Clinical case manager jobs in Boise, ID - 129 jobs

Benefits: YMCA Membership HRA (Health Reimbursement Agreement) 401(k) matching Company parties Flexible schedule Profit sharing Training & development We are seeking dedicated and compassionate individuals to join our team as Case Managers (CM) and Community Based Rehabilitative Specialists in Idaho. As a leading provider of community-based services, we are committed to supporting individuals in their journey towards independence and improved quality of life. Position: Case Manager (CM) and Community Based Rehabilitative Specialist (CBRS) Location: Idaho in multiple settings....*In Home, In Community, In Office and In Person* Responsibilities: Provide case management services to individuals with mental health, developmental disabilities, or substance use disorders. Conduct comprehensive assessments to identify clients' strengths, needs, and goals. Develop individualized service plans in collaboration with clients and their support networks. Coordinate and facilitate access to appropriate community resources, including healthcare, housing, employment, and social services. Advocate for clients' rights and assist in navigating the complex healthcare and social services systems. Monitor and evaluate clients' progress towards their goals, adjusting service plans as necessary. Collaborate with a multidisciplinary team to ensure integrated and holistic care. Maintain accurate and up-to-date documentation and records in compliance with regulatory standards. Qualifications: Bachelor's degree in social work, psychology, counseling, or a related field. Experience working with individuals with mental health, developmental disabilities, or substance use disorders is preferred. Knowledge of community resources and service networks in Idaho. Strong assessment, communication, and problem-solving skills. Ability to work independently and as part of a team. Familiarity with electronic documentation systems is a plus. Valid driver's license and reliable transportation. To apply, please submit your resume and a cover letter highlighting your relevant experience and qualifications to [email address]. We look forward to reviewing your application and considering you for this important role in supporting our clients' well-being and independence. Please note that only shortlisted candidates will be contacted for further steps in the selection process. Compensation: $21.00 - $25.00 per hour Are you interested in working with an industry leading mental health provider? At One Love Agency we are always looking for talented individuals to join our rapidly growing team at all levels Founded in 2012, One Love Agency is family owned and locally operated. Born from personal experience and with a mission to instill hope, One Love now provides general therapy, case management, community based rehabilitation, peer support, and payee services. From this extensive experience and diverse team, we are able to deliver collaborative and holistic care tailored to each client's needs.

at Clarvida - Idaho Clarvida's success is built on the strength of our people: individuals who bring the right skills and a deep commitment to our mission of improving lives and communities. Our employees are empowered to bring their full potential to the table, ensuring long-term success for our team and those we serve. Adult Crisis Center Case ManagerWhen individuals experience a behavioral health crisis, they require a focused level of attention and care. As part of the integrated treatment with our Clarvida Community Crisis Center of Southwest Idaho, the Case Manager focuses on providing support and encouragement to adult clients experiencing a behavioral health crisis. This position assists clients in achieving their personal recovery goals through individualized education on how-to obtain community services, maintain life supports such as housing or income, and carry out the tasks of daily living. The Crisis Case Manager helps clients connect to support groups and other community networks, and offers education and support towards their physical and mental wellness, including healthy living behaviors. This position maintains the safety and security of the center by conducting client and visitor check-ins and discharge, communicating with staff on shift, and providing assistance by connecting callers to the appropriate staff. Perks of this role: $18-19/hour Part time daytime, evening, weekend schedule Up to 29 hours/week Consistent Hours (no billable hour) Mental health field experience Stability and growth opportunities of working with a national agency What we're looking for: Bachelor's degree in a Human Service field (Social Work, Psychology, Sociology, Human Service, Education, Counseling, Family Relations, Nursing, Physical Therapy, Occupational Therapy, Therapeutic Recreation, Speech Language Pathology, Behavioral Sciences, Art Therapy, etc.) Ability to pass background checks, including Enhanced Fingerprinting with ID DHW. What we offer: Full Time Employees: Paid vacation days that increase with tenure Separate sick leave that rolls over each year Up to 10 Paid holidays* Medical, Dental, Vision benefit plan options DailyPay- Access to your daily earnings without waiting for payday* Training, Development and Continuing Education Credits for licensure requirements All Employees: 401K Free licensure supervision Employee Assistance program Pet Insurance Perks @Clarvida- national discounts on shopping, travel, Verizon, and entertainment Mileage reimbursement* Company cellphone *benefits may vary based on Position/State/County Application Deadline: Applications will be reviewed on a rolling basis until the position is filled. If you're #readytowork we are #readytohire! Now hiring! Not the job you're looking for? Clarvida has a variety of positions in various locations; please go to ******************************************** To Learn More About Us: Clarvida @ ************************************************** Clarvida is an equal opportunity employer with a commitment to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability, veteran status or any other protected characteristic. "We encourage job seekers to be vigilant against fraudulent recruitment activities that are on the rise across the healthcare industry. Communication about legitimate Clarvida job opportunities will only come from an authorized Clarvida.com email address, from a [email protected] email, or a personal LinkedIn account that is associated with a Clarvida.com email address."

