Safety Manager
Sheakley Workforce Staffing job in Columbus, OH
Job DescriptionConstruction Site Safety Manager
Duration: 12 Months (Start: 11/17) Type: 1099 Contractor
Job Details
Hourly Rate: $52/HR
Completion Bonus: $150/month
Pay: Weekly
Schedule: M - F | 0700 - 1500 | 40hrs/week Day Shift
Project Scope
The site safety manager will oversee safety for mechanical installation at the Expo Center. Must have a background in piping, sheet metal, and HVAC. Attend safety meetings and ensure proper paperwork for site activity. JHAs/AHAs/Toolbox Talks.
Qualifications
Candidates must have the following requirements:
OSHA 30, 500, or 510
3+ years of constrcution safety
Key Responsibilities
Conduct project safety inspections and employee orientations
Provide safety training as needed
Monitor worksite employees and enforce safety protocols
Review and manage safety-related documentation and contractor correspondence
Perform additional EHS-related tasks as required
Skills & KnowledgeSkills:
Excellent public speaking and communication abilities
Proficiency in Microsoft Office (Outlook, Word, Excel)
Strong organizational and multitasking skills
Ability to work independently and as part of a team
OSHA outreach training experience (preferred)
Professionalism and confidentiality in handling sensitive information
Knowledge:
Strong understanding of EHS and industry regulatory standards in construction
Ability to effectively communicate safety principles and regulations
Equal Opportunity Employer
Sheakley is committed to providing equal employment opportunities to all individuals, regardless of race, color, religion, age, sex, marital status, national origin, disability, or any other protected status.
Ready to Make an Impact? Apply Today!
Project Executive
Columbus, OH job
My top General Contractor client has an opening for an experienced Project Executive to lead multiple high-profile projects across Ohio in the Public/Commercial space. This is a strategic leadership role that oversees project execution, team performance, and client satisfaction from preconstruction through closeout.
You'll manage and mentor Project Managers, drive consistent project delivery standards, and ensure safety, quality, and profitability targets are achieved.
Responsibilities:
Oversee a portfolio of ground-up and renovation projects in the Public/Commercial sectors
Lead project planning, budgeting, scheduling, and client communications
Provide executive-level oversight of project teams, ensuring alignment with company goals
Collaborate with Preconstruction and Estimating during early project phases
Champion safety, quality control, and risk management across all sites
Support staffing, mentorship, and performance management for project teams
Build and maintain strong relationships with clients, architects, and trade partners
Qualifications
10+ years of progressive construction management experience, including 3+ years in a senior leadership or director role. ALSO open to senior project managers looking to make the leap.
Proven track record delivering on Public / Commercial projects
Strong financial and contractual acumen
Excellent leadership, communication, and problem-solving skills
Willingness to travel throughout Ohio as needed
Offering:
Competitive base up to $180K
Annual bonus
401K w/ Match
Excellent work/life balance
Care Coordinator I
Columbus, OH job
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
Title: Care Coordinator I
Duration: 5+ Months (possible extension)
Location: Columbus, OH
Responsibilities
:
· Monday to Friday 8am to 5pm Working in Office- but need to be mobile as they will be making visit for home assessments While in office: Reviewing Assessment with medical directors to determine if patients are receiving the level of in home care and if they need referrals as well Working with children with special needs.
· No clinical care Top Three Skill Sets: Experience with home health visit or case management, working with children and computer skills.
· Working with home health agencies and/or Medicaid Interview.
Face to Face Summary:
· Responsible for the assessment and review, coordination and distribution of review decisions for members identified with medical, surgical, and long-term care, needs including home and community-based waiver recipients.
· Interacts with Medical Directors, HCS department staff, various other staff and providers and practitioners to ensure timely receipt of decisions in accordance with Client policies, procedures and processes. Adheres to the company/department's confidentiality and HIPAA compliance programs.
· Adheres to the company/department's fraud and abuse prevention/detection policies and programs.
Essential Functions:-
· Provides various care coordination activities in collaboration with the client's managed care organization (MCO), health care providers, other HCS staff, involved medical case managers/care coordinators, public agencies, and other providers as required. Documents all findings, contacts and interventions.
· Maintains case-specific communication with state agencies, healthcare individuals and support systems to promote efficient and well-coordinated quality care.
· Provides scheduled assessment and review of health needs, individualized care plans, and monitoring of Medicaid eligibility.
