Clinical case manager jobs in North Charleston, SC - 113 jobs

Phaxis Education is hiring experienced and passionate Board Certified Behavior Analysts (BCBAs) school-based positions. If you're searching for school-based BCBA jobs near me or K-12 ABA positions, this is an excellent opportunity to make an impact while working with a team that values your expertise. Position Overview Join a supportive district team to provide comprehensive behavioral and academic support services for students across elementary settings. You'll collaborate closely with educators, school psychologists, and families to promote student success through assessment, intervention, and consultation. What You'll Do Conduct functional behavior assessments (FBAs) and develop behavior intervention plans (BIPs) Provide direct and indirect behavioral support to students Collect and analyze behavioral data to monitor progress and adjust interventions Train and support teachers and paraprofessionals in implementing ABA strategies Participate in IEP meetings and multidisciplinary team discussions Collaborate with staff and families to foster positive learning environments Position Details Schedule: Full-time, Monday-Friday, during regular school hours Requirements Master's degree or higher in Applied Behavior Analysis, Psychology, Education, or related field Active BCBA certification (BACB) Previous school-based experience preferred Why Work With Phaxis Education At Phaxis, we specialize in connecting talented educators and clinicians with exceptional school-based opportunities. When you work with us, you can expect: Competitive weekly pay aligned with your experience Day-one health benefits including medical, dental, and vision coverage Licensure and renewal reimbursement to support your professional growth Referral bonuses for helping us connect with other qualified professionals

Job Description Our busy law office is looking for a legal case manager-paralegal to help us oversee all aspects of case management. Ideal job seekers will be incredibly organized, and have experience drafting legal documents, conducting legal research, and managing case files. If you are an effective communicator and a great teammate who is a natural self-starter, we'd like to talk. Please apply today! Compensation: $35,000 - $60,000 yearly Responsibilities: Manage, update, and organize all case files and information with regard to engagement, whether electronic or paper, in accordance with firm policies Draw up legal documents for attorney review Review legal documents to ensure adherence to all legal requirements Collaborate with outside vendors, staff, and attorneys, to manage the law firm's case load, present case summaries/updates, and ensure that deadlines are met Aid attorneys with all aspects of case management, including billing, docketing deadlines, and providing reminders as requested Perform legal research to obtain documentation regarding health insurance, medical records, social security, and medical providers Inform clients and outside counsel on case status as requested Qualifications: Extensive experience conducting legal research, and drafting legal documents is essential Possesses exceptional organizational skills as well as effective communication skills, both written and oral Professional case management process experience is needed - preferably as a personal injury case manager, or related jobs such as legal assistant, legal secretary, or paralegal, at a non-profit, law firm, or human services agency Computer proficient - specifically with case management software, word processing, and spreadsheet presentation Self-starter with the ability to effectively manage multiple matters at once About Company Ted Law Firm is a next-generation personal injury law firm built on best practices from top firms nationwide. We're growing quickly and offer excellent opportunities for advancement.

Compensation Range: $28.00 - $45.00 Case Manager Career Opportunity Recognized for your abilities as a Case Manager Are you ready for a Case Management role that brings your career closer to home and heart? Join Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. As the leading provider of rehabilitation care in the nation, this opportunity allows you to leverage your clinical expertise while contributing to the well-being of individuals in your community. Manage resources, coordinate patient care from admission to post-discharge, and oversee interdisciplinary plan-of-care decisions. This is more than a career move; it's a chance to shape a future where care and compassion converge for truly meaningful outcomes. A Glimpse into Our World At Encompass Health, you'll experience the difference the moment you become a part of our team. Working with us means aligning with a rapidly growing national inpatient rehabilitation leader. We take pride in the growth opportunities we offer and how our team unites for the greater good of our patients. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For Award, among other accolades, which is nothing short of amazing. Starting Perks and Benefits At Encompass Health, we are committed to creating a supportive, inclusive, and caring environment where you can thrive. From day one, you will have access to: * Affordable medical, dental, and vision plans for both full-time and part-time employees and their families. * Generous paid time off that accrues over time. * Opportunities for tuition reimbursement and continuous education. * Company-matching 401(k) and employee stock purchase plans. * Flexible spending and health savings accounts. * A vibrant community of individuals passionate about the work they do! Become the Case Manager you always wanted to be * Work with interdisciplinary team, guiding treatment plans based on patient needs and preferences. * Coordinate with interdisciplinary team to establish tentative discharge plan and contingency plans * Participate in planning for and the execution of patient discharge experience. * Monitor patient experience: quality/timeliness/service appropriateness/payors/expectations. * Facilitate team conferences weekly and coordinate all treatment plan modifications. * Complete case management addendums and all required documentation. * Maintain knowledge of regulations/standards, company policies/procedures, and department operations. * Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs. * Attend Acute Care Transfer (ACT) meetings to identify trends and collaboratively reduce ACTs. * Meet with patient/family per Patient Arrival and Initial Visit Standard within 24 hrs. of admission. * Perform assessment of goals and complete case management addendum within 48 hours of admission. * Educate patient/family on rehabilitation and Case Manager role; establish communication plan. * Schedule and facilitate family conferences as needed. * Assist patient with timely procuring/planning of resources to avoid discharge delays or issues. * Monitor compliance with regulations for orthotics and prosthetics ordering and payment. * Make appropriate/timely referrals, including documentation to post discharge providers/physicians. * Ensure accuracy of discharge and payor-related information in the patient record. * Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or Certification: * Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling). * If licensure is required for one's discipline within the state, individual must hold an active license. * Must meet eligibility requirements for CCM or ACM certification upon entry into this position OR within two years of entry into the position. * CCM or ACM certification required OR must be obtained within two years of being placed in the Case Manager II position. * Minimum Qualifications: * For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an associate degree. * For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred. * 2 years of rehabilitation experience preferred. The Encompass Health Way

