Job Summary: Clinical Care Reviewer II – Behavioral Health is responsible for processing medical necessity reviews for appropriateness of authorization for behavioral health care services, assisting with discharge planning activities (i.e. outpatient services, home health services) and care coordination for members. Essential Functions: - Complete prospective, concurrent and retrospective review of Behavioral Health services - Identify, document, communication and coordinate care engaging collaborative care partners to facilitation transition to an appropriate level of care - Engage with medical director when additional clinical expertise if needed - Maintain knowledge of state and federal regulations, including State Contracts and Provider Agreements, benefits, and accreditation standards - Identify and refer quality issues to Quality Improvement - Identify and refer appropriate members for Care Management - Provide guidance to non-clinical staff - Provide guidance and support to LPN staff - Attend medical advisement and State Hearing meetings, as requested - Assist Team Leader with special projects or research, as requested - Perform any other job related duties as requested. Education and Experience: - Associates of Science (A.S) in Nursing required or - Bachelor of Science (B.S) in Social Work required - Three (3) years clinical experience required - Utilization Management/Utilization Review experience preferred - Medicaid/Medicare/Commercial experience preferred Competencies, Knowledge and Skills: - Proficient data entry skills and ability to navigate clinical platforms successfully - Working knowledge of Microsoft Outlook, Word, and Excel - Effective oral and written communication skills - Ability to work independently and within a team environment - Attention to detail - Proper grammar usage and phone etiquette - Time management and prioritization skills - Customer service oriented - Decision making/problem solving skills - Strong organizational skills - Change resiliency Licensure and Certification: - Current, unrestricted Registered Nurse (RN) Licensure or Licensed Social Worker (LSW) required - MCG Certification is required or must be obtained within six (6) months of hire required Working Conditions: - General office environment; may be required to sit or stand for extended periods of time - Travel is not typically required Compensation Range: $62,700.00 - $100,400.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Hourly Organization Level Competencies - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-JM1

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. Announcement will close once 50 applicants is reached. Temporarily eligible for Remote work within 50 miles of a VA Medical Center. May fall under the Presidential Memorandum titled "Return to In-Person Work" which will require you to go into the office if the exemption is not approved at the next review. Responsibilities - Responsible for reviewing the overall quality and completeness of clinical documentation. - Inpatient CDI focuses on the concurrent review of patient records with an emphasis on improving documentation while the patient is still in-house. - Outpatient CDI focuses on improving clinical staff documentation of outpatient encounters through retrospective review of outpatient encounters and extensive provider education. - Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures, and health services principles. - Reviews clinical documentation and provides education to clinical staff on both inpatient and outpatient episodes of care. - Prepares and conducts provider education on documentation processes in the health record. - Provides education to providers on the need for accurate and complete documentation in the health record. - Adheres to accepted coding practices, guidelines, and conventions. - Reviews VERA input on missed opportunities in provider documentation. - Assists facility staff with documentation requirements to accurately reflect patient care provided. - Searches the patient health record to find documentation justifying code assignment. - Provides advice and guidance on documentation requirements, liability issues, and patient privacy. - Compiles, reviews, abstracts, analyzes, and interprets medical data incidental to patient care activities. - Conducts daily reviews of all new admissions to identify potential documentation improvements. Work Schedule Monday-Friday, 7:30am-4:00pm Mountain Time Qualifications - U.S. Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major in health information technology/management, or related degree. - Completion of an AHIMA approved coding program or other intense coding training program. - Certification: Must have either Apprentice/Associate Level Certification, Mastery Level Certification, or Clinical Documentation Improvement Certification through AHIMA or ACDIS. - English Language Proficiency: Must be proficient in spoken & written English. Requirements - Experience equivalent to the journey grade level (GS-8) of a MRT (Coder-Outpatient and Inpatient). - An associate's degree or higher, and three years of experience in clinical documentation improvement. - Mastery level certification through AHIMA or AAPC and two years of experience in clinical documentation improvement. - Clinical experience such as RN, M.D., or DO and one year of experience in clinical documentation improvement. - Demonstrated knowledge of coding and documentation concepts, guidelines, and clinical terminology. - Knowledge of anatomy, physiology, pathophysiology, and pharmacology. - Ability to collect and analyze data and present results. - Knowledge of regulations defining healthcare documentation requirements. - Extensive knowledge of coding rules and regulations. - Knowledge of severity of illness, risk of mortality, and complexity of care for inpatients. - Knowledge of training methods and teaching skills for staff development. Benefits - Competitive salary and regular salary increases. - 37-50 days of annual paid time off per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays). - After 12 months of employment, up to 12 weeks of paid parental leave. - Child care subsidy for eligible employees after 60 days of employment. - Traditional federal pension (5 years vesting) and federal 401K with up to 5% contributions by VA. - Federal health/vision/dental/term life/long-term care insurance.