Job Description Since inception in 2004, BI Incorporated has operated ISAP for the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) and Enforcement and Removal Operations (ERO). ISAP is an essential part of ERO, providing intensive supervision of individuals in immigration proceedings. The program achieves positive results by combining comprehensive case management with proven supervision technology. In addition, BI maintains an extensive list of community-based partners to provide critical assistance for participants' basic life needs. With consistent positive outcomes, ISAP continues to grow and evolve, serving an ever-increasing number of participants. Experienced Case Managers-a world of opportunities awaits you! Are you looking for the kind of opportunity that truly challenges you to use the skills you've worked so hard to build? We can help! We are looking for Immigration Case Managers to fill the role of Government Site Specialist for the Intensive Supervision Appearance Program (ISAP). This alternative to detention program aims to supervise individuals who are navigating the U.S. immigration court system. In this dynamic role, you will use your criminal justice background and experience in case management to assist ISAP participants following the guidelines of our Department of Homeland Security contract. Utilizing a combination of face-to-face case management meetings, electronic monitoring technologies and home visits to engage participants and drive compliance you will ensure that participants attend court hearings and comply with conditions set by DHS. This is a great opportunity to continue building your career in criminal justice, psychology and/or social work and case management. If you are passionate about influencing positive changes in the lives of others, this may be the right opportunity for you! Responsibilities Job Responsibilities As the Government Site Specialist, you will use your background in criminal justice, psychology and/or social and case management to develop, implement, and coordinate case management and individual service plans for ISAP Program Participants in conformance with program requirements. Additional responsibilities for the Senior Specialist include: Meeting with participants face-to-face regularly as required by government contractual obligations. Developing and maintaining accurate and complete case records for all ISAP Program Participants from entry to release from ISAP, maintaining confidentiality of all records. Conducting intake interviews and orientation sessions with each ISAP Program Participant within contractual timeframes. Installing electronic monitoring equipment on ISAP Program Participants as necessary and monitoring compliance with electronic monitoring program. Assisting Program Participants with acquiring travel documents from the countries of citizenship and maintaining a log of travel document information for each Program Participant. Evaluating English proficiency of ISAP Program Participants to determine resources necessary to promote clear communication between ISAP staff and the participants. Assess the needs and vulnerabilities of ISAP Program Participants, and connect them with appropriate resources within the community. Qualifications Job Requirements As the Government Site Specialist you must have excellent interpersonal, oral and written communication skills, and demonstrated tact when interacting with employees, community contracts, government official, and participants. You will also need demonstrated sound judgment and even temperament with the ability to deal tactfully with the public. If this describes you, apply today! Additional requirements include: A Bachelor's Degree in Sociology, Psychology, Social Work, Criminal Justice, or related social services/human service field. At least two (2) years' relevant experience in a field related to law, social work, detention, corrections, government, or similar field. Bilingual language skills required. Experience dealing with multicultural clients. Effective verbal and written communication skills with employees, community contacts, government officials and participants. Ability to interpret and articulate rules, orders, instructions and materials. Ability to compose reports. Ability to maintain self-control in stressful situations such as interpersonal confrontations or emergencies, or defuse hostile or unstable situations. Strong attention to detail and problem-solving skills. Basic knowledge of immigration laws, regulations, and procedures. Computer proficiency, including Microsoft Office and the Internet. Ability to interpret electronic monitoring messages and daily summary reports. Ability to type thirty-five (35) words per minute to develop and maintain case records by performing data entry. Valid driver's license required. United States citizenship required. Must live in the United States 3 of the last 5 years (military and study abroad accepted). Successfully pass pre-employment (post offer) background check and obtain a suitability determination. BI Incorporated

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Field Case Manager-Sign-On Bonus Eligible **We are growing all across the US and are looking for experienced Workers Comp Field Case Managers! Required to have a minimum of** **1.5 years of prior Workers Compensation experience in order to be considered.** **PRIMARY PURPOSE OF THE ROLE:** Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate; though advocacy, progressive medical treatment, and timely return-to-work; while acting as a liaison and providing communication between all involved parties. While frequent travel is required, you will maintain a home-based office. **ARE YOU AN IDEAL CANDIDATE?** We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. + Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury. + Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment that allows face to face interaction with injured workers and medical professionals. + Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting. + Enable our Caring counts mission supporting injured employees from some of the world's best brands and organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. + Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. . **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers as they navigate through the recovery process. + Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation. + Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source **EDUCATION AND LICENSING** RN licensure preferred; or bachelor's degree in health or human services field required with one of the following certifications: CCM, CDMS, or CRC. Valid driver's license required. High speed internet required. **TAKING CARE OF YOU BY** + Offering a blended work environment. + Supporting meaningful work that promotes critical thinking and problem solving. + Providing on-going learning and professional growth opportunities. + Promoting a strong team environment and a culture of support. + Recognizing your successes and celebrating your achievements. + We offer a diverse and comprehensive benefits package including: + Three Medical, and two dental plans to choose from. + Tuition reimbursement eligible. + 401K plan that matches 50% on every $ you put in up to the first 6% you save. + 4 weeks PTO your first full year. **NEXT STEPS** If your application is selected to advance to the next round, a recruiter will be in touch. \#nurse #fieldcasemanager As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $80,000-$95,000/quarterly bonus eligibility and Sign on Bonus Eligible. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. _"Always accepting applications."_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Responsibilities Intermountain Hospital is looking for a dynamic Outpatient Program Therapist/Case Manager to work with a variety of patients! If you have a desire to work in an engaging environment with a team of professionals dedicated to the healing and health of the patients we serve, we want to hear from you! The Program Therapist/Case Manager performs Social Services functions to assist patients in meeting their biopsychosocial needs while assisting them through therapeutic treatment skills to acheive their optimal level of emotional health. Duties include completing assessments, treatment plans, grooup therapy, family therapy, individual therapy and discharge planning. Shift: PRN/Monday through Thursday 4:00 p.m. to 8:00 p.m. and Friday 9:00 a.m. to 3:30 p.m. available Intermountain Hospital, located in Boise, has been providing quality psychiatric and chemical dependency services to Idaho's Treasure Valley and the western US since 1980. This 151-bed facility is located on 10 beautiful acres near the foothills of Idaho's dramatic Sawtooth Mountains. At Intermountain Hospital we are positively changing lives - lives that are affected by mental and emotional stress or chemical dependency. It is our philosophy that nobody needs to cope alone. We provide a safe and secure environment for addressing the pressing problems that can dominate those lives in our care. We provide a wide range of services and programs that offer evidence-based treatment proven to have positive outcomes for our patients. Our inpatient and outpatient services offer supportive and compassionate care through specialty programs that are tailored to meet the needs of our patients. Our mission is to provide safe, effective, and compassionate mental health and substance use treatment. What do our current employees value at UHS? An environment that puts patient care first. One of the most rewarding aspects of working with UHS is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times. Having the opportunity to grow, learn, and advance in your career. There are very robust continuing education options and opportunities for leadership development within UHS. Supportive and responsive leadership. Competitive salary and comprehensive benefits package. One of the nation's largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World's Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies. Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve. Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom. Qualifications Master's Degree in Counseling, Social Work, or a clinical related mental health field. Must be trained in Crisis Prevention Instruction and CPR (we provide paid training). EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources Departments and Recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best-in-class candidate experience. During the recruitment process, no Recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The Recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: ************************* or **************.

Totius Therapies is seeking a qualified applicants to provide Case Management and Community-Based Rehabilitation Services to clients in need. Our ideal applicants will demonstrate empathy and a strong commitment to supporting clients on their mental health journey. Applicants must possess a bachelor's degree and successfully pass a background check. Compensation ranges from $21 to $25 per hour, depending on experience. Providers are expected to adhere to ethical guidelines in both client interactions and billing practices. Compensation: $21.00 - $25.00 per hour We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. CareersCome to work at a place that cares about you as much as it does its patients Mental health providers have been the unsung heroes of society, and we want the world to know it! We believe it is time you were treated as the valuable healer you are. We are working to develop a comprehensive clinic that provides for the majority of our patients' needs which means we are always looking for new providers of various sorts. If you don't see a listing for your provider type, please check back often to see what new listings are up. Totius Therapies is an equal opportunity employer.

At St. Luke's, our dedicated team of Case Managers are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which ultimately drives our exceptional, patient-centered care. Position Overview: The RN Case Manager collaborates with physicians and the multidisciplinary team to develop and manage personalized care plans for an assigned caseload. What You Can Expect: * Hospital at Home is an alternative to traditional inpatient care. Patients will be treated for acute medical conditions in the comfort of their own home or residence * Schedule: 8 hour weekday shifts 12-8:30 PM with occasional weekend rotation * Benefits: Full Benefits with hospital contributions * Additional Pay: Cert Pay available for qualifying certifications * Bonuses: Sign on Bonus Eligible and relocation assistance available (where applicable) Qualifications: * Education: Associates' of Nursing Degree/Diploma Bachelors' of Nursing Degree * Experience: 2 years' of RN experience * Licenses/Certifications: Current RN License in Idaho For more information, please contact Julie at ***************** At St. Luke's, caring for people in the communities we serve is our mission - and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals. St. Luke's is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law. *Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.