At the Lovely Law Firm, the Case Manager works on a dynamic caseload of pre-litigation personal injury cases, investigates facts, and prepares documents to assist the attorneys by performing a variety of support and administrative duties. The focus for the Case Manager must be on client service, communication, and medical management. DIRECT SUPERVISOR: Operations Team JOB DUTIES: Client Service & Communication · Performs client interviews and insurance inquiries to evaluate cases with attorney oversight. · Keep clients updated on the status of their cases and ensure they understand and approve of the actions being taken on their behalf. · Contacts clients at a minimum of every thirty (30) days to update clients, manage medical treatment and check on property damage. Meets KPI of 90% client contact. · Performs an initial telephone call within 24 hours of case assignment. · Schedules telephone calls for attorney with associated case parties. File Management/Demands/Settlements · Ensure all medical records and bills have been requested promptly. · Maintains document file. · Thoroughly documents case activity in a software-based case management system. · Performs a variety of administrative and support activities as needed. · Prepares case files for demand department and meets monthly demand goals. · Seeks liens and lien reductions under the guidance of the attorney. · Prepares Disbursement Statements as instructed by attorney. Medical Management · Communicates directly with the Marketing department and provides feedback. · from clients related to marketing efforts - tv, social media, etc · Review all medical bills and records for completeness and accuracy. · During 30-day client contact, obtains the following information: · Treatment Status · Property Damage Status · Lost Wage Status · Photos of injuries · Value Drivers · Locates providers and schedule medical appointments for treatment of injuries in a timely manner. · Reads, reviews, and analyzes medical records and billing. Litigation · Drafts petitions and initial discovery for attorney review and filing. · Generate pleadings as requested by the attorney to move the case to trial. · Draft discovery responses with client assistance. · Scheduling doctor conferences, depositions, mediations, etc, as requested. Requirements Requirements Education: High School Graduate Experience: Prefer 1-2 years of prior legal experience Good communication and organization skills Prefer someone with personal injury experience.

