Medical Necessity Specialist
2 weeks ago
We are seeking a detail-oriented Medical Necessity Specialist to join our team at Community Care Plan. As a key member of our Medical Management department, you will be responsible for reviewing prior authorization requests and ensuring compliance with regulatory guidelines.
Key Responsibilities- Prior Authorization Reviews: Conduct thorough reviews of prior authorization requests to determine medical necessity and appropriateness, utilizing standardized Review Criteria.
- Caseload Management: Prioritize and manage assigned caseload, ensuring timely completion and resolution of requests.
- Collaboration and Communication: Work closely with Medical Directors, physicians, and other stakeholders to coordinate requests and resolve issues.
- Clinical Experience: A minimum of two years of utilization review/case management experience, preferably in an acute care setting.
- Licensure: Current unrestricted Florida RN or LPN License.
- Knowledge and Skills: Familiarity with InterQual and Milliman Criteria, Florida Medicaid Program, and CMS Guidelines.
Community Care Plan is a leading provider of healthcare services, dedicated to delivering high-quality care to our patients. We are committed to fostering a diverse and inclusive work environment that values employee growth and development.
Compensation and BenefitsThe estimated salary for this position is $60,000 - $80,000 per year, depending on experience. We offer a comprehensive benefits package, including health insurance, retirement savings plan, and paid time off.
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Medication Support Specialist
2 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeCompany Overview:Pine City, a leading provider of healthcare services, is seeking certified and trained MEDICATION SUPPORT SPECIALISTS to join their team at assisted living and memory care facilities in the surrounding areas. With over 50 years of experience, our company offers stability and integrity as a career partner.Salary:$28-$34 per hour, depending on...
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Emergency Medical Specialist
4 weeks ago
Sunrise Manor, Nevada, United States Rapid Response EMS Full timeRapid Response EMS is seeking a dedicated Emergency Medical Specialist to join our team in Hendry County, FL. This is an excellent opportunity for individuals with a passion for providing exceptional patient care to work in a dynamic and fast-paced environment.Competitive Compensation: $60,000 - $80,000 per year, depending on experience.About the Role:The...
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Caregiver and Medication Specialist
2 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeJoin our team as a skilled Trained Medication Aide and make a difference in the lives of seniors! With a competitive salary range of $28-$34 per hour, you will have the opportunity to work in a dynamic and supportive environment.As a caregiver and medication specialist, your primary responsibility will be to assist with cares and provide excellent patient...
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Emergency Medical Care Specialist
4 weeks ago
Sunrise Manor, Nevada, United States AMR Full timeWe are seeking highly skilled and compassionate individuals to fill the role of Emergency Medical Care Specialist. As a member of our team, you will have the opportunity to make a meaningful impact in the lives of others while working in a fast-paced and dynamic environment.Job SummaryThe Emergency Medical Care Specialist will be responsible for assessing...
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Certified Medication Specialist
4 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeCareer Opportunity: Certified Medication Specialist in Pine CityWe are seeking a highly skilled and compassionate Certified Trained Medication Aide to support our residents at assisted living and memory care facilities in Pine City and the surrounding areas.Salary: $28-$34 per hour, depending on shift differential. We also offer a weekly pay structure and a...
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Medication Aide Assistant
2 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeJob OverviewWe are looking for a dedicated and compassionate Healthcare Support Specialist to join our team at Interim HealthCare Staffing. As a Healthcare Support Specialist, you will play a vital role in supporting residents at assisted living and memory care facilities in Albert Lea and surrounding areas.About the RoleThe successful candidate will be...
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Patient Care Specialist
4 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeInterim Healthcare is hiring for Patient Care Specialists to work in our Agency Staffing Department. With a diverse range of facilities available, you can choose your own shifts and work when and where you want.About the RoleThe Certified Patient Care Specialist is responsible for providing personalized care and support to patients of all ages in various...
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Utilization Management Nurse
1 month ago
Sunrise Manor, Nevada, United States Community Care Plan Full timeJob DescriptionThe Utilization Management Nurse (UMN) role at Community Care Plan requires a skilled professional to optimize healthcare resources and ensure seamless transitions of care.Main Responsibilities:Conduct thorough reviews of prior authorization requests to assess medical necessity and appropriateness, utilizing standardized Review...
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Pediatric Nurse Specialist
4 days ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timePediatric Nurse SpecialistInterim HealthCare is seeking a highly skilled Pediatric Nurse Specialist to join our team in Des Moines, Iowa. As a Pediatric Licensed Practical Nurse (LPN), you will provide home-based care to pediatric patients with illnesses, injuries, and chronic diseases.Job Description:We are looking for an experienced LPN to provide...
