-
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: Portland, US-ME
Salary / Rate: Not Specified
Posted: 2025-04-30 08:43:03
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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: Bowling Green, US-KY
Salary / Rate: Not Specified
Posted: 2025-04-30 08:43:02
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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: Louisville, US-KY
Salary / Rate: Not Specified
Posted: 2025-04-30 08:43:01
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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: Kansas City, US-KS
Salary / Rate: Not Specified
Posted: 2025-04-30 08:43:01
-
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: Davenport, US-IA
Salary / Rate: Not Specified
Posted: 2025-04-30 08:43:00
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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: Des Moines, US-IA
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:59
-
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: Sioux City, US-IA
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:59
-
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: Wichita, US-KS
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:58
-
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: Chicago, US-IL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:57
-
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
-
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
-
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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Licensed Practical Nurse (LPN) - $5,000 SIGN-ON BONUS for Full-Time.
$2,500 SIGN-ON BONUS for Part-Time
Elevate Your Nursing Career with NHC Glasgow!
Are you ready to make a real impact in healthcare? At NHC Glasgow, we're committed to creating a supportive and rewarding environment where you can thrive.
Join a team that values your expertise, rewards your dedication, and empowers you to provide exceptional patient care.
Get Paid Your Way! Experience the freedom of financial flexibility with OnShift Wallet - access up to 50% of your earned wages instantly, anytime, anywhere.
Your Role: Do you have the heart to serve others and the skills to lead in nursing? As an LPN at Glasgow, you'll connect with patients and families, ensuring they receive personalized and compassionate care in a family-oriented atmosphere.
You'll also enjoy opportunities to use your comprehensive nursing tools and advance your career.
Work Schedule: 12-hour shifts.
7pm-7am
Pay: Up to $44.00/hour (Based on years of experience).
Ask about shift diff and ask about our no paid leave status for the opportunity to earn more $$.
Job Type: Full-Time, Part-Time, and PRN
Why Join Us? Our competitive benefits package includes:
* Flexible Schedules: Customize your shifts to fit your life.
* Block Scheduling Available: Enjoy predictability and stability.
* Bonuses for Overtime: Get rewarded for going the extra mile.
* Generous Paid Time Off: Vacation, holidays, and personal days included.
* Comprehensive Health Coverage: Medical, dental, vision, and life insurance.
* Tuition Reimbursement: Advance your education with our support.
* Advancement Opportunities: Your career growth is our priority.
* Patient Ratios You Can Feel Good About: Focus on quality care.
* 401(k) with Generous Contributions: Plan for your future.
Qualifications:
* Active Tennessee RN Nursing License (we also welcome GNs and GPNs!)
* Commitment to providing high-quality, compassionate care.
RN Position Highlights:
* Maintain clinical competency through integrated nursing knowledge, skills, leadership, and communication.
* Utilize the nursing process for assessment, planning, and implementing care.
* Organize and prioritize workflow to meet patient care needs effectively.
* Adhere to current nursing standards of practice and regulations.
* Foster continuous quality improvement with problem-solving skills.
* Demonstrate compassion, positivity, and teamwork in all aspects of care.
Why NHC Glasgow?
* A supportive and inclusive environment where your contributions matter.
* Opportunities to grow personally and professionally.
* A mission-driven organization that prioritizes patient care and community well-being.
About NHC: National HealthCare Corporation is a nationally recognized leader in senior care, known for innovation and quality.
At Glasgow, we embrace a culture of compassion, integrity, teamwork, and con...
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Type: Permanent Location: Glasgow, US-KY
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
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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
-
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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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
-
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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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
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Type: Permanent Location: Springfield, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:49
-
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
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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
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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...
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Type: Permanent Location: Tallahassee, US-FL
Salary / Rate: Not Specified
Posted: 2025-04-30 08:42:47
