Role Description iMPROve Health is seeking an ophthalmologist to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type. - Current knowledge of brow ptosis surgery needed. Duties and Responsibilities - Conduct objective, evidence-based peer reviews of clinical cases. - Make final determinations regarding medical necessity and quality of care. - Ensure decisions are fair, unbiased, and aligned with current standards of practice. - Submit reviews in a timely and professional manner using the IT systems provided. Qualifications - Medical License: Must hold an unrestricted medical license in any U.S. state. - Board Certification: Required (if applicable), through a board recognized by: - The American Board of Medical Specialties (ABMS) - The American Osteopathic Association (AOA) - Another nationally recognized board granting certification. - Clinical Experience: - Have at least five (5) years full-time equivalent experience providing direct clinical care to patients. - Have experience providing direct clinical care to patients within the past three (3) years. - Knowledgeable of the issue under review, or of the current, evidence-based clinical guidelines and novel treatments for the medical or behavioral health condition, disease, treatment, or procedure under review. - Have the clinical expertise to manage the medical or behavioral health condition or disease under review. - Must be actively engaged in direct or virtual patient care for at least 20 hours per week. Administrative work does not qualify. Technology Requirements - Reliable Wi-Fi access. - Proficiency with Microsoft Word. - Access to a computer compatible with iMPROve Health’s IT systems. Other Requirements - Must complete the electronic credentialing application and receive organizational approval prior to performing a case review. - Must complete a conflict of interest attestation upon credentialing and prior to performing a case review. - Active hospital medical staff privileges may be required, as applicable. - Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status. - Cannot have current employment or affiliation with any Veterans Affairs (VA) hospital, health care system, or medical center if applying to perform VA-related peer reviews. Benefits - Make a Difference: Use your clinical knowledge to improve the quality of care patients receive. - Professional Recognition: Join a network of highly respected experts in your specialty. - Competitive Compensation: Receive fair pay for your time and expertise. - Protect Standards of Care: Help uphold the integrity of your profession. - Work Remotely: Review cases from the convenience of your home or office. Company Description

Role Description The Clinical Documentation Reviewer & QA Consultant will conduct comprehensive reviews of clinical documentation, assessments, treatment plans, and service notes to ensure compliance with DBHDD, CORE Behavioral Health standards, Medicaid requirements, and agency policies. This position will also provide training, coaching, and constructive feedback to clinical staff to improve documentation quality and reduce compliance risks. This role is ideal for a licensed clinician or healthcare professional with experience in behavioral health documentation, quality assurance, auditing, utilization review, or healthcare compliance. Essential Duties and Responsibilities - Review clinical service notes for accuracy, completeness, and compliance. - Review assessments, treatment plans, safety plans, and related clinical documentation. - Identify documentation deficiencies, trends, compliance concerns, and potential audit risks. - Provide written and verbal feedback to clinical staff regarding documentation improvements. - Train and educate staff on DBHDD documentation requirements and best practices. - Assist with quality assurance initiatives and continuous quality improvement activities. - Participate in quality assurance meetings and interdisciplinary discussions as needed. - Support preparation for audits, surveys, and regulatory reviews. - Assist leadership in identifying corrective actions and quality improvement opportunities. - Review agency documentation processes and recommend improvements. - Consult regarding policy and procedure development related to documentation and compliance. - Maintain strict confidentiality and HIPAA compliance at all times. Qualifications - Minimum of three (3) years of clinical experience in behavioral health, healthcare, nursing, social work, counseling, case management, utilization review, quality assurance, compliance, or related field. - Strong understanding of clinical documentation standards and medical record review. - Experience reviewing clinical notes, assessments, treatment plans, and service documentation. - Excellent written communication and documentation skills. - Strong organizational and analytical skills. - Ability to provide constructive feedback and training to clinical staff. - Proficiency with Electronic Medical Records (EMR) systems. Preferred Qualifications - Active LPC, LCSW, LMFT, RN, PsyD, PhD, or other related clinical licensure. - Experience working within DBHDD CORE Services. - Previous experience in Quality Assurance (QA), Utilization Review (UR), Compliance, Auditing, Risk Adjustment, or Managed Care. - Experience conducting chart audits and identifying documentation deficiencies. - Previous experience with Medicaid, Medicare, CareSource, Amerigroup, Peach State, or other managed care documentation requirements. - Experience training, coaching, or supervising clinical staff. Compensation & Benefits - Competitive starting rate of $40.00 per hour. - Opportunities for compensation increases based on performance, demonstrated expertise, and contribution to agency quality improvement efforts. - Flexible scheduling. - Remote work opportunities available. - Opportunity to help shape quality assurance and compliance processes within a growing behavioral health agency. How to Apply Qualified candidates should submit a resume, current licensure (if applicable), and a brief summary of their experience in clinical documentation review, quality assurance, compliance, auditing, or behavioral health services.

Role Description As a Text Reviewer / Proofreader, you perform a final quality check before publication to our customers and ensure that news clippings in German are complete and correct. - Correct spelling mistakes in OCR-processed news clippings to ensure error-free copy and consistent style. - Ensure that headlines, photos, captions, and other text zone types are correctly referred to and represented in the text. - Check whether news articles are complete and no subsequent pages are missing. - Ensure that news clippings are adequately represented in PDF format. - Report back any quality issues. Qualifications - You are highly proficient in written English and German (B2 under the CEFR standard). - You are able to work from 9am to 1pm (GMT+8). - You have good time management skills, know how to effectively prioritize your workflow, and thrive in a fast-paced work environment. - As a digital native, you are able to quickly adapt to our proprietary publishing platform and can effectively communicate technical issues to the team. - You must complete one assessment test before the interview and one assessment test live during the interview with a member of our team. - Please attach an informal cover letter describing your motivation for this job in the target language: German. Benefits - Remuneration: USD 4 per hour.

• Perform medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. • Document decisions using indicated protocol sets or clinical guidelines. • Provide support and review of medical claims and utilization practices. • Monitor process's timeliness in accordance with contractor standards. • Perform authorization process, ensuring coverage for appropriate medical services within benefit and medical necessity guidelines. • Utilize allocated resources to back up review determination. • Review interdepartmental requests and medical information in a timely/effective manner to complete utilization process. • Conduct/perform high dollar forecasting research and formulate overall patient health summaries with future health prognosis and projected medical costs. • Perform screenings/assessments and determine risk via telephone. • Review/determine eligibility, level of benefits, and medical necessity of services and/or reasonableness and necessity of services. • Provide education to members and their families/caregivers. • Review first level appeal and ensure utilization or claim review provides thorough documentation of each determination and basis for each. • Conduct research necessary to make thorough/accurate basis for each determination made. • Educate internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines. • Respond accurately and timely with appropriate documentation to members and providers on all rendered determinations. • Participate in quality control activities in support of the corporate and team-based objectives.