The College of Southern Nevada appreciates your interest in employment at our growing institution. We want your application process to go smoothly and quickly. We ask that you keep in mind the following when completing your application: * Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. * Required attachments are listed below on the posting. Your application will not be considered without the required attachments. * Please note that applications must be submitted prior to the close of the recruitment. Once a recruitment has closed, applications will no longer be accepted. If you are unable to attach the required documents to your online application or need assistance regarding the application process, please contact the Talent Acquisition team within Human Resources via email at ********************** or call ************** to be directed to the appropriate Recruiter. Job Description * Open Until Filled* Heating/Ventilation/Air Conditioning/Refrigeration (HVACR) Specialists perform skilled work in the installation, operation, maintenance and repair of a wide variety of heating, ventilation, air conditioning, and refrigeration equipment. Under direct supervision, responsibilities include: * Perform preventive maintenance on various equipment related to heating, ventilation, air conditioning and refrigeration systems, fuel and combustion systems, forced air furnaces, radiant heaters, chillers, air handlers, window air conditioning units, evaporative coolers and refrigeration units. * Maintain auxiliary equipment such as motors, pumps, fans, pipe systems, compressors, humidifiers, condensers and pneumatic and electronic control units; adhere to established maintenance schedules to replace filters, lubricate motors and fans, replace belts, conduct chemical analysis and add correct proportion of treatment chemicals, and cleaning other mechanical equipment located throughout a facility. * Inspect equipment for proper functioning; check meters, gauges and other instruments; inspect occupied areas for comfort; adjust safety and limit controls; log information related to temperatures, pressures, fuel consumption, water level, time and date, and respond to emergencies such as utility and equipment failure. * Repair and modify equipment and components related to heating and air conditioning systems by repairing or replacing damaged pipes or valves including brazing, soldering, pipe fitting or adding new piping valves and controls. * Troubleshoot electrical circuits associated with heating, air conditioning and refrigeration including tracing dead circuits, rewiring circuits, repairing or replacing electrical components such as starters, contactors, relays and control units; repair or replace burner gun assemblies; recover refrigerant and recharge refrigeration equipment. * Diagnose equipment failure; make repairs and test system functions using common hand and power tools, brazers, solderers, torches, voltmeters, amprobes, oxygen analyzers and precision measuring instruments. * Install new components such as thermostats, timers or insulation to make older equipment more energy efficient. * Make parts and material purchases and maintain inventories according to departmental policies and State regulations; and prepare and maintain records related to work activities. * Store, handle and dispose of coolants and other chemicals in accordance with established policies and regulatory requirements. * Perform related duties as assigned. Internal Candidates Please Note: Must be a current CSN employee with 6 months of continued service to be eligible to apply. Required Qualifications * Completion of a recognized HVACR apprenticeship program followed by one year of journey level experience in the installation, operation, maintenance and repair of a wide variety of heating, ventilation, air conditioning, and refrigeration equipment OR an equivalent combination of education and experience. Preferred Qualifications * Ability to: Estimate material and labor needed to complete a job; secure technical advice and diagnose system failures; design system modifications and installation; and all knowledge, skills and abilities required at the lower level. * Working knowledge of: Commercial heating cooling systems to include but limited to Chilled Water systems, Boiler Heating systems, 20 ton and above air handlers, walk in coolers, walk in freezers, reach in coolers, ice machines, air vacuum and air compressor systems, laboratory exhaust systems. Scheduled Weekly Hours This position will work four ten-hour shifts Thursday through Sunday 7:00am - 6:00pm, this is subject to change based on the needs of the college. This position may require traveling between campuses as needed. Starting Salary Grade 32 Step 5 - $69,948.00 Per Nevada Administrative Code (NAC 284.170), salaries for initial appointments for classified positions typically begin at Step 1. The College of Southern Nevada offers a generous benefit package, including an excellent 19.25% PERS retirement plan (a defined benefit plan), vacation & sick leave benefits, 12 paid holidays, educational benefits, and health insurance plans that can be added with flexible spending accounts or health savings accounts. Supplemental options (long term care, short term disability, and legal). Tuition discounts at the Nevada System of Higher Education (NSHE) institutions. As well as tuition discounts for spouses, domestic partners, and dependents. Perks encompassing on campus employee discounts, professional and personal development opportunities; and statewide employee purchase programs. Join a dynamic team investing in our future, Students First. * This position is contingent upon ongoing and available funding. Exempt No Full-Time Equivalent 100.0% Required Attachment(s) To be considered for this position, please upload the following documents to your application: * Resume - List a detailed description of the major duties that you performed as part of each job. You must demonstrate that you qualify for the position and your education and experience must be clearly documented. * Cover letter * Unofficial College Transcripts (optional) - If you have not graduated, please attach your transcripts to receive education credit for classes you have taken. Credit is given for classes relevant to the job posting. For more details on this position, please visit our website: My Career at CSN. CSN is an Equal Employment Opportunity/Affirmative Action institution. For more information, visit ************************************* NSHE - INTERNAL APPLICANTS PLEASE NOTE CSN employees or employees within the Nevada System of Higher Education (NSHE) MUST use the "Browse Jobs" process within Workday to find and apply for jobs at CSN and other NSHE Institutions. Once you log into Workday, type "Browse Jobs" in the search box which will navigate to the internal job posting site. Locate this specific job posting by typing the requisition number in the search box. If you complete an application outside of the internal application process and apply as an external candidate, your application will no longer be considered at the time of minimum qualification review. In order to prevent the disqualification of your application, you will need to reapply as an internal candidate before 11:59 pm the day prior to the position close date. Posting Close Date Note to Applicant Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications. The search committee will use this information during the initial review of application materials. All document(s) must be received by 11:59 p.m. the day prior to the closing date posted on the job announcement. This position may require that a criminal background check be conducted on the candidate(s) selected for hire. As part of the hiring process, applicants for positions in the Nevada System of Higher Education may be required to demonstrate the ability to perform job-related tasks. Schedules are subject to change based on organizational needs. CSN is responsive to serving the educational needs of a diverse and ever-changing community. CSN employs only U.S. citizens and aliens authorized to work in the U.S. CSN does not sponsor aliens applying for faculty, professional staff, or management positions (H-1B Visas) in the absence of exceptional circumstances as defined by the USCIS.

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. Responsibilities Summary Provides case management of Intensive Supervision Appearance Program (ISAP) participants from entry to release by administering the program's policies and procedures as defined by the Department of Homeland Security (DHS) contract. Primary Duties and Responsibilities Develops, implements, coordinates, reviews and updates case management and individual service plans for ISAP participants in conformance with state and federal regulations and program requirements. Meets with participants face-to-face regularly as required by contractual obligations. Develops and maintains accurate and complete case records for all ISAP participants from entry to release from ISAP. Proactively manages cases using all appropriate tools and techniques. Maintains confidentiality of all records. Conducts intake interview and orientation session with each ISAP participant within contractual timeframes and requirements. Installs electronic monitoring equipment on ISAP participants as necessary and monitors compliance with electronic monitoring program. Assists ISAP participants with acquiring travel documents from the countries of citizenship. Maintains a log of travel document information for each participant. Evaluates English proficiency of ISAP participants to determine resources necessary to promote clear communication between ISAP staff and participants. Coordinates and facilitates translation services for ISAP participants, including emergency translation services. Connects participants with community resources including, but not limited to, transportation, medical, food, shelter, clothing, educational, financial, legal, religious and other social adjustment or facilitative resources. Identifies and coordinates services as required. Supervises ISAP participants while in Company offices. Establishes schedules for ISAP participants that include, but are not limited to, counseling sessions, immigration Court appearances, and access to legal services. Coordinates with participants to ensure attendance at legal orientation and cultural orientation sessions, as well as supplemental services evaluations. Reviews individual service plans, conducts risk/needs assessments and writes progress reports on a regular basis in compliance with contractual obligations. Reports on program violations in a timely manner using established reporting parameters. Conducts home visits to verify participants' places of residence in compliance with contractual obligations. Performs emergency counseling for ISAP participants as needed. Identifies and maintains relationships with translation resources in the community, including private services, volunteers, universities, English as a Second Language (ESL) schools, NGOs, churches, and other organizations that might have resources to offer. Performs other duties as assigned. Qualifications Minimum Requirements Bachelor's Degree required. Degree in Sociology, Psychology, Social Work, Criminal Justice or related field preferred. At least two (2) years of customer service or case management experience required; experience in fields related to law, social work, detention, corrections or working with multi-cultural clients preferred. Bilingual English/Spanish required. Valid driver's license required and the ability to safely operate a motor vehicle in order to perform home visits. Ability to pass a federal background check and obtain a suitability determination. United States citizenship required. Must live in the US 3 of the last 5 years (military and study abroad included). 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. Demonstrated sound judgment and even temperament. Ability to maintain self-control in stressful situations, such as interpersonal confrontations or emergencies. Ability to defuse hostile or unstable situations. Ability to deal tactfully with the public. Attention to detail. Problem solving ability. Ability to deal with multicultural contacts with sensitivity. Basic knowledge of immigration laws, regulations and procedures. Basic computer skills. Ability to interpret electronic monitoring messages and daily summary reports. Good typing skills to develop and maintain case records by performing data entry. Ability to work with computers and the necessary software typically used by the department. Working Conditions: Encountered on a regular basis as part of the work this job performs. Typical office environment. Some local travel is required. Use of standard office equipment such as copier, computer, keyboard, telephone and fax machine. Bending, stooping and use of hands and fingers to place electronic monitoring equipment on participants. Ability to use hands and fingers to install electronic monitoring equipment and to perform data entry. Ability to stand, walk, sit, climb or balance, enter and exit a car, and climb stairs multiple times in one day in order to make home visits.