we are seeking a (RN) Registered Nurse who must hold a compact license. , home office with internet connectivity of high speed required Work Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Collaborate closely with physicians, nurses, social workers and a wide range of medical and non-medical professionals to coordinate delivery of healthcare services. Assess the member's specific health plan benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services which promote quality, cost-effective outcomes by helping member populations achieve effective utilization of healthcare services. Facilitate outstanding member care using fiscally responsible strategies. Essential Responsibilities: * Collect and assess member information pertinent to member's history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services. * Coordinate necessary resources to achieve member outcome goals and objectives. * Accurately document case notes and letters of explanation which may become part of legal records. * Perform concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization programs. * Maintain contact with the inpatient facility utilization review personnel to assure appropriateness of continued stay and level of care. * Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions. * Review referral and preauthorization requests for appropriateness of care within established evidence-based criteria sets. * When applicable, identify and negotiate with appropriate vendors to provide services. * When appropriate, negotiate discounts with non-contracted providers and/or refer such providers to Provider Network Department for contract development. * Work with multidisciplinary teams utilizing an integrated team-based approach to best support members, which may include working together on network not available (NNA), out of network exceptions (OONE), and one-time agreements (OTA). * Serve as primary resource to member and family members for questions and concerns related to the health plan and in navigating through the health systems issues. * Interact with other PacificSource personnel to assure quality customer service is provided. * Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies. * Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients. * Identify high cost utilization and refer to Large Case Reinsurance RN and Care Management team as appropriate. * Assist Medical Director in developing guidelines and procedures for Health Services Department. Supporting Responsibilities: * Act as backup and be a resource for other Health Services Department staff and functions as needed. * Serve on designated committees, teams, and task groups, as directed. * Represent the Heath Services Department, both internally and externally, as requested by Medical Director. * Meet department and company performance and attendance expectations. * Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. * Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of three (3) years of nursing or behavioral health experience with varied medical and/or behavioral health exposure and capability required. Experience in acute care, case management, including cases that require rehabilitation, home health, behavioral health and hospice treatment strongly preferred. Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Registered Nurse or a clinically licensed behavioral health practitioner with current unrestricted state license. Within six (6) months of hire licensure may need to include Oregon, Montana, Idaho and/or other states as needed. Case Manager Certification as accredited by CCMC preferred. Knowledge: Thorough knowledge and understanding of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance and state-mandated benefits. Understanding of contractual benefits and options available outside contractual benefits. Working knowledge of community services, providers, vendors and facilities available to assist members. Understanding of appropriate case management plans. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: * We are committed to doing the right thing. * We are one team working toward a common goal. * We are each responsible for customer service. * We practice open communication at all levels of the company to foster individual, team and company growth. * We actively participate in efforts to improve our many communities-internally and externally. * We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. * We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Description If you are a new or recent grad with a passion for delivering exceptional patient care and becoming the very best ER doctor you can be, MedVet's Emergency Clinician Mentorship Program (ECMP) is a great fit for you. Our ECMP is an accelerated training program providing the opportunity for veterinarians to gain the knowledge and skills necessary to be an exceptional Emergency Clinician in an organization owned and led by veterinarians that practices the highest quality of specialty healthcare. Why Boise, ID? Boise is the perfect blend of urban activity and outdoor adventure. There's a vibrant art community, a lively downtown with shopping and delicious restaurants, and family-friendly attractions and events. For the outdoor adventurer, Boise has easy access to mountains, rivers, and lakes that offer recreation opportunities all year long. The Bogus Basin Mountain Recreation Area boasts 80 runs across 2,600 acres of terrain for winter sports enthusiasts. Student loan repayment program! Accelerated ER mentored training Includes specialty rotations that focus on ER relevance Doctor salary with full benefits from the beginning, salary plus production the second year Long-term career development support & leadership opportunities MedVet doctors have the opportunity to become shareholders! Qualifications: DVM degree from an AVMA-recognized institution Current license to practice veterinary medicine in the state of your program Employment interview with background check Two letters of recommendation from clinical faculty members with knowledge of applicant's clinical abilities and communication skills (new grads) For more information: Please visit our website at medvet.com or to submit a confidential CV, please email either Amanda at [email protected], Hannah at [email protected], ECMP is a 1-year training program with a 1 year ER commitment with your training hospital. It starts with mentored training and specialty rotations as you develop your ER clinical expertise. In the 2nd year you will be a full ER doctor earning salary plus production pay! For more details: ***************************************** Thinking about an internship or still planning your externship rotations? MedVet has those too! See the VIRMP webpage or click the link below for info on all of our training programs. ************************************************************ We would love to have you join the top-notch doctors & health care team members at MedVet who strive every day to deliver the very best care to pets, their loving families, & the veterinary community Come as you are. MedVet is an equal opportunity employer. We are also a drug-free organization, therefore employment with MedVet is dependent upon the passing of a drug screen and background check.

