Job Summary: The Team Lead, Clinical Care Review is responsible for providing direct oversight of Clinical Care Review (CCR) employees and overseeing day-to-day workflow within the CCR team. Essential Functions: - Provide direct oversight of CCR employees and oversee day-to-day workflow within the CCR team - Ensure all direct reports are performing at minimum quality and productivity standards or better - Understand complexities of health conditions and services - Develop plan for management of workload after analyzing trends and act as advocate for CCR team - Provide feedback, guidance, orientation, training and ongoing resources to CCRs and pre-authorization team - Standardize activity and outcome reporting for department initiatives and programs including documentation required by the State and accrediting bodies - Responsible for utilization review and discharge planning activities for CareSource members - Monitor and ensure appropriate delivery of healthcare services in cost-effective manner - Assist manager and director in development of process improvement activities and refining of processes that facilitate cost-effective utilization and appropriate levels of care - Act as a liaison between Care Management, Claims, Enrollment, Customer Service and other areas as needed to assist in problem resolutions - Perform audits of CCR team members to ensure compliance with CareSource policies, processes, regulatory requirements, NCQA utilization review guidelines and standards, and URAC review guidelines - Provide input into CCR team evaluations and assist with development of team goals - Design and present UM informational meetings as needed - Responsible for attending state hearings as necessary - Perform any other job duties as requested Education and Experience: - Graduate level degree as a mental health professional or Bachelor of Science degree in Nursing or equivalent years of relevant work experience is required - One year of Utilization Management/Utilization Review experience required - Minimum of five (5) years clinical experience preferred - Certified Care Manager experience is preferred Competencies, Knowledge and Skills: - Basic computer skills - Basic proficiency in Microsoft Word and Excel - Communication skills - Management skills - Prior supervisory skills - Ability to work independently and within a team environment - Attention to detail - Familiarity of the healthcare field - Critical listening and thinking skills - Training/teaching skills - Negotiation skills/experience - Proper grammar usage - Time management skills - Proper phone etiquette - Customer service oriented - Decision making/problem solving skills - Leadership experience and skills Licensure and Certification: - Current, unrestricted license as a Registered Nurse (RN) or a mental health professional (i.e. Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), etc.) is required. This listing may not include all acceptable licenses; please refer to your state licensing board for complete information on licensure requirements for your state or practice. - Compact RN license or Multi-state Counselor/Social Worker licensure is preferred - MCG Certification preferred Working Conditions: - General office environment; may be required to sit or stand for extended periods of time Compensation Range: $72,200.00 - $115,500.00CareSource 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): Salary 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

Clinical Specialist Consultant - Vietnamese Speaking Location: Remote/virtual Hours: Estimated 10-16h/month Role: Clinical Specialist Job Description: The Clinical Specialist reviews scales administered by raters in a clinical trial to ensure that assessments are being conducted in a standardized manner to ensure data reliability. The quality of assessments is evaluated, and live interaction with raters is conducted to discuss assessment methodology, scoring technique, and to provide guidance, as necessary. Other Clinical Specialist responsibilities may include, but are not limited to, functional assessments of rater performance (e.g., mock interview) and assistance in preparing and disseminating communications. Required Experience, Knowledge, Skills: • Minimum of a Master’s degree (MA/MS) in Psychology, Counseling, Psychiatric Nursing or Social Work, or equivalent. MD, DO or PhD preferred • Minimum of 3 years’ experience administering psychiatric assessments, ratings scales and/or structured clinical interviews. Specifically, YMR, SCID-5, PANNS, CGI, SSRS, YGTSS-R, TS-CGI-S/C, SIGH-A, SCID Secondary SIGMA, CSSRS, CGI-S/I • Minimum of 3 years clinical experience with related psychiatric populations. • Minimum of 3 years experience with administering scales in clinical research trials (not including graduate/doctoral research work). • Experience in central nervous system (CNS) trials preferred. • Strong interpersonal skills with ability to interact with all levels of personnel and clientele in a professional manner. • Excellent organization, attention to detail, time management and problem-solving skills. • Computer proficiency with Windows and Microsoft Office system and applications. Tasks/Responsibilities: • Participate in all orientation, training and calibration activities as required. • Evaluate case data and appropriately prepare for discussions with raters (e.g., prepared to discuss relevant issues and scale items, and have necessary documents available). • Complete rater interactions and assigned tasks as scheduled. • Responsible for timely submission of all documentation associated with assigned tasks. *Current openings require fluency in English and a native speaker in the language needed for the trial. #LI-DNP #LI-Remote #LI-HCPN IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

