Role Description Carebridge LPN/LVN at CareBridge Health is responsible for the examination and treatment of patients under the direction of the physician. - Reviews patient medical records, interviews patients, and records vital signs. - Provides nursing interventions and coaching in accordance with the scope of practice and standing orders. - Facilitates patient transfers to alternate level of care as needed. - Documents using standard templates. - Ability to be on the phone engaging with patients up to 80% of the shift. - Ability to work assigned weekends per standard team rotation. - Reliable internet and a high level of customer service. Qualifications - Requires an LPN or LVN and a minimum of 2 years of experience as an LPN/LVN; or any combination of education and experience that would provide an equivalent background. - Current LPN/LVN license in the applicable state required. - Satisfactory completion of a Tuberculosis test is a requirement for this position. Requirements - Bi-lingual (English/Spanish) preferred. - Experience with Telephonic Triage preferred. - Acute care experience (e.g., urgent care or ER) preferred. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

Overview Works with the Utilization Management team responsible for prior authorizations, inpatient and outpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Mentors and trains new team members. Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. This position also trains and mentors new team members as well as assesses services for Sendero members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Utilizes clinical skills to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care for members that are hospitalized in acute, skilled and long-term care settings. Performs telephonic reviews of inpatient hospital admissions and assist with the coordination ofdischarge planning needs. Obtains the information necessary to assess a member's clinical condition, identify ongoing clinical care needs and ensure that members receive services in the most optimal setting to effectively meet their needs. Evaluates the options and services required to meet the member's health needs, in support and collaboration with disease management interventions. Performs prospective, concurrent & retrospective review of inpatient, outpatient, ambulatory & ancillary services requiring clinical review including all levels of appeal requests. Hours of operation are Monday through Friday 8 am to 5 pm to include extended hours that may occur on a weekend and/or holidays as required by State and Federal regulations in order to maintain operational compliance. This position is considered Remote, which means that individuals in this position may work at an approved Offsite location; however, they may be required to occasionally visit a Central Health office in Austin, Texas. Remote work not available for residents of California, Colorado, New York, New Jersey, Hawaii, Maryland, Montana, Pennsylvania, Virginia, or Washington. Responsibilities Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations): - Provides concurrent review and prior authorizations (as needed) according to policy. - Perform concurrent and retrospective reviews on all inpatient, facility and appropriate home health services. - Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures. - Responsible for the proactive management of acutely and chronically ill patients with the objective of improving quality outcomes and cost. - Completes assigned work plan objectives and projects on a timely basis. - Collect pertinent documentation and conduct medical services review applying appropriate national standardized medical criteria, Sendero medical policy, and state and federal guidelines. - Perform discharge planning activities in coordination with facility or provider case manager. - Act as a member/family advocate in coordinating and accessing medical necessity of health care services within the benefit plan. - Consult with a Medical Director as appropriate for all requests requiring MD approval or not meeting criteria for approval. - Maintain open communication flow with to other care management staff to facilitate smooth transition and - follow-up as member is transitioned from one level of care and/or service to another. - Seek out opportunities to improve HEDIS, NCQA, URAC or general accreditation and QIA activities. - Perform other related tasks as assigned by supervisor or manager and maintains department productivity and quality measures. - Attends regular staff meetings, conducts self in a professional manner at all times, and completes assigned work objectives and projects in a timely manner. Knowledge/Skills/Abilities: - Knowledge of Managed Care principles and practices, involving medical and behavioral case management, disease management, utilization and pharmaceutical management. - Skilled with clinical knowledge and experience in the treatment of human injuries, diseases, and deformities including symptoms, treatment alternatives, drug properties and interactions, behavioral health conditions and preventive health guidelines. - Demonstrated ability to lead, communicate, problem solve, and work effectively with people. - Excellent organizational skill with the ability to manage multiple priorities. - Work independently and handle multiple projects simultaneously. - Knowledge of applicable state, and federal regulations. - In depth knowledge of InterQual and other references for length of stay and medical necessity determinations. - Subject matter expert with NCQA requirements. - Ability to take initiative and see tasks to completion. - Computer Literate (Microsoft Office Products). - Computer