· Confers with appropriate staff, including, but not limited to, case managers/care coordinators, medical directors, social workers, health care providers and practitioners, and state agency staff to provide timely and accurate service authorizations and reviews based on a recipient's current needs/functioning.
· Communicates review decisions and prior authorizations to various professionals involved in the client's care, including practitioners and primary care providers (PCP).
· Shared responsibilities for professional responses to client, provider and practitioner, and state agencies via telephone.
· Assists other department team clients when needs are identified.
· Establishes and maintains professional rapport with providers, clients, public agencies, and others involved in the client's care.
Knowledge/Skills/Abilities:
· Must have strong oral and written communications skill to ensure accurate exchange of information and to build rapport that will ensure the trust, confidence and cooperation of others in a work situation.
· Must have the skills to learn and adapt to company policies and procedures as they relate to hospital authorization/denials, physician review, appeals, etc.
· Must have the ability to successfully apply established guidelines and regulation to individual and specific situations.
· Must have excellent organization skills to establish and maintain a variety of records necessary to provide complete and accurate information and documentation for relevant and appropriate medical determination.
· Ability to perform independently and to handle multiple projects simultaneously. Must have excellent interpersonal skills.
· Must be PC literate (Microsoft Office) and able to work in multiple database/systems simultaneously. Excellent verbal and written communication skills.
· Ability to abide by policies. Maintain regular attendance based on agreed-upon schedule.
· Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
· Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
Qualifications
Required Education:
· Unencumbered license to work as a Registered Nurse in the State of Ohio.
· Required Experience: 0-2 year's clinical experience or equivalent combination of education and experience.
· Desired Experience: 0-2 years' experience.
Additional Information
Kind Regards
Sumit Agarwal
732-902-2125
Case Manager
Columbus, OH job
Monday to Friday 8:30 am to 5:30pm. Researching members and reaching out to members to enroll them into Programs. Traveling to surrounding hospitals in 30 mile radius to enroll members. Need to have strong computer skills with Excel (intermediate level) and be able to work with dual computers screens
Skills:
·
Multi-task, detail oriented and strong customer service
·
Strong written and verbal English communication skills
Training is one on one training with an experience CM and supervisor for about one to two weeks
After training is complete then the production metrics is three enrollments per day. Reviewed bi-weekly with manager.
Qualifications
Required Education:
Bachelor's degree in Nursing.
Required Experience:
2-4 years of bedside nursing experience and case management experience is a plus.
Required Licensure/Certification:
Active, unrestricted State Registered nursing license.
Must have valid drivers' license with good driving record and be able to drive locally.
Additional Information
Summary:
·
Responsible for health care management and coordination of Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care.
·
Coordinates and monitors member's progress and services to ensure consistent cost effective care that complies with policy and all state and federal regulations and guidelines.
Essential Functions:
·
Provides case management services to members with chronic or complex conditions including: oProactively identifies members that may qualify for potential case management services. oConducts assessment of member needs by collecting in-depth information from information system, the member, member's family/caregiver, hospital staff, physicians and other providers.
·
Identifies, assesses and manages members per established criteria.
·
Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.
·
Performs ongoing monitoring of the plan of care to evaluate effectiveness.
·
Documents care plan progress in information system.
·
Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes.
·
Measures the effectiveness of interventions to determine case management outcomes.
·
Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for members.
·
Conducts face to face or home visits as required.
·
Maintains department productivity and quality measures.
·
Manages and completes assigned work plan objectives and projects in a timely manner.
·
Demonstrates dependability and reliability.
·
Maintains effective team member relations.
·
Adheres to all documentation guidelines.
·
Attends regular staff meetings.
·
Participates in Interdisciplinary Care Team (ICT) meetings.
·
Assists orientation and mentoring of new team members as appropriate.
·
Maintains professional relationships with provider community and internal and external customers.
·
Conducts self in a professional manner at all times.
·
Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct.
·
Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.
·
Complies with required workplace safety standards. Knowledge/Skills/Abilities:
·
Demonstrated ability to communicate, problem solve, and work effectively with people.
·
Excellent organizational skill with the ability to manage multiple priorities.
·
Work independently and handle multiple projects simultaneously.
·
Strong analytical skills.
·
Knowledge of applicable state, and federal regulations.
·
Knowledge of ICD-9, CPT coding and HCPC.
·
SSI, Coordination of benefits, and Third Party Liability programs and integration.
