Role Description The Macmillan Health Care Team provides a robust and consistent package of care for end of life patients and their families seven days a week over 24 hours. The service can also include night sits. The Macmillan Health Care Service is a central point of referral for end of life services. The team works in collaboration with: - District Nurses - Therapists - General Practitioners - Macmillan Nurses A full UK driving license and use of own car is required for this position as the job is community based covering the whole of North Lincolnshire. We assist with patient’s personal care up to 4 visits a day over 7 days a week and also offer night sits. We care for patients who are at the end of their life journey and choose to remain at home. With compassion, we support those who are rapidly deteriorating and sensitively support the family. We nurture independence wherever possible so that the patient preserves their sense of control and pride and we adapt to their choices. We care for the individual physically with respect and promote dignity to the end. We respect the individual’s wishes and secure consent for our activities. We are motivated to provide a high standard of care, adaptable to the individual and family’s needs, resourceful when needed. This is an exciting opportunity for joining a compassionate team who deliver end of life services. The team works closely with: - District Nurses - Community Macmillan Nurses - End of Life Lead Nurse - Unscheduled Care Team - Outside agencies when necessary Qualifications - Full UK driving license - Use of own car Requirements - Compassionate care for end of life patients - Ability to support families sensitively - Adaptability to individual and family needs - Resourcefulness in care provision Benefits - Flexible working opportunities - Support for work-life balance - Commitment to health and well-being of staff - Recognition and value of contributions

Dane Street is seeking experienced Orthopedic Surgeons to join our growing team of expert medical reviewers. In this role, you will apply your expertise to conduct comprehensive reviews of clinical cases and provide objective, evidence-based medical opinions. This is a telework opportunity that allows you to customize your schedule while working as a 1099 independent contractor. Your primary responsibilities will include reviewing medical records, preparing clear and concise clinical summaries, and responding to specific questions from our clients related to orthopedic care. Join a team that values your clinical judgment and commitment to improving the quality, accuracy, and consistency of healthcare assessments. Your expertise plays a vital role in supporting high-quality, defensible medical determinations.

Employment Type: Full timeShift: Day Shift Description: Why MediGold? MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more. Position Purpose The Coordinator, Utilization Management Intake performs duties to support the Utilization Management department including management of internal and external calls, managing/triaging all departmental authorization/referral requests and assisting in compliance-driven auditing and reporting. What You Will Do: - Assists with the management of departmental processes, auditing and reporting deliverables and initiatives in compliance with federal and state regulatory agencies. - Receives, interprets and responds to evaluation utilization review inquiries - · Manages incoming medical records, authorization requests and referrals for department. - · Manages department call tracking system and triage incoming calls as appropriate. - · Coordinates, oversees, records and transmits information pertinent utilization review processes. - · Assists with administrative responsibilities such as meeting preparation, minutes, mailings faxing/scanning department records, ordering of departmental supplies, etc. - · Responsible for performing a variety of tasks requiring independent judgement and initiative. - · Establishes and maintains effective working relationships with other departments. - · Establishes and maintains strong positive communication with key stakeholders. ​ Minimum Qualifications: - Education: High School required; Bachelor's degree preferred - · Experience: Minimum of two (2) years data entry experience, with healthcare field preferred. - · Effective Communication Skills - · Understanding of medical terminology required. - · Must have in-depth computer skills including word processing software (e.g. Microsoft - Office) and data entry. - · Ability to work independently with minimal supervision. - · Must be able to document data accurately into computer system, and maintain statistical - records and reports. - · Must possess a high degree of motivation, initiative and organizational ability. - · Familiarity with managed care and claims processing required, including CPT & ICD-10 - · coding, phone triaging, referrals and authorizations. - · Must be able to maintain confidentiality of work documents. - · Knowledge of managed care issues related to utilization management, plan benefits and provider contacts. - · Ability to work with physician offices in facilitating authorizations. ​ Position Highlights and Benefits: - Mount Carmel Health System recognized by Forbes in 2025 as one of America’s Best State Employers. - Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one. - Retirement savings account with employer match starting on day one. - Generous paid time off programs. - Employee recognition programs. - Tuition/professional development reimbursement starting on day one. - RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing. - Relocation assistance (geographic and position restrictions apply). - Employee Referral Rewards program. - Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day! - Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups. Ministry/Facility Information: Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You! We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

• Perform Medicare comprehensive medical record and claims review to make payment determinations for Medicare Durable Medical Equipment (DME). • Perform projects or duties as assigned as a Medical Review Specialist. • Conducts in-depth claims analysis utilizing ICD-10-CM, CPT-4, and HCPCS Level II coding principles. • Utilize electronic health information imaging and input medical review decisions by electronic database module. • Utilize internet and intranet sources for policy verification. • Utilize Microsoft Office suite and other software templates as associated source input for claims review. • Make clinical judgment decisions based on clinical experience when applicable. • Meeting quality and production standards.