Job Description GENERAL DESCRIPTION The role of the Case Manager is responsible for ensuring a smooth registration process for new patients and efficient appointment scheduling for new and existing patients. The Case Manager will be responsible for coordinating appointments between patients and appropriate healthcare providers in accordance with the Company's policies and procedures, maintain accurate records, and providing exceptional customer service. This is a full time position working 12 hour shifts (7a-7p) on a Track Schedule. 7 days on & 7 days off. AREAS OF RESPONSIBILITY A successful Case Manager will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions. The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s). •Appointment Scheduling: Schedule appointments for patients with healthcare providers based on availability, medical urgency, and patient preferences. Ensure all providers (which includes pharmacists, medical social workers, etc.), nurses, etc. Schedules are fully optimized. •Patient Communication: Interact with patients via email, patient portal, telephone, text, in-person, etc. to gather necessary information, schedule and confirm appointments, and provide pre-appointment instructions. Respond to patient inquiries, resolve scheduling conflicts, and assist in rescheduling appointments when necessary. •Records Management: Maintain accurate and up-to-date patient records, including demographic information, contact details, insurance information, appointment history, etc. Ensure confidentiality and adhere to privacy regulations when handling sensitive patient information. •Coordination with Healthcare Providers and Staff: Collaborate closely with care team members and other staff members to ensure optimal scheduling and coordination of patient care. Communicate changes, cancellations, or rescheduling of appointments to relevant parties in a timely manner. Communicate with providers and staff via phone, email, Teams, Athena, or in-person. •Insurance Verification: Verify insurance coverage and eligibility for patients ensuring accurate documentation of insurance information at all times. Collaborate with the billing department to address any insurance-related issues or concerns. •Workflow Optimization: Continuously assess and improve appointment scheduling processes to enhance office efficiency and productivity. Identify areas for improvement and propose solutions to streamline operations. •Customer Service: Provide exceptional customer service to patients, exhibiting a compassionate and empathetic attitude. Address patient concerns, inquiries, and complaints professionally and promptly, striving to meet patient needs and ensure their satisfaction. •Administrative Functions: Perform general administrative tasks and support other staff as needed. Work assigned buckets, ticklers, census lists, and region's scheduling voicemail tasks. Utilize the company's software systems to enhance patient care and staff productivity. •Collaboration and Coordination: Collaborate with internal and external resources to facilitate and ensure seamless operations. •Communicate with patients, families, and caregivers. •Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects. •Utilize the company's software systems and update information as required. •Participate in coaching calls. •Perform other duties as requested or required, in the sole discretion of the Company. MISSION EXPECTATIONS Take responsibility for own work in completing tasks. Assist others so that the resources, assistance, or support is provided to achieve success in their daily work. •Communicate, endorse, and demonstrate the Company's mission, vision, and values. •Prompt and regular attendance. •Adhere to standards of behavior, dress code including name tag and approved uniform, personnel department, and company policies. •Attend in-services and meetings on a regular basis. •Promote a culture of outstanding customer service at all times. •Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects. •Must possess the ability to deal tactfully with patients, employees, management, visitors, government agencies, and the general public and maintain an open-door policy for all employees. •Must possess the ability to make independent decisions when circumstances warrant. WORK ENVIRONMENT The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job: •May be exposed to housekeeping cleaning agents and chemicals, humidity, hot equipment, and/or noise. •May be exposed to infections, communicable diseases, odors, bloodborne pathogens, excreta, and hazardous materials. COMPLIANCE WITH POLICIES AND PROCEDURES •Comply with all federal, state, and local laws and regulations. •Knowledge of and compliance with Patient's Bill of Rights. •Must be knowledgeable of Medicare guidelines, applicable laws and regulations, and the Company's policy and procedures. •Adhere to the Company's Code of Conduct / Ethics. •Must exercise a high degree of confidentiality regarding patients, personnel, and the company. •HIPAA compliant. •Promote a culture of compliance. 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 the job. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions. •Must be able to lift, reach, bend, push, pull, use repetitive hand motions, walk, and carry simultaneously. •Must be able to withstand reaching, stooping, bending, kneeling, and crouching; walking and standing for periods of time; lifting up to fifty (50) pounds. •Must be in good general health and demonstrate emotional stability. QUALIFICATIONS High school diploma or equivalent required while an associate's or bachelor's degree in healthcare is preferred. •Previous experience in a medical or healthcare setting, preferably a scheduling or administrative role. •Familiar with medical terminology, procedures, and insurance verification processes. •Strong organizational and time management skills, with the ability to multitask and prioritize responsibilities effectively. •Ability to read and communicate effectively. •Strong written and verbal skills. •Basic computer knowledge. •Ability to manage and demonstrate effective leadership skills. •Should demonstrate good interpersonal and communication skills under all conditions and circumstances. •Ability to foster a cooperative work environment. •Team player with ability to manage multiple responsibilities and demonstrate sound judgment. •Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile

At Morgan & Morgan, the work we do matters. For millions of Americans, we're their last line of defense against insurance companies, large corporations or defective goods. From attorneys in all 50 states, to client support staff, creative marketing to operations teams, every member of our firm has a key role to play in the winning fight for consumer rights. Our over 6,000 employees are all united by one mission: For the People. Summary We are seeking a Case Manager to join our team. As a Case Manager you must be highly organized and able to work on a varied caseload. The Case Manager will assist the attorney in developing settlements, preparing documents and correspondence as needed. The ideal candidate is customer focused and empathetic. Responsibilities Daily interaction with existing and potential clients, via telephone and in person. Order medical records from providers and communicate with clients and providers during the course of treatment. Obtain documents necessary to support injury and/or liability positions Interact with insurance carriers and healthcare providers to secure records and account balances Work directly with multiple coworkers involved in the management and support of case files Maintain organized case files. Interact with attorneys and present case synopsis when required Prepare comprehensive demands and assemble support for submission to carriers under the direct supervision of an attorney Manage case files from intake to closing under the direction of an attorney Performs other related duties as assigned to meet the needs of the business. Qualification Bachelor's degree (preferred) Prior experience as a Personal Injury Case Manager preferred. At least 2 years of working in a legal position or insurance adjuster experience preferred. Ability to be a team player and follow procedures. Proactive interaction with clients, insurance companies and medical providers. Must possess the ability to multi-task, prioritize, and manage workload with a positive attitude and minimal supervision. Highly organized with the ability to juggle multiple deadlines in a fast-paced environment Strong writing and communication skills along with attention to detail Extensive computer and database expertise, Microsoft Word, Excel, Outlook, and type no less than 35 wpm. #LI-EM1 Benefits Morgan & Morgan is a leading personal injury law firm dedicated to protecting the people, not the powerful. This success starts with our staff. For full-time employees, we offer an excellent benefits package including medical and dental insurance, 401(k) plan, paid time off and paid holidays. Equal Opportunity Statement Morgan & Morgan provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. E-Verify This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the I-9 Form. Privacy Policy Here is a link to Morgan & Morgan's privacy policy.

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.

Full-time Certified Child Life Specialist to serve pediatric cardiology inpatient population, including Cardiac ICU and Cardiac Step-Down. This is a great opportunity to work in a U.S, News and World Report #1 rated children's hospital in South Carolina and #4 ranked pediatric cardiology program. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type Regular Cost Center CC004545 CHS - CHW Foundation Funds Pay Rate Type Hourly Pay Grade Health-24 Scheduled Weekly Hours 40 Work Shift Day (United States of America) The Certified Child Life Specialist (CCLS) serves as an integral member of the multidisciplinary team within the nationally ranked, #4 Children's Hospital Cardiac Unit. This specialist provides evidence-based, developmentally appropriate psychosocial care to infants, children, adolescents, and young adults with congenital or acquired cardiac conditions. The role focuses on supporting patients and families through extensive hospitalizations, complex procedures, and long-term care experiences, including those awaiting and recovering from heart transplant. Key Responsibilities: * Psychosocial Support: Conduct individualized assessments and implement therapeutic interventions that promote coping, and resilience, while minimizing Pediatric Medical Traumatic Stress. * Preparation and Procedural Support: Prepare patients and families for medical procedures, surgeries, and cardiac interventions using age-appropriate education, medical play, and coping strategies. * Therapeutic Play: Facilitate developmentally supportive play, creative expression, open-ended play and socialization opportunities to foster emotional well-being and maintain a sense of normalcy. * Family-Centered Care: Provide emotional support, education, and advocacy for families, including siblings, addressing the stress and uncertainty associated with chronic cardiac illness and transplant journeys. * Collaboration and Team Integration: Participate in multidisciplinary rounds, projects and care conferences with physicians, nurses, social workers, psychologist, and Arts and Healing Team. * Education and Mentorship: Educate staff, students, and volunteers on child life practices, developmental needs, and trauma-informed care for cardiac patients. * Program Development: Contribute to ongoing program growth and quality improvement initiatives within the pediatric cardiology and cardiac surgery service lines. * Child Life Team Involvement: Work closely with child life peers on team projects, education, events and donations. Attend and contribute to staff meetings, clinical discussions and team focused programming. Additional Job Description Education: Child Life Degree required. Master's preferred or Bachelor's Degree with 2 years of relevant experience. Child Life Certification required. If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: ***************************************