·
Familiarity with NCQA standards, state/federal regulations and measurement techniques.
·
In depth knowledge of CCA and/or other Case Management tools.
·
Ability to take initiative and see tasks to completion.
·
Computer skills and experience with Microsoft Office Products.
·
Excellent verbal and written communication skills.
·
Ability to abide by policies.
·
Able to maintain regular attendance based upon agreed schedule.
·
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
·
Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.
Entry Level Outside Sales Position
Columbus, OH job
ADP is hiring a **Sales Representative, Small Business Services.** + _Are you ready to build a rewarding future? Uncapped commissions, lavish incentive trips, and career advancement are some of the ways._ + _Do you want to join a Fortune 250 company with industry-leading sales training and the latest sales technology to help you achieve success_ _?_
+ _Are you looking to join a fast-paced, inclusive environment with a culture of collaboration and belonging?_
If so, this may be the opportunity you've been searching for. Read on and decide for yourself.
In this role, you will work within a defined geographic territory that targets clients and prospects with 1-49 employees. You will identify and sign new clients for payroll, tax, human resources, benefits, and more and sell additional solutions to existing clients. Daily, you will cultivate relationships, set appointments, gather leads from established business partners, assess client or prospect needs to present the best ADP solutions, and spend your time in the field closing business. Don't worry if you have no prior sales experience; we are known for our high-quality sales training and will teach you how to use the latest sales technology to set you up for success.
Integrity, resilience, positivity, and a refuse to lose attitude are must-haves in this job. As with any role in sales, you will experience ebbs and flows. However, challenges should ignite your determination and invigorate you to thrive, not weigh you down. In return, you'll be rewarded with uncapped commissions, incentive trips, and opportunities to advance your career in a fun and friendly environment -- all while gaining serious credibility as part of an industry-leading sales team in a stable and highly respected tech company.
Ready to #MakeYourMark? **Apply now!**
**To learn more about Sales at ADP** , watch here: ********************************
**What you'll do:** _Responsibilities_
+ **Grow Our Business While Growing Yours.** You will work independently and collaboratively as part of various teams within your assigned geography to close sales, win business, and reach sales goals.
+ **Turn Prospects into Loyal Clients and Raving Fans.** You will implement a sales strategy targeted to decision-makers and business owners to build a network and capture new business.
+ **Deepen** **Relationships Across the ADP Family.** In addition to selling cloud-based human resources solutions, you will strategically cultivate additional business within existing accounts. But it's not all business; you will make life-long friendships here.
+ **Collaborate** **Daily.** You will serve as a trusted advisor, partner, and ADP ambassador to your clients, internal partners, and overall network while demonstrating grace under pressure and the highest ethical standards.
**TO SUCCEED IN THIS ROLE** **:** _Required Qualifications_
+ **Positive Self-Starter** **.** You have an upbeat, persistent style and the ability to cold call without fear of rejection, manage your time well, and can present your ideas in a clear professional manner on paper, in-person, and over the phone.
+ **Agile Solution Seeker** **.** You're a problem solver who can find an answer, or a solution, even in times of fast-paced change.
+ **Continuous Learner** **.** You're always learning, growing, and questioning how things were done in the past to make them even better.
A college degree is great but not required. What's more important is having the skills to do the job. Other acceptable experiences could include:
+ One to two years of prior work experience or internships in Retail, Marketing, Business Development, Food Service, Insurance Sales, or another relevant industry, OR
+ Military experience We recognize and appreciate the unique talents and experiences Veterans bring to the table. We value the discipline, commitment, and problem-solving abilities you have developed and are excited to provide an environment where you can continue to make a meaningful impact.
**Bonus points for these:** _Preferred Qualifications_
+ Prior quota-carrying experience
+ Ability to successfully build a network and effectively use social media for sales
**YOU'LL LOVE WORKING HERE BECAUSE YOU CAN:**
+ **Be yourself** in a culture that values equity, inclusion, and belonging and creates a safe space for diverse perspectives and insights.
+ **Belong** by joining one of our Business Resource Groups where you can connect globally with networks and allies who share common interests and experiences.
+ **Grow your career** in an agile, fast-paced environment with plenty of opportunities to progress.
+ **Continuously learn** through ongoing training, development, and mentorship opportunities.
+ **Be your healthiest.** Best-in-class benefits start on Day 1 because healthy associates are happy ones.
