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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Evansville, US-IN
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:57
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Indianapolis, US-IN
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:56
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Springfield, US-IL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:55
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Fort Wayne, US-IN
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:55
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Idaho Falls, US-ID
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:54
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The RN/LPN, Nurse Educator is responsibilities include, but are not limited to orientation, clinical in servicing, all-staff training, Hiring, interviewing, and onboarding.
Qualifications:
* Must have Registered Nurse (RN) license or Licensed Practical Nurse (LPN) License
* Must be caring, compassionate, team player, and have a heart for the geriatric patient
* Prior experience as Nurse Educator preferred.
Responsibilities include:
* Creates a learning environment based on evidence-based practice using a variety of teaching strategies appropriate for the adult learner.
* Teaches clinical skills to RNs, CNAs, LPNs and ancillary staff as required by state laws.
* Ability to build professional development plans for and with learners with the goal of developing their skills and assisting them to advance their professional practice.
* Supports clinical leaders in the development of action plans and performance improvement plans to ensure best practices.
* Supports the development and implementation of clinical programs, initiatives, standards and policies.
* Actively recruits, hires, and onboards new partners
* Functions as a change agent and leader who advocates for nursing and nursing education and participates in interdisciplinary efforts to address health care and educational needs within the facility, community and system.
* Performs other duties, as assigned.
NHC offers a competitive compensation package for full time employment including health, dental, vision, life, disability insurance, uniforms, paid time off, 401 (k) with generous company match, stock options, and more.
National HealthCare Corporation is recognized nationwide as an innovator in the delivery of quality care.
Our goal is to provide a full range of extended care services, designed to maximize the well-being and independence of patients of all ages.
We are dedicated to meeting patient needs through an interdisciplinary approach combining compassionate care with cost-effective health care services.
The NHC environment is one of encouragement and challenge ...
innovation and improvement ...
teamwork and collaboration ...
and honesty and integrity.
All NHC employees are committed as partners, not only to the health of our patients, but to the well-being of the communities we serve.
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity, please apply today and find out more about us at nhccare.com/locations/Glasgow/
We look forward to talking with you!!
EOE
....Read more...
Type: Permanent Location: Glasgow, US-KY
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:53
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Columbus, US-GA
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:52
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Position: Executive Chef-Food and Nutrition Director
Are you looking to have fun in a work environment where you can express your talents and creativity, while making a difference in the lives of others? Come join our Food Nutrition Service Team! The Palmettos of Bluffton Assisted Living fosters an environment of teamwork and provides opportunities in a culinary environment in a healthcare setting.
The Executive Chef position will work to maintain an organized, productive kitchen in a safe and sanitary environment.
The Executive Chef will supervise the Food and Nutrition Services (FNS) partners, along with managing the daily operations of the kitchen.
The residents, partners, and guests will be served appetizing, nutritionally balanced meals in a timely manner to promote high customer satisfaction.
Job Type : Full Time
Why NHC? We are celebrating our 50-year Anniversary at National HealthCare Corporation!! We offer a culture of recognition, empowerment, and fun.
At NHC, we are all partners (employees) in a family - oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Experience
-Must have a sincere interest in foodservice and enjoy working with the senior care living-Accredited Culinary training or Chef Certification are required.
-ServSafe Manager
-3 years of hands-on food prep/presentation experience.
-Previous experience with administrative management is beneficial, but not required.
BenefitsEarned Time Off
Holiday Incentive Pay
Health, Dental, Vision, Disability and Life insurance
Flex Spending Plan
401k with generous company contributions
Flexible Schedule
Uniforms
Tuition Reimbursement Opportunities
Advancement Opportunities
No Late Nights
Work Location:The Palmettos of Bluffton
3035 Okatie Highway
Okatie, SC 29909
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity , please apply today and find out more about us at nhccare.com/locations/palmettos-bluffton/
EOE
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Type: Permanent Location: Bluffton, US-SC
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:52
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Boise, US-ID
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:51
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Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:50
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Weekend House Supervisor, RN
Don't miss this great opportunity for a Registered Nurse (RN)to join our team as a Weekend Supervisor at NHC Maury Regional Transitional Care Center.