Overview Work Location: Remote (must reside in an authorized state: FL, GA, MO, PA, NC, SC, TN, TX) Ensures the accuracy, completeness, and regulatory compliance of clinical documentation. Collaborates with healthcare providers to enhance documentation quality and analyzing clinical records to identify discrepancies. Implements improvement initiatives, monitors adherence to policies, and educates clinical staff on best practices. Supports audits and quality assurance activities, reporting findings and recommending corrective actions to management for continuous improvement. Responsibilities Key Responsibilities - Ensures the accuracy, completeness, and regulatory compliance of clinical documentation. - Collaborates with healthcare providers to enhance documentation quality and accuracy. - Analyzes clinical records to identify discrepancies and implement improvement initiatives. - Monitors adherence to documentation policies and educates clinical staff on best practices. - Supports audits and quality assurance activities related to clinical documentation. - Reports findings and recommends corrective actions to management for continuous improvement. Qualifications Minimum Requirements Education:Associate degree in a healthcare-related field required.Graduate of an accredited school of Nursing preferred. Qualifications - 3+ years of experience in clinical documentation improvement (CDI). - Strong knowledge of healthcare regulations and clinical documentation standards. - Experience conducting audits and quality assurance activities. - Proven ability to collaborate effectively with clinical providers and coding teams. - Ability to develop and deliver staff education and training programs. Licensure/Certification/Registration (Required):One of the following credentials is required: - Registered Nurse (RN) - Licensed Practical Nurse (LPN) Motor Vehicle Operator Designation (Required):Employees in this position are designated as Frequent Drivers and will operate a personal or University of Florida Health vehicle for assigned business purposes. A Frequent Driver is defined as an individual who: - Drives at least once daily, or - Completes at least five (5) individual trips per week, or - Drives an average of more than 150 miles per week in the performance of job duties. Note: The appropriate operator designation must be indicated on the Request for Personnel (RFP) form when submitting the position for posting.

When our values align, there's no limit to what we can achieve. At Parexel, we all share the same goal - to improve the world's health. From clinical trials to regulatory, consulting, and market access, every clinical development solution we provide is underpinned by something special - a deep conviction in what we do. Each of us, no matter what we do at Parexel, contributes to the development of a therapy that ultimately will benefit a patient. We take our work personally, we do it with empathy and we're committed to making a difference. REGISTER YOUR INTEREST Parexel FSP is currently registering interest for experienced Regulatory & Submissions Leads to join our team in the UK, to be dedicated to a large single sponsor. This will be a home-based position. Working at Parexel offers tremendous long-term job security and prospects. We undertake vital clinical studies for sponsors including the leading global biotechs and Pharma top 50. We have an incredible pipeline of work and a world of opportunity waiting for you. The Regulatory & Submissions Lead is accountable for performance and compliance with assigned protocols in a country in compliance with ICH/GCP and country regulations, Client policies and procedures, quality standards, and adverse event reporting requirements internally and externally. Experience required to be a fit for this role: · Mandatory – Extensive experience in local EC and RA submission (must be familiar with XML completion) – including initial submission and protocol amendments submission. · Experience in Independently preparing submissions (CTC supports with documents collection) to both EC and RA. · Experience in ICF preparation using templates. · Skilled knowledge of the local regulatory environment, submissions, and approval processes, and understanding of how these impact study start-ups. · Experience in IMP supplies management at the local level (vendors providing background meds, the standard of care, etc.) · Experience in validation of translated documents. We care about our people and your passion, as they are the key to our success, and provide an open and friendly work environment where we empower people and provide them with opportunities to develop their long-term careers. In addition, you will have the opportunity to develop within your role and tackle further responsibilities or develop your skill set within other related departments of Parexel. Who are Parexel? Parexel supports clinical studies across the full range of therapeutic areas, and we have longstanding partnerships with a vast client base. We supported the trials of most of today’s top 50 best-selling drugs, but equally we enable more niche drug developments that are critical to the well-being of many patients. You’ll be an influential member of the wider team. Not quite the role for you? Join Our Talent Community and we’ll reach out with job alerts when positions that match your career interests become available. We’ll also share periodic updates about the latest company news and events. Sign up today https://jobs.parexel.com/en/functional-service-provider