+ **Balance work and life.** Resources and flexibility to more easily integrate your work and your life.
+ **Focus on your mental health and well-being.** We're here to provide exceptional service to our clients, and none of that happens without each of us taking care of ourselves and being there for one another.
+ **Join a company committed to giving back** and generating a lasting, positive impact upon the communities in which we work and live.
+ **Get paid to pay it forward.** Company-paid time off for volunteering for causes you care about.
What are you waiting for? **Apply today!**
**A little about ADP:** We are a comprehensive global provider of cloud-based human capital management (HCM) solutions that unite HR, payroll, talent, time, tax and benefits administration and a leader in business outsourcing services, analytics, and compliance expertise. We believe our people make all the difference in cultivating a down-to-earth culture that embraces our core values, welcomes ideas, encourages innovation, and values belonging. We've received recognition for our work by many esteemed organizations, learn more at ADP Awards and Recognition (********************************************************** .
**Diversity, Equity, Inclusion & Equal Employment Opportunity at ADP:** ADP is committed to an inclusive, diverse and equitable workplace, and is further committed to providing equal employment opportunities regardless of any protected characteristic including: race, color, genetic information, creed, national origin, religion, sex, affectional or sexual orientation, gender identity or expression, lawful alien status, ancestry, age, marital status, protected veteran status or disability. Hiring decisions are based upon ADP's operating needs, and applicant merit including, but not limited to, qualifications, experience, ability, availability, cooperation, and job performance.
**Ethics at ADP:** ADP has a long, proud history of conducting business with the highest ethical standards and full compliance with all applicable laws. We also expect our people to uphold our values with the highest level of integrity and behave in a manner that fosters an honest and respectful workplace. Click ********************************* to learn more about ADP's culture and our full set of values.
Talend / Hadoop Lead
Dublin, OH job
A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
Talend / Hadoop Lead
City: DUBLIN
State/Province: Ohio
Additional Skills:
Big Data - 6 plus years of understanding of analytics, BI and other tools.
ETL - 8 plus years to understand most ETL and ELT capabilities in managing large data.
Talend lead to help simplify the integration of big data and respond to business demands without having to write or maintain complicated Apache Hadoop code. Good leadership skills, but more independent in capabilities to be hands-on with Big Data knowledge and the use of Hadoop in large environments.
The following are areas of need:
• Enable existing developers to start working with Hadoop and NoSQL databases today. Use simple, graphical tools and wizards to generate native code that leverages the full power of Hadoop and accelerates your path to informed decisions.
• Use native Hadoop profiling and data matching to understand and cleanse data accurately.
• Leverage Big Data consoles to centrally manage and monitor multiple projects.
• Knowledge on utilizing the Talend Studio gives you access to over 800 connectors and components, including native support for Hadoop, NoSQL, and all your structured and unstructured data sources.
• How to use graphical drag-and-drop tools and wizards speed design, deployment and maintenance. Understanding MapReduce and tweak custom code, design integration jobs and to help Talend do the heavy lifting.
• Some knowledge of no SQL is good to have.
Other requirements:
• Big Data - 6 plus years of understanding of analytics, BI and other tools.
• ETL - 8 plus years to understand most ETL and ELT capabilities in managing large data.
• Location: Dublin, OH
• Client: HealthCare
• Length: 1 year to 18 months
Qualifications
• Big Data - 6 plus years of understanding of analytics, BI and other tools.
• ETL - 8 plus years to understand most ETL and ELT capabilities in managing large data.
Additional Information
Regards
Warm Regards,
Harshad
Direct Line: 732-429-1922
Contract Specialist
Columbus, OH job
: The Contract Specialist will be responsible for reviewing multiple contracts that have been turned in by the Providers and ensuring all is completed. This will be done by following a step-by-step process that includes instructions on "scrubbing" the contracts for necessary signatures, verifying amendments are attached, scanning and loading completed contracts.
Temp will be responsible for following each step of the contract process from waiting for credentialing to routing it up to the negotiation team, if necessary.
During the contract process the Specialist will be keeping detailed notes of the process in Sales Force and/or MS Excel. These notes are important to keep up-to-date so that anyone else can go in and pick up where the other person left off.
If any signatures or documentation is missing the Contract Specialist will be responsible for following up directly with the Provider via email or phone call.
Software:
Microsoft office: Outlook, Excel
QNXT, Sales force, Emptoris (contract software tool)
Experience:
Manager is seeking candidates who have a minimum of
2 years of Healthcare contract experience.