IVAAL Solutions, LLC provides support to the Air Force (AF) Family Advocacy Program (FAP) and is responsible for staffing qualified Licensed Clinical Social Workers, Licensed Registered Nurses, Certified Victim Advocates, and Program Assistants at U.S. AF Military Treatment Facilities (MTFs) across the country. The AF FAP is a Department of Defense, (DoD) funded program whose purpose is to both prevent and respond to intimate partner abuse, child abuse, and problematic sexual behavior with children and youth. Job Description: The Domestic Abuse Victim Advocate (DAVA) provides AF personnel, their family members, or intimate partners who are victims of intimate partner abuse non-clinical emergent and urgent service whenever requested. With the exception of mandatory state, federal, and military reporting requirements (i.e., domestic violence, child abuse, and duty to warn situations) the DAVA provides a private and confidential service to encourage victims in seeking assistance. Essential Functions: Provides 24/7 response to victims alleging abuse (these services are provided based on the needs of client via telephone or in-person). Establish a Victims Safety Plan on a case-by-case basis. The victims safety is the DAVAs top responsibility and priority. The DAVA will review the Safety Plan during each victim contact. Conduct initial and ongoing risk assessments. If imminent risk of serious harm or death is established, notify the social work supervisor, law enforcement, and Command. If children are involved, the process also includes child physical safety and emotional well-being; refer involved children to the social worker for follow-on care. Immediately report any changes in the victims circumstances that changes or impacts the safety plan to the supervisor and/or social worker or mental health provider in charge. Advise victims of the military or civil actions available to promote safety (e.g., military order of protection, restraining order, and injunction). Offer victims information regarding their identified needs (e.g., emergency shelter, housing, childcare, legal services, clinical resources, medical services, transitional compensation). Accompany clients to appointments or court proceedings when requested by the client. Assistance with transportation is typically not provided to clients, however, after consultation with the social work supervisor and when no other reasonable means exist the DAVA may transport the victim to important appointments (i.e.: medical, court, protective actions). The DAVA cannot transport minor children unless accompanied by the parent or legal guardian and has the appropriate safety restraints in the vehicle. Establish a contact file for each victim served that contains minimal information about the allegations or nature of the incident. The primary purpose of the DAVA contact file is to maintain victims name and contact information as well as a log of the victim contacts and nature of the contacts or service provided by the DAVA. Develop process to keep the social work supervisor and designated POC (e.g. on-call mental health provider, emergency room.) informed of DAVAs location and timelines when providing DAVA victim services. This process will include location, arrival, and departure notification. Continually evaluate the quality of the installations coordinated community response and collaborate with base agencies to improve the system response to victims. Empower victims to be involved in plans or decisions about the safety of self and children. Collaborate and establish protocols with Security Forces Squadron (SFS), Office of Special Investigations (OSI), and Military Medical Treatment Facilities confirming. At the discretion of the Social Work Supervisor, the DAVA may also provide emotional support and information and referral services to the non-offending caregiver in a child maltreatment or youth sexual assault case. Required Education and Experience/Qualifications: Must possess a minimum of a bachelors degree from an accredited University in any of the following disciplines: Social Work; Psychology; Marriage, Family, and Child Counseling; Counseling or Behavioral Science; Criminal Justice, or related field. Must possess 2 years of experience assisting and providing advocacy services to victims of domestic violence/abuse or sexual assault. Must obtain the Basic Advocate Credential with designation of Comprehensive Intervention Specialist as approved and offered by the National Advocate Credentialing Program, which is overseen by the National Organization for Victims Assistance. Must pass a criminal history/Security Clearance background check. Must have transportation and a valid drivers license. Health Requirements: All DAVA personnel working within an MTF must maintain current certification in either the American Heart Association Basic Life Support Course (BLS) (Course C) or the American Red Cross Cardiopulmonary Resuscitation (CPR)/BLS (Heart Saver) Course. Before starting work, DAVA personnel working with MTFs shall provide proof of immunization from the following diseases according to CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza, and proof of a negative TB skin test (completed within the past 12 months (if positive, proof of negative chest X-ray within the past 12 