fast-paced environment. Competencies - Clinical Judgment & Decision Making - Regulatory & Policy Compliance - Communication & Collaboration - Customer-focused Service Delivery - Time & Workload Management If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 31 - 52 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Role Description The RN Case Manager primary responsibility is to create, implement, and monitor treatment plans to assist patients/members in meeting their healthcare goals. You would use knowledge of healthcare and social services to assess needs and provide interdisciplinary care options in treatment planning for the member. This would include understanding the member's healthcare benefits and healthcare best practices needed for effective treatment planning. - Case Management process includes assessing the member’s health status and care coordination needs. - Contact with patient, family, physicians, additional health care providers, and community resources. - Identification of alternative treatment plans, which would have to be approved by all parties. - Assessment of the clinical status and resultant sequela to coordinate the most appropriate service. - Identification of services, resources, providers, and facilities that could best serve members. - Development and implementation of Case Management goals, both short and long term, with documented care plans. - Utilize technology/resources to evaluate the cost-effectiveness of the elected treatment plan. - Accurate and timely reporting as deemed appropriate by each client member. - Medical record review to determine medical necessity of requested services. - Interpreting individual health plans and authorizing/coordinating care in accordance with plan provisions. Qualifications - 5+ years related work experience with a professional background in clinical nursing and patient assessment. - Bilingual in Spanish. - Related Bachelor’s degree or additional related equivalent work experience. - Graduate of an accredited school of nursing. - RN - Registered Nurse - State Licensure. - Compact State Licensure in good standing. - Knowledgeable in medical terminology, reasonable and necessary treatment plans, delivery quality health care services and cost containment practices. - Ability to collaborate with cross-operational areas within the organization. Requirements - (CCM) Certified Case Manager preferred. - New York state Registered Nurse licensure preferred. - Prior experience in utilization management or case management preferred, preferably within the managed care environment. - Intensive care or higher-acuity patient experience preferred. - Knowledge of managed care in a self-funded employer population is preferred. - Ability to identify problems such as underutilization or overutilization of services. - Ability to promote and maintain quality care through analysis. Benefits - Medical, dental, vision, life and global travel health insurance. - Income protection benefits: life insurance, Short- and long-term disability programs. - Leave programs to support personal circumstances. - Retirement Savings Plan includes employer contribution and employer match. - Paid time off, volunteer time off, and 11 holidays. - Additional voluntary benefits available and a comprehensive wellness program. General Physical Demands Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.