Contract experience is a MUST
as the candidates need to have knowledge and familiarity of contract language and
previous exposure to working/speaking directly with Providers.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Care Review Nurse
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Medicaid Division
Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care
Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications
Background
Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience)
Potential for longer term dependent on enrollment
Workers will be doing Concurrent Inpatient Review
MUST have one of the following AT LEAST
-Utilization Review in hospital setting
Nurses who are used to doing both production and review work
Additional Information
All your information will be kept confidential according to EEO guidelines.
Java Developer
Columbus, OH job
A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
This is a Direct Hire role with the client
Job Description
General: This role will allow you to work on product strategy, development and interface with senior leadership in creating our next generation, Agile driven V3 Software platform. Our product team pushes the boundary on feature development, resulting in a varied and interesting assortment of tech challenges to solve.
Basic Qualifications
• Experience with an IOC container such as Spring a plus
• Experience with an ORM tool such as Hibernate a plus
• Knowledge of Oracle PL/SQL is a plus
• Master's degree preferred
Key Functions:
• Bachelor's degree in Information Systems, Computer Science, Engineering or similar.
• Minimum of 5 year of experience with Java J2EE programming/Java Development
• Experience with one or more web technologies such as GWT (Google Web Toolkit), HTML, CSS, Ajax, etc.
• Familiarity with one or more application servers such as Tomcat, Oracle 10gAS, WebSphere, WebLogic, etc.
• Web Services, AJAX, REST, XML, JQuery
• Strong written and verbal communication skills
• Self-motivated and able to work in a team environment
Note - Strong Coding experience is highly prefer.
If you would like to transfer your H1B visa then our company and our Client will be applying Green Card Process those will be working with us or our client.
Qualifications
Java Development and coding experience
Additional Information
Regards,
Sweta Verma
IT Recruiter
Integrated Resources, Inc.
“INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES” (7th Year in a Row)
Direct:- 732 549 5907
Tel: (732) 549 2030 x 210
Fax: (732) 549 5549
sweta(at)irionline.com
http://www.irionline.com
https://www.linkedin.com/nhome/?trk=nav_responsive_tab_home
License Practical Nurse
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Duties:
Complete face to face visits with members in case management and as directed by the case manager. This role requires driving to multiple locations in a given day and will cover multiple counties. Case Manager will provide the series of questions that need to be asked. The goal is to educate members on their benefits and advise them on how they are utilize them to their fullest potential. Hands off care, more observing and documenting through computer. Candidate must be a self-starter.
Qualifications
Must Haves:
Active, unrestricted State Nursing License Practical Nurse, license in good standing for the State of Ohio.
5+years of LPN with home care experience.
Driving around the Columbus, OH area.
Required Education:
Completion of an accredited Registered Nursing program. (a combination of experience and education will be considered in lieu of Registered Nursing degree).
Required Experience:
Minimum 0-2 years of clinical practice. Preferably hospital nursing, utilization
Required Licensure /Certification: Active, unrestricted State Nursing (LPN) license in good standing.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Care Review Processor
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
Job Description
Duties:
Build waiver authorizations for members on Medicaid and Medicare.
Providing authorization to providers so they can bill for the dual services.
Will also work in claims flow, research for waiver for pending claims for waiver services.
Heavy data entry. Will utilize QNXT, Care Advanced and Microsoft Outlook and Excel (beginning to intermediate level)
A minimum 1 year of Managed care experience, Medical billing, within a healthcare background.
Manager will consider candidate with no healthcare experience but has a 4 year college degree and willingness to learn.
Training: Onsite classroom style training for 3 weeks.
Expectation after training is to handle 20-25 claims per day.
Summary:
Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Members that require hospitalization and/or utilization review for other healthcare services
Checks eligibility and verifies benefits, obtains and enters data into systems, processes requests, and triages members and information to the appropriate Health Care Services staff to ensure the delivery of high quality, cost-effective healthcare services according to State and Federal requirements to achieve optimal outcomes for Members.
Essential Functions:
Provide computer entries of authorization request/provider inquiries by phone, mail, or fax.
Including: Verify member eligibility and benefits, o Determine provider contracting status and appropriateness, o Determine diagnosis and treatment request
Assign billing codes (ICD-9/ICD-10 and/or CPT/HCPC codes), o Determine COB status, o Verify inpatient hospital census-admits and discharges, o Perform action required per protocol using the appropriate Database. ? Respond to requests for authorization of services submitted to CAM via phone, fax and mail according to operational timeframes. ? Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long Term Care.