months) prior to start of work). Technical Skills: Must be computer-proficient to work autonomously using Microsoft Office and possess data entry skills needed to create and maintain client files. Specifically, DAVAs must utilize Family Advocacy Program Network computer software to document client visits and safety plans in compliance with AF FAP policies and accepted professional practice guidelines. Work Environment: This role routinely uses standard office equipment such as computers, phones, copiers, filing cabinets and fax machines. Travel may be required as needed and is primarily local during the business day, although some out-of-area and overnight travel may be expected and will comply with Joint Travel Regulation (JTR). Expected Hours of Work: This is a full-time position. General hours of work are 7:30am-4:30pm when the AF Clinic is open; however, the DAVA is required to remain on call after normal duty hours if/when a victim of family maltreatment/intimate partner sexual assault is in need of assistance. After normal duty hours, if requested, the DAVA is required to respond telephonically or in-person (with AF Social Work Leadership permission) to the hospital or law enforcement agency. Hours worked after normal duty hours will be accounted for in the form of "flexing hours" or "overtime" pay in accordance with govt policy and labor laws. EOE Statement: We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors. EOE/AA/M/F/D/V Indian Preference Statement: IVA'AL Solutions, LLC, a federally recognized American Indian owned company, provides an Indian Preference Policy for hiring and promoting of fully qualified American Indians. When considering candidates for employment or promotion, that are basically equal in qualifications including education, skill, training, experience and a successful background screening process, priority is extended to an American Indian candidate unless a valid, documented reason of unsuitability or unsatisfactory performance exists to justify non-selection of an Indian employee or applicant. Requirements: Compensation details: 34.37-34.37 Hourly Wage PI604a41e8adc2-31181-38657517

KUNA JT. SCHOOL DISTRICT NO. 3 VACANCY ANNOUNCEMENT JOB TITLE: Contracted Worker or Intern (this must be pre-approved) BENEFITS: This is a contracted/Intern position and therefore does not offer employee benefits such as health insurance or retirement plans. PAY: Contracted personnel are paid through our Accounts Payable Dept. Job Overview As a Contracted Worker or Intern, you will be responsible for working with and for Kuna School District employees in assisting with duties as assigned. This position offers an excellent opportunity to work with a dynamic team and contribute to the success of our organization. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand, walk; sit; use hands for fine manipulation, handle or feel and reach with hands and arms using a keyboard and monitor.

Job DescriptionBenefits: YMCA Membership HRA (Health Reimbursement Agreement) 401(k) matching Company parties Flexible schedule Profit sharing Training & development We are seeking dedicated and compassionate individuals to join our team as Case Managers (CM) and Community Based Rehabilitative Specialists in Idaho. As a leading provider of community-based services, we are committed to supporting individuals in their journey towards independence and improved quality of life. Position: Case Manager (CM) and Community Based Rehabilitative Specialist (CBRS) Location: Idaho in multiple settings....*In Home, In Community, In Office and In Person* Responsibilities: Provide case management services to individuals with mental health, developmental disabilities, or substance use disorders. Conduct comprehensive assessments to identify clients' strengths, needs, and goals. Develop individualized service plans in collaboration with clients and their support networks. Coordinate and facilitate access to appropriate community resources, including healthcare, housing, employment, and social services. Advocate for clients' rights and assist in navigating the complex healthcare and social services systems. Monitor and evaluate clients' progress towards their goals, adjusting service plans as necessary. Collaborate with a multidisciplinary team to ensure integrated and holistic care. Maintain accurate and up-to-date documentation and records in compliance with regulatory standards. Qualifications: Bachelor's degree in social work, psychology, counseling, or a related field. Experience working with individuals with mental health, developmental disabilities, or substance use disorders is preferred. Knowledge of community resources and service networks in Idaho. Strong assessment, communication, and problem-solving skills. Ability to work independently and as part of a team. Familiarity with electronic documentation systems is a plus. Valid driver's license and reliable transportation. To apply, please submit your resume and a cover letter highlighting your relevant experience and qualifications to [email address]. We look forward to reviewing your application and considering you for this important role in supporting our clients' well-being and independence. Please note that only shortlisted candidates will be contacted for further steps in the selection process.