You will find such a rewarding experience in building relationships with our residents and their families while using your comprehensive nursing tools in a holistic approach to treating your patients!
The ideal Registered Nurse candidate is caring, compassionate, has a positive attitude and is a team player.
Responsibilities include working with the interdisciplinary care team to assure accurate patient assessment and plan of care; maintaining open and ongoing communication with patients and families; assuring that appropriate nursing care is provided; assisting with medications and treatments; supervising LPNs and other nursing partners; and performing other patient care duties as assigned.
NHC Maury Regional Transitional Care Center offers competitive compensation package for full time employment including affordable health, dental, vision, life, disability insurance, paid time off, 401 (k) with generous company match, stock options, scrub uniforms, and more.
You also earn vacation beginning the first day of employment!!
Requirements:
- Must have Tennessee RN ( Registered Nurse) license.
- Must be caring, compassionate, have a positive attitude and be a team player
We are located at:
NHC Maury Regional Transitional Care Center5010 Trotwood Avenue
Columbia, TN 38401
The NHC environment is one of encouragement and challenge ...
innovation and improvement ...
teamwork and collaboration ...
and honesty and integrity.
All NHC employees are committed as partners, not only to the health of our patients, but to the well-being of the communities we serve.
If you are interested in working for a leader in senior care, share NHC's values of honesty and integrity, and have a heart for the geriatric patient, please apply today and find out more about us at nhccare.com/locations/maury-regional/
We look forward to talking with you! NHC is an Equal Opportunity Employer.
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Type: Permanent Location: Columbia, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:50
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Cook for Beautiful SNF in Springfield, MO
We are a 146 bed facility with a home like environment and a new 30 bed rehab wing!! We are pleased to share we have received the CMS 5 star rating for the past several years!!
Position: Cook MUST HAVE EXPERIENCE AS A COOK IN A LONG TERM CARE FACILITY
Are you looking to have fun in a work environment where you can express your talents and creativity, while making a difference in the lives of others? Come join our Food Nutrition Service Team! NHC fosters an environment of teamwork and provides opportunities in a culinary environment in a healthcare setting.
The Dietary Cook performs specified duties to maintain high standards of quality food preparation, production, service, and portion control, using standardized recipes, for all customers.
Position Highlights:
* Assists in receiving and storing food and supplies to prevent waste and assure quality products.
Dates, labels, and stores items properly.
Uses proper food handling techniques.
* Review's menus, therapeutic menus, recipes, and production sheets before preparing meals; prepares and serves diets properly, accurately, and attractively as planned using proper portions and special diet items.
* Follows standardized recipes and special diet orders, preparing sufficient quantities to meet all service requirements.
* Responsible for testing and tasting foods of all consistencies for proper appearance, flavor, aroma, and temperature and adjust if needed.
* Responsible for timing of preparation of meals/snacks to meet time schedule for service for patients and customers to ensure all meals/snacks are served as scheduled.
* Checks trays for accuracy of diets, preferences, and quality before they are delivered.
Serves on tray line and delivers carts to floors as needed.
Job Type: Full Time
Work Shift: Varied Hours, Days and Shifts
Why NHC? Springfield Rehabilitation and HealthCare Center is pleased to be a part of the NHC (National HealthCare Corporation) family.
We offer a culture of recognition, empowerment, and fun.
At NHC, we are all partners (employees) in a family - oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Experience
Healthcare food service experience required.
Benefits Earned Time Off Holiday Incentive PayHealth, Dental, Vision, Disability and Life insurance401k with generous company contributionsUniformsAdvancement Opportunities
Work Location: Springfield Rehabilitation and HealthCare Center
2800 S Fort Ave
Springfield, MO 65807
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity , please apply today and find out more about us at nhccare.com/locations/springfield-rehabilitation/
EOE
....Read more...