Contact physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director. ? Provide excellent customer service for internal and external customers.
Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores. ? Notify Care Access and Monitoring Nurses and case managers of hospital admissions and changes in member status. ? Meet productivity standards.
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). ? Participate in Care Access and Monitoring meetings as an active member of the team. ? Meet attendance guidelines per Healthcare policy.
Standards of Conduct Guidelines as described in Healthcare HR policy. Comply with required workplace safety standards.
Knowledge/Skills/Abilities:
Demonstrated ability to communicate, problem solve, and work effectively with people. ? Working knowledge of medical terminology and abbreviations. ? Ability to think analytically and to problem solve. ? Good communication and interpersonal/team skills. ? Must have a high regard for confidential information. ? Ability to work in a fast paced environment. ? Able to work independently and as part of a team.
Additional Information
Feel free to forward my email to your friends/colleagues who might be available. We do offer referral Bonus.
Thank you.
Kind Regards,
Harris Kaushik
Clinical Recruiter
Integrated Resources
, Inc.
IT Life Sciences Allied Healthcare CRO
DIRECT # - (650)-399-0891
Gold Seal JCAHO Certified ™
for Health Care Staffing
“INC
5
0
0
0
's
FASTEST GROWING, PRIVATELY HELD COMPANIES” (8th Year in a Row)
Care Manager
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
Job Description
As a RN Care Manager (RNCM) you would work collaboratively as part of a care team to assess consumer needs and establish a person-centered plan of care. In this role you would monitor the daily health and well-being of our consumers using technology and information provided by the caregiver and by conducting monthly home visits. Responsibilities: Coaching, educating and supporting family caregivers Developing person-centered plans of care Using structured assessment tools to assess consumer health status Conducting regularly scheduled home visits Representing Caregiver Homes in a professional manner in the community
Qualifications
Qualified candidates must be compassionate, able to build strong relationships with our families, work collaboratively with others, solve problems, and be flexible and technology proficient. You must also hold an active RN License, and have a minimum of two years of relevant experience as a registered nurse, preferably with elders, people with disabilities, and other complex medical needs in a health care, long-term care, social service or community setting. In order to serve our caregivers and consumers in their homes, you must also be willing and able to travel. Valid Driver's
Additional Information
Kind Regards
,
Kavita Kumari
Delivery Lead
Integrated Resources
, Inc.
IT Life Sciences Allied Healthcare CRO
DIRECT # -
732-844-8726
Care Review Clinician
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications
• Utilization Review in hospital setting .
• Prior author experience .
• Inpatient hospital experience .
• Nurses who are used to doing both production and review work .
• RN required .
• Millemen is a MUST .
• Interqual is PLUS .
• Good clerical experience .
• Insurance experience PLUS .
• Required Experience: Minimum 3-4 years of clinical practice in hospital setting.
• 1+ year utilization management, and/or case management.
• Required Licensure/Certification: Active, unrestricted State Nursing (RN) license in good standing.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Behavioral Health Medication Technician FT Nights
Groveport, OH job
We are looking for dynamic and compassionate Behavioral Health Medication Technicians to join our TEAM in Columbus, OH!
The Recovery Village Columbus Drug and Alcohol Rehab (RVC) is dedicated to connecting those struggling with substance use disorder to hope. We're here to help through every step of the process, from detox to discharge. Multidisciplinary treatment delivered by compassionate physicians, clinicians and addiction specialists help clients get to the root of their addictions, while first-rate amenities like yoga and art therapy promote mind and body healing.
The Recovery Village Columbus Drug and Alcohol Rehab is a premier treatment facility in the picturesque town of Groveport, Ohio. Our facility is close enough to airports and major roadways for convenience, but far enough away from the hustle and bustle of Columbus to encourage renewal and relaxation. RVC, an 80-bed facility, offers a complete continuum of care, from medical detox and inpatient treatment to outpatient care and aftercare. Our care team of doctors, clinicians, counselors and addiction professionals at The Recovery Village Columbus Drug and Alcohol Rehab use their years of experience to provide high-quality and compassionate care to those seeking recovery.
Take the first step toward making a difference and saving lives.