Job Description For more than 126 years, Epworth has grown and adapted to the individual needs of children and families by providing a safe and nurturing environment, evidence-based practices, and programs across the continuum of care and across the state of South Carolina. Position Summary: Licensed Clinical Counselors facilitate therapeutic services in accordance with Epworth Center for Counseling policies and procedures. Licensed Clinical Counselors provide individual, group and family counseling services to clients and significant others with substance use problems, at-risk behaviors and/or behavioral needs. In addition, provide intake, assessment, case management, referral, and intervention services as needed. Qualifications: Master's degree in social work or another license-eligible field. LPC, LPC-A, LMFT, LMFT-A, LPES, LPES-A, LISW-CP, OR LMSW in South Carolina. Two (2) years-experience working with children who have therapeutic needs preferred, not required. Must be able to pass standard background checks, including drug screen, employment physical, SLED, DSS Central Registry, and Sex Offenders Registry. Has a belief system and engages in faith practices that are compatible with those of the United Methodist Church. Bilingual a plus! What Epworth offers full time employees: Rewarding Client Focused work environment Excellent Medical, Dental, Vision and Prescription Drug Plans Company paid life insurance Voluntary benefits such as STD, LTD, Group life 403(b) with company match Ample vacation and sick leave Mission/Volunteer leave Credit Union Employee Assistance Program Eligible employer for the Public Service Loan Forgiveness (PSLF) program Career opportunities throughout the state of SC! Free supervision towards full licensure with South Carolina for an LPC-A or LMSW. The mission of Epworth is to serve children, youth and families through caring, safe, Christian communities, where hurts are healed, hope is nurtured, and faith in God, self, and others is developed.

KE Camps is the leading provider of summer camps for country clubs nationwide. We partner with over 230 private clubs all over the country to implement traditional-style day camps for elementary-aged children. Our Staff are the backbone of our programs and therefore, we pride ourselves on giving them an incredible amount of support. As a staff member, we guarantee you will feel a part of the KE Camps Team! Our Camp Counselor positions have the potential to serve as competitively paid internships that meet your course credit needs. First and foremost, your primary responsibilities will be as a Camp Counselor. As an Intern, you will be expected to fulfill your regular daily job responsibilities and it will be up to you to complete your internship responsibilities and to ensure that they do not interfere with your work obligations. Contact your college advisor in advance and ask them if you can use your summer camp job as a practicum, internship or for other course credits. If KE Camps can meet your internship requirements, your on-site Camp Director will be your field supervisor and oversee your course work. You will also be connected to a KE Camps contact at our HQ in Skillman, NJ. To receive credit, you must complete the course, practicum or internship per your college's parameters and complete your summer employment. As a Camp Counselor, you will be an active participant in all camp activities and will assist your Camp Director with a variety of daily tasks, all with the goal of creating a memorable and meaningful camp experience for your campers. Our Counselors interact with our campers throughout the entire day, helping them make friends, try new things, and generally caring for their well-being. The role of a Counselor is to participate, build relationships and have fun while ensuring the physical and emotional safety of every child. Camp Counselor Qualities Ability to help children grow in character, experiences and insights Ability to guard the health and well-being of campers at all times Capable of sustaining energy for participation in a full day's worth of activities Prior experience working with children Enthusiastic, Responsible, Dependable, Consistent, Level-Headed, Flexible, and Calm in all situations CPR/First Aid Certified OR willing to become certified before the summer begins Camp Counselor Responsibilities Work with group of campers and provide a fun, safe and exciting camp experience Cooperate with fellow Counselors and Camp Director Greet families and campers upon arrival Support Camp Director in establishing rules and emergency procedures with campers Participate in all camp activities Supervise daily swim time in a hands-on manner from within the water (lifeguard certification not required) Help out where needed and lead activities when asked to by the Camp Director Complete other duties, as assigned Benefits of Interning with KE Camps Build Critical Skills - You will gain skills sought after by employers. 21st Century Skills such as creativity, problem solving, flexibility, collaboration, organization, planning and communication are just a few of the strengths you'll build throughout the summer. Networking Opportunities - You will build professional contacts with other staff and camp alumni. You'll have the opportunity to create connections that can provide a link to future internships and job opportunities in a variety of careers. Hands on Leadership Experience - You will supervise a group of campers, lead programs and positively influence the next generation. This is a hands-on leadership experience in which you will engage in active decision-making, behavior management, and team development. Our camp is located at Country Club of Charleston in Charleston, SC. Camp will run Monday-Friday from June 8 through July 10 - staff members must be available to work the full camp season. Find out more at ****************