Literate (Microsoft Office Products). - Excellent verbal and written communication skills. - Ability to abide by Sendero’s policies. - Ability to maintain attendance to support required quality and quantity of work. - Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). - Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers. Qualifications MINIMUM EDUCATION: High School Diploma or equivalent Required and Completion of an accredited (RN) or an accredited (LVN) program Required MINIMUM EXPERIENCE: One (1) year clinical practice experience Required AND Two (2) years managed care experience with utilization management and/or case management REQUIRED CERTIFICATIONS/LICENSURE: Holds and maintains these certifications as a professional. Lapsing/expiration of these certifications/licensure will result in suspension of work:1. Active, unrestricted State Registered Nursing license in good standing

A WORLD LEADER IN TESTING, INSPECTION & CERTIFICATION SERVICES Bureau Veritas offers dynamic, exciting employment opportunities with an attractive salary/benefit package and an opportunity to play a vital role with a global organization. If you would enjoy working in a dynamic environment and are looking for an opportunity to become part of a stellar team of professionals, we invite you to apply online today. Bureau Veritas is an Equal Opportunity Employer, and as such we recruit, hire, train, and promote persons in all job classifications without regard to race, color, religion, sex, national origin, disability, age, marital status, citizen status, sexual orientation, gender identity, genetics, status as a protected veteran, or any other non-job-related characteristics. This position is responsible to ensure equal opportunity in employment in that all persons are treated equally and on the basis of merit, in decisions regarding selection, placement, promotions, training, work assignments, transfers and other personnel actions. City: Remote State: Remote SUMMARY: Reviews Environmental Site Assessment (ESA), Property Condition Assessment (PCA), Property Condition Equity (PCE), and/or Facility Condition Assessment (FCA) reports and/or Seismic Reports (including Seismic Risk Assessments, Tier 1 Reports, and Structural Building Systems Assessments. Communicates with the field staff and provides feedback on quality of written report. Helps instruct the field staff and provides “redlined” versions of reports to field staff when the submitted report requires changes or improvements that should have been completed by the field staff. Monitors, prioritizes, and tracks work progress while providing quality control reviews and technical editing of reports generated. Provides direct data to the team and is knowledgeable about client protocols. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other job-related duties may be assigned in conformance with state and federal regulations. - Responsibilities include serving as technical reviewer for Equity and BSA (Building Systems Analysis) reports, including but not limited to reviews of: Acquisition/Investor grade Property Condition Assessments (PCEs), Building Systems Analysis assessments (MEP, Structural, Roofing, Façade, etc.), Site Investigation, ESG, and Property/Climate Resiliency reporting, as well as provide support and complete other technical services requested by clients in conjunction with the reports discussed above - Familiar with current Property Condition and other Equity or BSA program-related ASTM standards - Optimize workflow efficiency, ensuring on-time delivery of due diligence reports within fast-paced investment cycles. - Travel by Plane, Motor Vehicle, Train (50% of workweek) to client sites across the U.S. Common patterns of travel include one to two day on-site followed by one to two days at home. Overnight stays away from home may be required. - May be considered and hold the responsibility as program lead for certain Clients or scopes of work. - Reviews, writes, and technically edits reports to ensure 100% accuracy, completeness, and quality. Prepares report for on-time delivery to client with accompanying correspondence. Ensures that reports are reviewed and submitted to client delivery in advance of the due to client date. - Upholds industry and company standards by providing guidance on technical issues. - Responsible for escalation regarding quality of reports and issues that should be brought to a client’s attention in advance of the client receiving the report. Authorizes shipment/transmittal of completed reports to client. - Reviews and makes changes as necessary to assigned project reports, including completing the cross checks for projects. Reviews, provides feedback, and evaluates field staff work and progress and identifies and resolves problems in reports. - Provides technical direction and guidance to field staff. Provides “redlined” versions of reports to field assessors when the report submitted requires changes or improvements that should have been completed by the field staff. Participates in providing quality data to field staff to identify the improvements necessary for their reports so that field staff performance in report writing and data collection continues to improve. - Actively participates in portfolios including review of reports for portfolio properties, assisting in creating protocols and participates in development of protocol checklists. - Acts as back up technical lead, providing guidance and technical direction for assigned regional clients and protocols. - On occasion, will be required to meet the job requirements and perform the duties of the onsite Project Assessor (field). - Enhances professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies. - Maintains open communication with management and staff regarding departmental and operational matters. - Protects operations by keeping company information confidential. - Delivers outstanding customer service through timely response and proactive solutions to clients’ needs. - Demonstrates BV’s guiding principles in support of the company's strategic goals. - Follows all documented policies, Standard Operating Procedures, and Work Instructions applicable to the position and support of BV's quality standards and strategic initiatives. - Maintains safe and clean work area by complying with all procedures, rules, and regulations. - May be responsible for managing as the lead of other Technical Report Reviewers. - May be responsible for managing vendors and subcontractors. - Must be able to meet the physical demands of the job. SUPERVISORY RESPONSIBILITIES: May indirectly or directly supervise employees on the team. May carry out supervisory responsibilities in accordance with the organization's policies and applicable laws. May have responsibilities including training employees, planning, assigning, and directing work. QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: - Bachelor's degree (B.A. or B.S.) from four-year college or university in related field; minimum of five years of related experience. In lieu of degree, eight years of related experience and/or training, or equivalent combination of education and experience. Certificates, Licenses, Registrations: - Valid driver's license required with no significant MVA points/violations (clean driving record). - Employees who incur $2,000 or more per year in company-related travel expenses will be required to obtain a Corporate Credit Card. Employees who incur less than $2,000 per year in company-related travel expenses will be required to have sufficient personal credit to cover their business travel costs. Language Ability: Ability to write reports, business correspondence, and standard operating procedures. Ability to effectively present information and respond to questions from clients, peers, and technical field staff. Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of instructions and deal with several abstract and concrete variables. Technology Skills: To perform this job successfully, an individual must be proficient in operating a computer, having knowledge of word processing software, spreadsheet software, and project management software. To perform this job successfully, an individual must be able to operate an electronic tablet in the field for live data collection. Knowledge, Skills, and Other Abilities: - Time management skills - Active listening skills - Critical thinking skills - Problem solving skills - Oral and written communication skills - Ability to motivate, develop, and direct people - Ability to work independently, as well as in a team environment. - Ability to work in a constant state of alertness and safe manner. - Ability to successfully work from remote location. - Ability to meet the physical demands of the job. - Must have a cell phone and supply your own internet service. PHYSICAL DEMANDS: The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the office/offsite duties of this job: The employee is regularly required to use hands. The employee is frequently required to stand, walk, sit, talk and hear. The employee is occasionally required to reach with hands and arms, climb or balance, and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. The noise level in the home or company office environment is usually quiet. While performing the onsite/field duties of the Project Assessor (field), the employee is required to: - Walk (material part of an 8-hour workday, up to 3 to 4 continuous hours at one time.) - Stand (material part of an 8-hour workday, up to 3 to 4 continuous hours at one time.) - Sit, Stoop, kneel, crouch, or crawl to observe basement and grade-level crawl spaces, and/or to read equipment data plates when necessary (at least once for each building assessed) - Climb and balance Stairs (at least once for each building assessed) - Climb and balance various types of ladders to access flat roofs/hatch access (at least once for each building assessed) - Repetitive use of hands/fingers for keyboard interaction (frequently) - Reach with hands and arms - Talk and hear (communicate with onsite contact) - Vision (close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus) - Lift and or move (occasionally up to 40 pounds) - Operate an electronic tablet in the field for live data collection. - Operate a computer (up to 100% of workweek) - Operating a motor vehicle - Travel by Plane, Motor Vehicle, Train to client sites across the U.S. - Onsite visits can occur up to one continuous week at a time. As a general expectation, for approximately 2 to 3 days of the workweek, travel and onsite work is anticipated and expected. Overnight stays away from home may be required. - Work Environment: The employee is regularly exposed to outdoor weather conditions, moving mechanical components and assemblies, frequently exposed to work near energized electrical components and assemblies. The employee is occasionally exposed to work in high, precarious places, fumes or airborne particles, extreme cold (non-weather), extreme heat (non-weather), and risk of electrical shock. The noise level at the project site is usually moderate. Equal Opportunity Employer/Veterans/Disabled. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status or on the basis of disability. 