at Clarvida - Idaho Clarvida's success is built on the strength of our people: individuals who bring the right skills and a deep commitment to our mission of improving lives and communities. Our employees are empowered to bring their full potential to the table, ensuring long-term success for our team and those we serve. PRN Adult Crisis Center Case ManagerWhen individuals experience a behavioral health crisis, they require a focused level of attention and care. As part of the integrated treatment with our Clarvida Community Crisis Center of Southwest Idaho, the Case Manager focuses on providing support and encouragement to adult clients experiencing a behavioral health crisis. This position assists clients in achieving their personal recovery goals through individualized education on how-to obtain community services, maintain life supports such as housing or income, and carry out the tasks of daily living. The Crisis Case Manager helps clients connect to support groups and other community networks, and offers education and support towards their physical and mental wellness, including healthy living behaviors. This position maintains the safety and security of the center by conducting client and visitor check-ins and discharge, communicating with staff on shift, and providing assistance by connecting callers to the appropriate staff. Perks of this role: $18-19/hour 5 hours a week- daytime, evening, and weekend times available PRN stipend for every three shifts covered within a 60-day period Overnight pay differential Mental health field experience Stability and growth opportunities of working with a national agency What we're looking for: Bachelor's degree in a Human Service field (Social Work, Psychology, Sociology, Human Service, Education, Counseling, Family Relations, Nursing, Physical Therapy, Occupational Therapy, Therapeutic Recreation, Speech Language Pathology, Behavioral Sciences, Art Therapy, etc.) Ability to pass background checks, including Enhanced Fingerprinting with ID DHW. What we offer: Full Time Employees: Paid vacation days that increase with tenure Separate sick leave that rolls over each year Up to 10 Paid holidays* Medical, Dental, Vision benefit plan options DailyPay- Access to your daily earnings without waiting for payday* Training, Development and Continuing Education Credits for licensure requirements All Employees: 401K Free licensure supervision Employee Assistance program Pet Insurance Perks @Clarvida- national discounts on shopping, travel, Verizon, and entertainment Mileage reimbursement* Company cellphone *benefits may vary based on Position/State/County Application Deadline: Applications will be reviewed on a rolling basis until the position is filled. If you're #readytowork we are #readytohire! Now hiring! Not the job you're looking for? Clarvida has a variety of positions in various locations; please go to ******************************************** To Learn More About Us: Clarvida @ ************************************************** Clarvida is an equal opportunity employer with a commitment to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability, veteran status or any other protected characteristic. "We encourage job seekers to be vigilant against fraudulent recruitment activities that are on the rise across the healthcare industry. Communication about legitimate Clarvida job opportunities will only come from an authorized Clarvida.com email address, from a [email protected] email, or a personal LinkedIn account that is associated with a Clarvida.com email address."

we are seeking a (RN) Registered Nurse who must hold a compact license. , home office with internet connectivity of high speed required Work Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Clinicians incorporate the essential functions of professional case management concepts to enhance patients' quality of life and maximize health plan benefits. These functions include but are not limited to: coordination and delivery of healthcare services, consideration of physical, psychological, and cultural factors, assessment of the patient's specific health plan benefits, and additional medical, community, or financial resources available. Essential Responsibilities: Clinician Care Managers facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation. Collect and assess patient information pertinent to patient's history, condition, and functional abilities in order to develop a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services. Based on the needs and values of the client, and in collaboration with all service providers, the clinician links clients with appropriate providers and resources throughout the continuum of health and human services and care settings, while ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable. Clinicians have direct communication among, the client, the payer, the primary care provider, and other service delivery professionals. The case manager is able to enhance these services by maintaining the client's privacy, confidentiality, health, and safety through advocacy and adherence to ethical, legal, accreditation, certification, and regulatory standards or guidelines. Interact with other PacificSource personnel to assure quality customer service is provided. Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies. Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients. Practice and model effective communication skills: both written and verbal. Utilize and promote use of evidence-based tools. Utilize lean methodologies for continuous improvement. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of three (3) years of clinical experience, including case management. Insurance industry experience preferred. Education, Certificates, Licenses: Clinical Social Worker, Licensed Professional Counselor, or Licensed Independent Clinical Social Worker with unrestricted license required in current state of residence. OR Registered Nurse with current appropriate unrestricted state license based on line of business: Commercial and Medicare: Oregon, Idaho or Montana, and Washington; Medicaid and DSNP: Oregon. Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) strongly desired at time of hire. CCM certification required within two years of hire. Knowledge: Knowledge of health insurance and state mandated benefits. Experience and expertise in case management practice including advocacy, assessment, planning, communication, education, resource management and service facilitation. Ability to deal effectively with people who have various health issues and concerns. Knowledge and understanding of contractual benefits and options available outside contractual benefits. Knowledge of community services, providers, vendors and facilities available to assist members. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Competencies Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Compensation Disclaimer The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range. Base Range: $70,950.00 - $106,424.99Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