Type: Permanent Location: Springfield, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:49
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Position: Director of Nursing, RN
Pay: $80,000 - $92,000 yearly Depending on Experience
Caris Healthcare Director of Nursing, RN serves as a leader with overall clinical management of the hospice agency.
The hallmarks of this position include ensuring high quality hospice care to each patient, developing people, process improvement, financial management, and business development.
Caris Healthcare's mission is to provide hospice care with grace.
Serving patients throughout the Southeast region, we support our team members, patients and their families with compassion, accountability, respect, integrity and service.
If you are ready for a rewarding career with a company that offers employees a culture of integrity and excellence, consider joining the Caris Healthcare team.
At Caris, you will have a career, not just a job.
Our mission driven culture is evident by our current employees and the impact made on patients and families.
All Caris team members commit to The Better Way, a list of promises we make to each other and our customers.
The Better Way commitment is reflected in the benefits we provide.
Benefits include:
* Competitive Salary
* Bonus Eligibility
* Eligible for benefits within 60 days
* Health Benefits (Medical, Dental, Vision); health savings account
* Earned Time Off
* 401 (K) plan with company match
* Paid Training
* Mileage Reimbursement
* Tuition Reimbursement
* Flexible Scheduling
* Career Advancement Opportunities
Responsibilities
* Responsible for all aspects of patient care and supervision of the clinical team
* Plans and facilitates conferences for the Interdisciplinary Team (IDT)
* Manages and evaluates quality of care and makes supervisory patient visits with employees as appropriate
* Responsible for evaluating patient care data and satisfaction surveys to identify trends and address opportunities for improvement
* Ensures hospice agency and all clinical personnel are in compliance with regulations, policies, and procedures
* Recruits, hires, and directs training and education for employees
* Demonstrates leadership and management skills by maintaining high employee satisfaction and low employee turnover
* Maintains budget by ensuring productivity of employees and utilization of services
* Functions as an alternate for the Administrator as needed
Qualifications
* Current licensed RN in state of operation
* One (1) to three (3) years of healthcare experience: hospice, palliative care, oncology, or home health preferred
* Preferred management experience
* Excellent communication and interpersonal skills
* Proficient computer and technology skills
If you see yourself a good fit and want to join our team apply today! Caris HealthCare is an affiliate of NHC.
EOE
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:48
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Savannah, US-GA
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:48
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Tallahassee, US-FL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:47
-
PRN Physical Therapist - NHC Maryland Heights, MO
We are an in-house therapy team that prioritizes quality care.
Why NHC Maryland Heights?
We offer a culture of recognition, empowerment, and fun.
At NHC Maryland Heights, we are all partners (employees) in a family -oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Benefits:
* Excellent compensation
* Dental and Vision insurance
* 401k with generous company contribution
* Continuing Education
* Stock options
* Uniforms
NHC Maryland Heights is looking for a PRN Physical Therapist to join the team.
Experienced therapists, flexible scheduling, and excellent pay rates make this a great opportunity for a PT interested in becoming a part of a caring, innovative, and evidence based outcomes focused rehab team.
Requirements:
* Must have Missouri Physical Therapist license
* Must be flexible, positive, a team player and reliable transportation
* Prior SNF experience a plus
The NHC environment is one of encouragement and challenge ...
innovation and improvement ...
teamwork and collaboration ...
and honesty and integrity.
If you are interested in working for a leader in senior care, please apply.
EOE
....Read more...
Type: Permanent Location: Maryland Heights, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:46
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:46
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Miami, US-FL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:45
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Jacksonville, US-FL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:43
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Hartford, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:42
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Wilmington, US-DE
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:40
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Dover, US-DE
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:39
-
HR Director Position in Knoxville
Full-Time Behavioral Medicine HR Director/Adult Geriatric Psychiatrist
Knoxville Center for Behavioral Medicine - a comprehensive inpatient behavioral health facility.
Our center will provide acute behavioral health care and outpatient treatment to adults and geriatric adults who are in crisis from severe symptoms related to behavioral health and/or substance use disorder.