KE Camps is the leading provider of summer camps for country clubs nationwide. We partner with over 230 private clubs all over the country to implement traditional-style day camps for elementary-aged children. Our Staff are the backbone of our programs and therefore, we pride ourselves on giving them an incredible amount of support. As a staff member, we guarantee you will feel a part of the KE Camps Team! Our Camp Counselor positions have the potential to serve as competitively paid internships that meet your course credit needs. First and foremost, your primary responsibilities will be as a Camp Counselor. As an Intern, you will be expected to fulfill your regular daily job responsibilities and it will be up to you to complete your internship responsibilities and to ensure that they do not interfere with your work obligations. Contact your college advisor in advance and ask them if you can use your summer camp job as a practicum, internship or for other course credits. If KE Camps can meet your internship requirements, your on-site Camp Director will be your field supervisor and oversee your course work. You will also be connected to a KE Camps contact at our HQ in Skillman, NJ. To receive credit, you must complete the course, practicum or internship per your college's parameters and complete your summer employment. As a Camp Counselor, you will be an active participant in all camp activities and will assist your Camp Director with a variety of daily tasks, all with the goal of creating a memorable and meaningful camp experience for your campers. Our Counselors interact with our campers throughout the entire day, helping them make friends, try new things, and generally caring for their well-being. The role of a Counselor is to participate, build relationships and have fun while ensuring the physical and emotional safety of every child. Camp Counselor Qualities * Ability to help children grow in character, experiences and insights * Ability to guard the health and well-being of campers at all times * Capable of sustaining energy for participation in a full day's worth of activities * Prior experience working with children * Enthusiastic, Responsible, Dependable, Consistent, Level-Headed, Flexible, and Calm in all situations * CPR/First Aid Certified OR willing to become certified before the summer begins Camp Counselor Responsibilities * Work with group of campers and provide a fun, safe and exciting camp experience * Cooperate with fellow Counselors and Camp Director * Greet families and campers upon arrival * Support Camp Director in establishing rules and emergency procedures with campers * Participate in all camp activities * Supervise daily swim time in a hands-on manner from within the water (lifeguard certification not required) * Help out where needed and lead activities when asked to by the Camp Director * Complete other duties, as assigned Benefits of Interning with KE Camps * Build Critical Skills - You will gain skills sought after by employers. 21st Century Skills such as creativity, problem solving, flexibility, collaboration, organization, planning and communication are just a few of the strengths you'll build throughout the summer. * Networking Opportunities - You will build professional contacts with other staff and camp alumni. You'll have the opportunity to create connections that can provide a link to future internships and job opportunities in a variety of careers. * Hands on Leadership Experience - You will supervise a group of campers, lead programs and positively influence the next generation. This is a hands-on leadership experience in which you will engage in active decision-making, behavior management, and team development. Our camp is located at Country Club of Charleston in Charleston, SC. Camp will run Monday-Friday from June 8 through July 10 - staff members must be available to work the full camp season. Find out more at ****************

Serving the Tri-County- Dorchester, Charleston, and Berkeley Counties Seeking more balance in your social services career? This is it! As a Hospice MSW for Interim HealthCare, you'll have the flexibility to set your own schedule in a way that works for you and your patients. Since 1966, Interim HealthCare has been a leading employer of LMSWs who want to make a difference in the lives of others through personalized, home-based care. It's an opportunity to be the best medical social worker you can be without compromising your personal priorities. If that sounds like a career path, you're ready to embark on, you are made for this! Our Hospice Medical Social Workers enjoy some excellent benefits: Competitive Pay $28.00 to $32.00 DOE Weekly pay - Mileage 1:1 social worker-to-patient ratios where you impact outcomes Flexible assignments, autonomy and work-life balance Online training, growth and ability to earn CEUs PTO, Holidays, Medical, Dental, Vison, 401k Insperity Perks: Earned Wage Access, Banking and Card Member Discounts, Cashback, and More As a Hospice Medical Social Worker, here's a big-picture view of what you'll do: Conducts an initial psychosocial assessment of assigned patients/families within five (5) calendar days of admission to contribute to the comprehensive assessment of the patient's/family's needs and the IDG plan of care. Provides individual and/or family counseling in response to the mental and emotional status of the patient/family to reduce barriers to achieving the goals of care. Identifies special needs related to religious or cultural diversity and how these impact the implementation of the IDG plan of care. Provides counseling in response to identified anticipatory grief or pathological grief, if so qualified, or identifies alternative resources for such and provides direction to those resources. Evaluates identified financial or environmental concerns and directs the patient/family to appropriate community resources, as well as provides follow-up and acts as a liaison when indicated. Provides crisis intervention support to the patient/family, members of a facility caregiver group or the IDG. Provides psychosocial updates to facility staff providing short term inpatient care or respite care. Participates in the development of the IDG plan of care and attends regularly scheduled IDG meetings. Assists the attending physician and other IDG members, including facility staff, in understanding significant social and emotional factors related to death/dying issues of the patient/family. Participates in discharge planning for the patient/family when needed. Assists the patient/family in electing advance directives, securing durable power of attorney, making funeral arrangements and other financial, legal and healthcare aspects of end-of-life choices. A few must-haves for Hospice Medical Social Workers: Graduate of a Master's program in social work accredited by the Council on Social Work Education. Licensed to practice as a Social Worker in the state in which employed. License is active and in good standing. Minimum of one (1) year's experience in health care. Hospice experience preferred. Strong interpersonal skills, good communicator, empathetic, compassionate and resourceful Why Work for Interim HealthCare? Founded in 1966, Interim HealthCare is the nation's first home care company and a leading employer of Hospice Health Medical Social Workers (MSWs). Operating through 300+ offices, our commitment to you is expressed through a family-oriented culture that values and appreciates social workers, and a passion to put patients first. Join a nationwide network of MSWs who are making a significant impact in the lives of others through the home-based, social services they provide. Interim HealthCare provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, gender, religion, sexual orientation, national origin, age, disability or veteran status. #Pando PandoLogic. Keywords: Medical Social Worker, Location: Goose Creek, SC - 29445