We are seeking dedicated and compassionate individuals to join our team as Case Managers (CM) and Community Based Rehabilitative Specialists in Idaho. As a leading provider of community-based services, we are committed to supporting individuals in their journey towards independence and improved quality of life. Position: Case Manager (CM) and Community Based Rehabilitative Specialist (CBRS) Location: Idaho in multiple settings....In Home, In Community, In Office and in Person** Responsibilities: Provide case management services to individuals with mental health, developmental disabilities, or substance use disorders. Conduct comprehensive assessments to identify clients' strengths, needs, and goals. Develop individualized service plans in collaboration with clients and their support networks. Coordinate and facilitate access to appropriate community resources, including healthcare, housing, employment, and social services. Advocate for clients' rights and assist in navigating the complex healthcare and social services systems. Monitor and evaluate clients' progress towards their goals, adjusting service plans as necessary. Collaborate with a multidisciplinary team to ensure integrated and holistic care. Maintain accurate and up-to-date documentation and records in compliance with regulatory standards. Qualifications: Bachelor's degree in social work, psychology, counseling, or a related field. Experience working with individuals with mental health, developmental disabilities, or substance use disorders is preferred. Knowledge of community resources and service networks in Idaho. Strong assessment, communication, and problem-solving skills. Ability to work independently and as part of a team. Familiarity with electronic documentation systems is a plus. Valid driver's license and reliable transportation. To apply, please submit your resume and a cover letter highlighting your relevant experience and qualifications to [email address]. We look forward to reviewing your application and considering you for this important role in supporting our clients' well-being and independence. Please note that only shortlisted candidates will be contacted for further steps in the selection process. Compensation: $18.00 - $25.00 per hour Are you interested in working with an industry leading mental health provider? At One Love Agency we are always looking for talented individuals to join our rapidly growing team at all levels Founded in 2012, One Love Agency is family owned and locally operated. Born from personal experience and with a mission to instill hope, One Love now provides general therapy, case management, community based rehabilitation, peer support, and payee services. From this extensive experience and diverse team, we are able to deliver collaborative and holistic care tailored to each client's needs.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The role of an Appeals Clinician is to accurately and succinctly represent the clinical component of an appeal. This is accomplished by close collaboration with external and internal partners/departments, assuring regulatory compliance, and eloquently representing the member/provider interests. Duties include but are not limited to: presenting the clinical component of appeals through thorough case review, careful research, application of policies, best practice standards, and available current, peer-reviewed information. The Appeals Clinician provides a concise summary of the appeal and represents the interests of the appealing party to the medical director for final determination. Essential Responsibilities: Represent PacificSource Health Plans with external customers and maintain positive working relationships. Review appeal requests for appropriateness of care within established evidence-based criteria sets. Work with Medical Directors to facilitate appeals within established timeframes and regulatory guidelines. Prepare case presentations for educational purposes and collaborative efforts with each LOB. Interact with other PacificSource personnel to assure quality customer service is provided. Act as an internal resource by answering questions requiring medical or appeal interpretation that are referred from other departments. Utilize Lean methodologies for continuous improvement. Utilize frequent huddles to monitor key performance indicators and identify improvement opportunities. Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy. Collaborate with the leadership team, as well as other departments, for maintenance and accuracy of system resources Collect and interpret accurate claims data as needed for complete appeal review Ability to research and interpret various tools such as; OHA guidelines, member handbooks, provider contracts, NCCI standards, etc. Supporting Responsibilities: Serve on designated committees, teams, and task groups, as directed. Represent the Appeals and Grievance Department, both internally and externally, as requested by Medical Director, the Appeals and Grievance Manager, and The Director of Health Services Quality Assurance and Appeals and Grievances. Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of three (3) years of nursing or behavioral health experience with varied medical and/or behavioral health exposure and capability required. Experience in acute care, case management, including cases that require rehabilitation, home health, behavioral health, and hospice treatment strongly preferred. Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Registered Nurse or licensed behavior health specialist with current unrestricted state license. Within six (6) months of hire, licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed. Knowledge: Thorough knowledge and understanding of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance and state-mandated benefits. Understanding of contractual benefits and options available outside contractual benefits. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community. Competencies Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Compensation Disclaimer The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range. Base Range: $70,950.00 - $106,424.99Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

For this position we are seeking a RN with a current active license for state of KY and or compact licensure The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and inpatient services for the KY Medicaid behavioral health population. Strong post-acute level of care experience (Nursing Facilities, Acute Inpatient, Rehabilitation, Long Term Acute care hospital, Behavioral Health Facility. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role. Good analytical thought process is important to be successful in this role. Prefer candidates that have experience doing prior authorizations for outpatient services preferrable within Behavioral Health Population. WORK SCHEDULE: Monday thru Friday 8:00 AM to 5:00 PM EST - Training Schedule (30 to 60 days) Permanent schedule will require you to work 4 to 5 days a week - with one weekend day required (Saturday, Sunday (either one or both)) This is a Remote position, home office with internet connectivity of high speed required. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.