The Behavioral Medicine HR Director position is responsible for providing human resources leadership and support in the
areas of talent management, partner (employee) satisfaction, benefits administration, HR-related metrics, and management/leadership training.
Qualifications:
* Bachelor's degree and ten years of health care-related human resources
experience.
* Human Resources-related certification preferred.
* Be able to work accurately with pressures of deadlines and interruptions while at
the same time being well organized, persistent, and working as a team player.
* Be able to be an effective listener and problem solver of partner issues.
* Possess good communication and analytical skills with ability to pay attention to
details.
Job Details:
* 64-bed acute inpatient setting
* IOP/PHP oversight
* Adult and Geriatric client population
* Behavioral Health and Addiction Treatment
* Acute intervention focus with short term stays
* Joint venture/Professional partnerships between NHC, Tennova and University of Tennessee - Knoxville
Position Highlights: Reasonable accommodations may be made to enable individuals with disabilities to
perform the essential job functions.
* Recruits, interviews, and facilitates the hiring of qualified job applicants for open positions; collaborates with departmental managers to understand skills and competencies required for openings.
* Reviews, tracks, and documents compliance with mandatory and non-mandatory training, continuing education, and work assessments.
This may include safety training, anti-harassment training, professional licensure, and corporate
compliance training and certifications.
* Performs tasks required to administer and execute human resource programs including but not limited to compensation, benefits, and leave; disciplinary matters; disputes and investigations; performance and talent management;
productivity, recognition, and morale; occupational health and safety; and training
and development.
Knoxville Center for Behavioral Medicine: Mission and Vision
We are committed to improve the quality of life of our patients by delivering personalized behavioral health in a safe and supportive environment.
Our vision is to bring communities, families, and healthcare providers together to improve behavioral health, one patient at a time.
The Knoxville Center for Behavioral Medicine provides a comprehensive continuum of care for adults and geriatric patients with psychiatric, emo...
....Read more...
Type: Permanent Location: Knoxville, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:39
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Bridgeport, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:38
-
Description & Requirements
Maximus is currently hiring for Consultant - Medical to join our team.
This is a remote opportunity and contingent upon award of contract.
The Consultant will be responsible for providing independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
*
*
*Please note that this position is contingent upon contract award
*
*
*
Essential Duties and Responsibilities:
- Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments.
- Provide written clinical rationales for CA Workers Compensation cases.
- Review, organize and identify all medical records provided for CA workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as legal research, general medical research, etc.
- Work on special projects to improve CA IMR project or other special projects as assigned.
- Become a subject matter expert (SME) using job aides and learning tools.
- Review and provide independent medical reviews for prior authorization requests for relating to Workers' Compensation benefits (WC), Disability benefits (DB), Paid Family Leave (PFL) benefits, Volunteer Firefighters' benefits, and Volunteer Ambulance Workers' benefits.
- Evaluate Level 3 prior authorization requests (PARs) for medical services and goods including but not limited to all PAR types (Medication, Confirmation, Variance, Special Services, Durable Medical Equipment), all New York State Workers' Compensation Medical Treatment Guidelines and Drug Formulary criteria for all medical services, medications, medical devices contemplated therein, or requests for variances for medical treatment not addressed or recommended.
- Ensure all basic documentation requirements are available or requested via development action prior to review by medical and pharmacy review personnel.
- Render medical/clinical determinations based on professional experience that is clear, professional and grammatically correct.
- Ability to perform comfortably in a fast-paced, production and deadline-oriented work environment.
- Provide written clinical rationales for Workers Compensation cases.
- Review, organize and identify all medical records provided for prior authorization requests (PAR) for assigned workers comp cases.
- Monitor timeliness of reviews to ensure applicable standards are met.
- Consistently meet production and quality standards.
- Perform special projects as assigned such as clinical research, general medical research, etc.
- Become a subject matter expert (SME) using job aides and learning tools.
- Work on special projects as assigned.
- Other duties as assigned by management.
Minimum Requir...
....Read more...
Type: Permanent Location: Colorado Springs, US-CO
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:37
