Workforce Solutions for Modern Health Plans
Today’s health plans face increasing pressure to improve member outcomes, meet regulatory requirements, manage costs, and deliver exceptional service. Having the right workforce in place is critical.
TotalMed partners with health plans nationwide to provide experienced clinical, operational, and leadership talent, along with scalable outsourcing solutions that help organizations improve efficiency without sacrificing quality.
Whether you’re expanding your internal team, filling specialized roles, or outsourcing an entire function, we’ll help you choose a workforce approach that supports your organization’s goals.
Health Plan Staffing
We provide experienced professionals across every major health plan function, helping organizations quickly scale while maintaining compliance, productivity, and exceptional member experiences.
Medical Management Staffing
Clinical professionals who support medical management departments with expertise in:
Case Management
Care Management
Disease Management
High-Risk Case Management
Behavioral Health
Social Work
Utilization Management
Prior Authorization
Concurrent Review
Retrospective Review
Operational Staffing
Professionals supporting critical health plan operations, including:
Claims Processing
Member Services
Provider Services
Provider Network Operations
Enrollment
Credentialing
Project Management
Data & Reporting
Business Operations
Contact Centers
Leadership Staffing
Experienced healthcare executives and management professionals, including:
Medical Directors
Clinical Directors
Directors of Case Management
Utilization Management Leaders
Operations Directors
Quality Directors
VP-Level Healthcare Leaders
Health Plan BPO Solutions
When your organization needs additional capacity without expanding internal headcount, TotalMed provides scalable outsourcing services designed around your operational goals. Our flexible business process outsourcing (BPO) services improve efficiency while reducing administrative burden—supporting individual departments or fully managed functions.
Utilization Management Outsourcing
Experienced nurses and clinical reviewers who support:
Prior Authorization
Concurrent Review
Retrospective Review
Medical Necessity Reviews
Clinical Documentation
Appeals & Grievance Outsourcing
Dedicated teams that manage:
Member Appeals
Provider Appeals
Grievances
Regulatory Compliance
Turnaround Time Management
Physician Review Services
Board-certified physician reviewers available to support:
Medical Necessity Reviews
Peer-to-Peer Reviews
Appeals
Clinical Consultation
Care Management Outsourcing
Extend your care management team with professionals focused on:
Complex Case Management
Chronic Disease Management
Population Health
Transitional Care
Member Engagement
Health Risk Assessment (HRA) Services
Clinical teams that improve member outreach and risk identification through:
Health Risk Assessments
Member Outreach
Clinical Documentation
Risk Stratification
Care Gap Closure Services
Support quality initiatives through outreach programs focused on:
Preventive Care
Quality Measures
HEDIS® Support
Member Education
Population Health
Clinical Call Center Services
Clinical contact center professionals providing:
Nurse Advice Lines
Care Coordination
Member Support
Medication Adherence Outreach
Wellness Programs
Clinical Triage Support
Why Health Plans Choose TotalMed
Healthcare organizations trust TotalMed because we understand the complexities of payer operations. Our healthcare recruiting experts combine deep industry knowledge with AI-powered sourcing and proactive talent engagement to identify highly qualified professionals before they reach the open market.
Every candidate is thoroughly screened for clinical expertise, operational experience, and cultural fit, ensuring you receive professionals who are ready to contribute from day one.
Whether you need a single specialist, an executive leader, or a fully outsourced operational function, TotalMed delivers the expertise and scalability to help your organization succeed.
Flexible Workforce Solutions
Our customizable workforce solutions include:
Contract Staffing
Contract-to-Hire
Direct Hire
Project-Based Teams
Managed Workforce Solutions
Health Plan BPO Services
Clinical Outsourcing
Leadership Search
Secure Top Talent First
Experience the TotalMed advantage in health plan staffing. Discover how.
Our approach to staffing is about precision. We meticulously vet each candidate, ensuring a match that aligns with your unique needs—reflected in our low 11% attrition rate.