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Caregiving Specialist
4 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeCare for Seniors in Albert Lea and Surrounding AreaWe are seeking a compassionate Caregiving Specialist to join our team at Interim HealthCare Staffing. As a Medication Aide, you will play a vital role in supporting residents at assisted living and memory care facilities.About the RoleAssist with medication administration and other care-related tasksProvide...
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Sales Growth Specialist
7 days ago
Sunrise Manor, Nevada, United States Florida Regional Insurance Group Inc Full timeSales Growth Specialist">We are seeking a highly motivated Sales Growth Specialist to join our team at Florida Regional Insurance Group Inc. As a key member of our sales team, you will be responsible for identifying and pursuing new business opportunities to drive revenue growth and meet or exceed targets.">Responsibilities">">Identify and pursue new...
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Ice Surface Specialist
3 weeks ago
Sunrise Manor, Nevada, United States Las Vegas Ice Center Full timeJob DescriptionWe are seeking a skilled and dedicated individual to work as an Ice Surface Specialist at the Las Vegas Ice Center. This role is responsible for maintaining the overall quality of our ice surfaces.Key Responsibilities:Maintaining ice surface quality through regular maintenance tasks.Operating a Zamboni ice resurfacing machine to ensure smooth...
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Medical Professional
1 week ago
Sunrise Manor, Nevada, United States SpecialtyRx Full timeJob OverviewWe are seeking a highly skilled Licensed Pharmacist to join our team at SpecialtyRx, a leading Long-Term Care pharmacy. As a key member of our healthcare team, you will be responsible for providing exceptional patient care and services to our clients.Responsibilities:Evaluate medication orders for appropriateness, ensuring accurate dosages and...
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Personal Care Specialist
2 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeAbout Our Company:Interim Healthcare is a leading provider of healthcare staffing services, dedicated to delivering high-quality care to patients in need. With a focus on compassion, integrity, and expertise, we strive to make a positive impact in the lives of those we serve.Job Description:As a Personal Care Specialist with Interim Healthcare, you will be...
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Medical Director Opportunity in Family Medicine
4 weeks ago
Sunrise Manor, Nevada, United States The Inline Group Full timeJoin Our Team at Austin Regional Clinic - Manor">Austin Regional Clinic is seeking a highly skilled Physician/Family Medicine Specialist to join our team at our state-of-the-art facility in Manor, Texas. As a key member of our medical staff, you will be responsible for providing exceptional patient care and contributing to the success of our clinic.">About...
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Medical Device Assembly Specialist
6 days ago
Sunrise Manor, Nevada, United States MDI Repairs Full timeAre you looking for a challenging career in medical equipment repair? At MDI Repairs, we're seeking skilled professionals to join our team as Entry-Level Repair Technicians.We offer comprehensive training and mentoring to ensure your success in this role. As an Entry-Level Repair Technician, you will assist in the repair, maintenance, and calibration of...
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Patient Support Liaison Specialist
7 days ago
Sunrise Manor, Nevada, United States Dope Doctors Full timeWe are seeking a skilled Patient Support Liaison Specialist to join our team at Dope Doctors.About the RoleThe ideal candidate will have a medical background and excellent communication skills to provide top-notch support to our patients through various channels.Key Responsibilities:Follow up with patients within 24 hours of inquiry or appointment via phone,...
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Pediatric Nursing Specialist
4 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeJob Summary">We are seeking a skilled Pediatric Nursing Specialist to join our team. The ideal candidate will have experience in pediatric care and be able to work independently with minimal supervision.">Duties and Responsibilities">">Follow a designated care plan in accordance with the patient's needs">Perform assigned duties, including administration of...
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Senior Caregiver
4 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeAt Interim HealthCare Staffing, we're dedicated to providing exceptional care to seniors in assisted living and memory care facilities. We're currently seeking a compassionate and skilled Certified Trained Medication Aide to join our team.Salary: $28-$34 per hour, depending on the shift differential, with opportunities for advancement and a $3,000 sign-on...
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Healthcare Support Specialist
4 weeks ago
Sunrise Manor, Nevada, United States Interim Healthcare Full timeJob Title: Healthcare Support SpecialistLocation: Lumberton, North Carolina (NC)About the Job:We are seeking a dedicated and compassionate Certified Nursing Assistant (CNA) to provide high-quality home healthcare services to our clients in Lumberton, NC.Responsibilities:Assist with light housekeeping and daily living activitiesProvide companionship and...