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, or protected veteran status and will not be discriminated against on the basis of disability. Benefits: At Bureau Veritas, we are dedicated to ensuring our employees receive fair and competitive pay, accompanied by comprehensive health and wellness benefits. Here's a breakdown of what we provide: Salary range starting at: $80,000+ Annual Incentive Bonus Plan Base Pay is adjusted based on job-related knowledge, skills, experience, and market location. Our Health and Welfare Benefits are designed to meet your needs, eligible on your first day of employment: Medical, Dental, and Vision coverage Company-matched Retirement plan Generous Paid Time Off and Company Holidays Life Insurance and AD&D coverage Short-Term Disability (STD) and Long-Term Disability (LTD) Tuition Assistance, along with optional life and pet insurance Access to Corporate Discounts This information is transparently provided in adherence to several state and local Equal Pay and Pay Transparency Laws, with our base pay determined by market location. Join us at Bureau Veritas, where your well-being and professional growth are our top priorities. If you are an individual with a disability and you would like us to assist you with searching the Careers Page site for employment opportunities and/or assistance with completing your profile and application, please contact us at 1-888-357-7020 or email us with your request to NorthAmericaTA@bureauveritas.com. We are happy to assist you and encourage you to consider Bureau Veritas for your next great career opportunity! If you would like additional information regarding Bureau Veritas' federal obligations in regards to equal employment opportunity, please click the link below: https://www.dol.gov/agencies/ofccp/posters

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Job Summary Acentra Health is seeking a dedicated and experienced Clinical Reviewer to join our growing and mission-driven team. This role offers the opportunity to make a meaningful impact by supporting high-quality healthcare decisions that improve outcomes for patients and communities. In this position, you will leverage your clinical expertise to review medical records, ensuring alignment with established clinical criteria, evidence-based guidelines, and contractual requirements. Your work will play a critical role in supporting informed healthcare decisions, improving health outcomes, promoting quality care, and ensuring regulatory and contractual compliance. We currently have four Clinical Reviewer openings. Available schedules include one position with a Sunday–Thursday, 8:00 AM–5:30 PM schedule; one position with a Tuesday–Saturday, 8:00 AM–5:30 PM schedule; and two positions with a Monday–Friday, 10:00 AM–6:30 PM schedule. This is a remote, work-from-home position, and candidates must reside in California and must hold an active, unrestricted California LMFT or LCSW license. Job Responsibilities - Ensure the accuracy, quality, and timeliness of all assigned review cases in accordance with contractual and regulatory requirements. - Proactively assess, prioritize, and manage daily workloads and review queues, adjusting work schedules as needed to effectively meet departmental demands. - Collaborate with the Supervisor to support and participate in ongoing quality monitoring and performance improvement initiatives. - Maintain current knowledge of clinical practices, evidence-based guidelines, and internal review processes to ensure high-quality, compliant reviews. - Serve as a liaison to healthcare providers by addressing customer service inquiries and facilitating effective problem resolution. - Perform all applicable types of clinical reviews as dictated by workload volume and business needs. - Build and sustain positive, professional working relationships with both internal teams and external stakeholders. - Participate in required training sessions and scheduled meetings to remain informed of process updates, policy changes, and organizational initiatives. - Cross-train across functions to support a flexible workforce and ensure continuity in meeting client and customer needs. - Read, understand and adhere to all corporate policies and procedures, including full compliance with HIPAA Privacy and Security regulations. Qualifications Required Qualifications, Skills and Experience - Must hold an active California license as a Licensed Marriage and Family Therapist (LMFT) or Licensed Clinical Social Worker (LCSW) and a master’s degree in a directly related field from an accredited institution. - Demonstrated knowledge of medical records review, medical terminology, and common disease - Experienced in performing clinical reviews to ensure established criteria are met, maintaining accuracy in inpatient documentation, and adhering to all compliance guidelines and contractual obligations. - Skilled in conducting utilization reviews and patient chart reviews with accuracy and timeliness. - Strong clinical assessment, analytical, and critical-thinking skills with the ability to apply evidence-based criteria. - Excellent written and verbal communication skills, with the ability to effectively collaborate with providers, peers, and stakeholders. - Detail-oriented with excellent organizational skills and the ability to prioritize and complete tasks efficiently within established timelines. - Proficient in computer-based software and tools, including Microsoft Office Suites; Word, Excel, Outlook, and Teams. Why us We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career. We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Compensation The compensation for this role is $35.00 hour $40.00 per hour Based on ou0r compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level. #LI-JS1 Pay Range USD $28.37 - USD $39.19 /Hr.