Radiologist - Remote (#3341) - Location: Brooklyn, NY (Remote) - Employment Type: 1099 Independent Contractor - Hourly Rate: $30.00 - $35.00 per reading About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: We are seeking a skilled Radiologist to join a remote role in well-established multi-specialty practice in Brooklyn. This 1099 contractor role is exclusively focused on diagnostic interpretation, offering a flexible opportunity to contribute to patient care through expert analysis of medical imaging. The ideal candidate will bring technical proficiency and diagnostic acumen to support our collaborative healthcare team. Candidate needed for reading purposes only. Why Join Us? - Competitive Compensation: Earn a competitive rate of $30.00 - $35.00 per reading, with earnings directly tied to your productivity. - Comprehensive Benefits: This is a 1099 independent contractor position. - Work Schedule: Enjoy maximum flexibility with a contractor schedule that you control, ideal for balancing professional and personal commitments. - Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive multi-specialty environment. - Impactful Work: Play a critical role in a mission-driven organization by providing diagnostic insights that directly improve patient treatment plans and outcomes. Key Responsibilities: - Accurately interpret and generate diagnostic reports for medical images, including X-rays, MRIs, and Ultrasounds. - Ensure all readings are completed in a timely manner with meticulous documentation. - Provide clear and concise communication of findings to referring physicians within the practice. - Maintain the highest standards of diagnostic quality, accuracy, and adherence to clinical guidelines. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives.

Role Description We are looking for a dedicated Medical Nurse to join our growing team. In this role, you’ll play a vital part in supporting patient care and improving clinical workflows. You will work closely with physicians and the care team to provide exceptional patient support, precise documentation, and reliable administrative assistance. - Conduct patient intake questionnaires (collecting medical history, allergies, medications). - Accurate review and updating of patient charts. - Review lab results and imaging with patients. - Pre-screen patients for eligibility, referrals, or insurance requirements. - Manage pre- and post-appointment check-ins (follow-up calls, instructions review, satisfaction surveys). - Provide care coordination by relaying provider instructions to patients in non-clinical terms. - Schedule labs, imaging, or specialist referrals. - Handle chronic disease management outreach (reminder calls for meds, check-ins). - Remote patient monitoring. - Medical transcription and drafting standard correspondence. - Maintain clinical compliance by reviewing documentation accuracy and completeness. Qualifications - Must be a licensed Nurse (RN or equivalent) or licensed Medical Doctor / Dentist / Veterinarian. - License acceptable from any country approved to be in our candidate pool or the United States (need state licenses). - Minimum of 1 year working remotely at a US based healthcare company in a clinical capacity. - OR Minimum 2 years of working in their medical capacity as a Doctor, Nurse, Dentist, Vet in their own country. - Strong understanding of medical terminology and clinical workflows. - HIPAA compliance knowledge required. - Other Front or Back Office knowledge preferred but not required. - Willingness to work in US time zones (PST, EST, CST). - High school diploma or equivalent. Requirements - Internet: Minimum speed of 25 Mbps or higher, with a reliable backup connection available in case of power outages or service provider issues. - Processor: Intel Core i5 7th Generation or higher (or equivalent). - Memory: 8 GB RAM. - Storage: 256 GB SSD or HDD with at least 50% free space available. - Webcam: 720p resolution or higher. - Operating System: Windows 10 or later (or equivalent). - Audio Equipment: Noise-canceling earphones or headset. - Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and focus. - Permanent remote work setup. Benefits - Competitive starting rate paid in USD. - Internet Allowance. - HMO insurance (PH). - Retirement Fund. - Paid US holidays. - Paid Vacation and Sick Leaves.