Behavior Specialist - School-Based Setting: K-12 School Environment Schedule: Full-Time | School Hours We are seeking a compassionate and experienced Behavior Specialist to support students within a school-based setting in Charleston, SC. This role focuses on collaborating with educators, families, and support staff to address behavioral, social-emotional, and academic needs, while promoting positive behavior and inclusive learning environments. The ideal candidate is student-centered, proactive, and skilled in implementing evidence-based behavioral strategies across classroom and individual settings. Key Responsibilities Provide direct behavioral support to students with identified behavioral, emotional, or social-emotional needs Conduct functional behavior assessments (FBAs) and assist with developing and monitoring behavior intervention plans (BIPs) Collaborate with teachers, administrators, school psychologists, and related service providers to support student success Support classroom management strategies and positive behavior interventions Collect and analyze behavioral data to track progress and inform interventions Provide consultation and training to school staff on behavior strategies and best practices Participate in IEP, MTSS, and team meetings as appropriate Maintain accurate documentation in compliance with district, state, and federal guidelines Qualifications Bachelor's or Master's degree in Behavior Analysis, Psychology, Special Education, Social Work, or a related field Experience working with students in school-based or pediatric settings preferred Knowledge of positive behavior supports, de-escalation strategies, and trauma-informed practices Licensure / Certification BCBA, BCaBA, or other relevant behavioral certification preferred South Carolina certification or eligibility preferred Why Join Us Supportive and collaborative school environment Consistent school-day schedule (no evenings or weekends) Opportunity to make a meaningful impact on students' lives Professional growth within an inclusive educational team

Our busy law office is looking for a legal case manager-paralegal to help us oversee all aspects of case management. Ideal job seekers will be incredibly organized, and have experience drafting legal documents, conducting legal research, and managing case files. If you are an effective communicator and a great teammate who is a natural self-starter, we'd like to talk. Please apply today!

Provides direct patient care, manages groups of patients, and provides a safe and therapeutic milieu. Direct patient care services to include assessment, planning, monitoring, advocacy, psychosocial rehab services and direct intervention. Under the direction of the Program Coordinator the Clinical Counselor is responsible for group therapy care as directed by the multi-disciplinary treatment plan. The Clinical Counselor will plan and lead groups focusing on coping skills, social skills, and self-esteem for children with Behavioral Health problems. Clinical Counselors will be involved in treatment team meetings and work closely with Social Workers, psychiatrists, and Nurses to assist children and adolescents in rehabilitating back into the school and home environment Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type PRN Cost Center CC000682 CHS STAR Children's Day Treatment Program (Offsite) Pay Rate Type Hourly Pay Grade Health-25 Scheduled Weekly Hours 8 Work Shift Day (United States of America) General Provides direct patient care, manages groups of patients, and provides a safe and therapeutic milieu. Direct patient care services to include assessment, planning, monitoring, advocacy, psychosocial rehab services and direct intervention. Under the direction of the Program Coordinator the Clinical Counselor is responsible for group therapy care as directed by the multi-disciplinary treatment plan. The Clinical Counselor will plan and lead groups focusing on coping skills, social skills, and self-esteem for children with Behavioral Health problems. Clinical Counselors will be involved in treatment team meetings and work closely with Social Workers, psychiatrists, and Nurses to assist children and adolescents in rehabilitating back into the school and home environment Clinic specific Provides direct patient care. Manages groups of patients. Provides a safe and therapeutic milieu. Maintains current and up to date knowledge and skills related to patient treatment. Participates in program development. Serves a preceptor/ mentor for new CTMs. Able to work autonomously and as an active member of the CDT team Additional Job Description Education: Bachelors Degree or equivalent Work Experience: 5 years for support or 0-2 years for professional Current state licensure required. Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: ***************************************

For more than 126 years, Epworth has grown and adapted to the individual needs of children and families by providing a safe and nurturing environment, evidence-based practices, and programs across the continuum of care and across the state of South Carolina. Position Summary: Licensed Clinical Counselors facilitate therapeutic services in accordance with Epworth Center for Counseling policies and procedures. Licensed Clinical Counselors provide individual, group and family counseling services to clients and significant others with substance use problems, at-risk behaviors and/or behavioral needs. In addition, provide intake, assessment, case management, referral, and intervention services as needed. Qualifications: Master's degree in social work or another license-eligible field. LPC, LPC-A, LMFT, LMFT-A, LPES, LPES-A, LISW-CP, OR LMSW in South Carolina. Two (2) years-experience working with children who have therapeutic needs preferred, not required. Must be able to pass standard background checks, including drug screen, employment physical, SLED, DSS Central Registry, and Sex Offenders Registry. Has a belief system and engages in faith practices that are compatible with those of the United Methodist Church. Bilingual a plus! What Epworth offers full time employees: Rewarding Client Focused work environment Excellent Medical, Dental, Vision and Prescription Drug Plans Company paid life insurance Voluntary benefits such as STD, LTD, Group life 403(b) with company match Ample vacation and sick leave Mission/Volunteer leave Credit Union Employee Assistance Program Eligible employer for the Public Service Loan Forgiveness (PSLF) program Career opportunities throughout the state of SC! Free supervision towards full licensure with South Carolina for an LPC-A or LMSW. The mission of Epworth is to serve children, youth and families through caring, safe, Christian communities, where hurts are healed, hope is nurtured, and faith in God, self, and others is developed.

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.