Responsibilities
The Behavioral Health Medication Technician is responsible for reading and understanding a medication order while monitoring the client's self-administration of medication. The Behavioral Health Medication Technician should also be able to retrieve, store and dispose of medication properly. This role will also provide observation of patients in treatment and reporting duties as indicated and contributes to the welfare of the organization and assists patients in a variety of patient activities. Assists in maintaining a safe and secure environment.
Works effectively with the facility leadership team to ensure success of the facility by completing the following:
Core Job Duties:
1. Obtains and records patient vital signs.
2. Observe and record patient self-administration of medication.
3. Maintains a filing system for various company functions.
4. Assists with projects from other departments as necessary.
5. Address problem behavior as needed through verbal de-escalation techniques.
6. Communicate and enforce facility program rules and ensure compliance in a firm but fair and professional manner.
7. Communicate patient behavior with immediate supervisor and clinical team as appropriate.
8. Adhere to time schedules
9. Maintain healthy and professional boundaries with patients and staff
10. Ensure that documentation is timely, consistent, clear, accurate and legible.
11. Keep clinical records secure at all times.
Other Required Duties:
12. Encourage patient to maintain Recovery post-discharge
13. Understand and apply the program's clinical philosophy
14. Communicate all urgent matters with immediate supervisor.
15. Maintain good communication, both written and verbal.
16. Assist nurses during intake as well as taking vital signs and weights. Notify nurse of any abnormalities
17. May provide for additional holistic activities as per employee's certification (i.e. Yoga, Massage Therapy, Meditation, etc.).
18. May provide for transportation of patients.
19. During State of Emergency, ensures appropriate Behavioral Health Technician staffing levels are maintained at all times and may be required to remain onsite throughout the State of Emergency period.
20. Other duties as assigned.
FT Nights shifts available.
Schedule: 3 / 12-hour shifts
Urgently Hiring: FT Nights (7p-7a)
What we offer:
$2.00 Night Shift Differential
Benefits begin on the 1st day of the month following date of hire.
Matching HSA - up to $1500/yr contribution from the company to your HSA
401(k), medical, dental, vision, and generous vacation time!
Employee Referral Bonus - you can earn up to $4000.
Qualifications
Associate's Degree and minimum one (1) year experience in BHT or similar role required.
In lieu of Associate's Degree, minimum two (2) years experience in BHT or similar patient care role required.
Successful completion of the ARS Medication Technician training.
Adult Facilities: Prefer experience working with adults.
Children and Adolescent Facilities: Prefer experience working with children and adolescents.
Good driving record that meets safety and company insurance standards.
LICENSURE/CERTIFICATIONS REQUIRED:
Med Tech Certification Course (annually) or QMAP Certification (Colorado) required.Preferred in New Jersey.
CNA, MA, Certified Behavioral Health Technician (CBHT) or in process of obtaining preferred.
CPR and Standard First Aid certification
Advanced Recovery Systems, a national integrated behavior healthcare management company dedicated to the treatment of addiction, substance abuse, eating disorders and mental health issues. We invite you to learn more about us at our website!
The Company complies with state and federal nondiscrimination laws and policies that prohibit discrimination based on age, color, disability, national origin, race, religion, or sex. It is unlawful to retaliate against individuals or groups based on the basis of their participation in a complaint of discrimination or on the basis of their opposition to discriminatory practices/EEO
We are proud to be a drug-free workplace.
Auto-ApplyData Center Operations
Dublin, OH job
A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
Position: Data Center Operations
Duration: 5 Months +
Location: Dublin, OH
(W2 Candidates Only)
Responsibilities:
• 24x7 technical support for the center
• 4 * 10 hour, second shift rotation (1400 - 0100)
• Server and network hardware installs and de-installs
• Perform cable site surveys and cable runs
• Address hardware troubleshooting needs
• Perform environmental monitoring within the Center
• Ability to lift 30lbs and reach under sub-floor for installing or removing cables.
• Good understanding of data center hardware and technology
• Good understanding of facilities infrastructure
• Excellent troubleshooting skills
• Excellent team and customer skills
• PC skills including Microsoft Office
• Good written and verbal communications in English
Qualifications:
• 2-3 years in operations environment
• Working knowledge of Generator, UPS, and HVAC systems.
• Associates degree or higher
Qualifications
Generator Ups Hvac
Additional Information
Thanks & Regards,
Ron Tamba
Technical Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I
(Direct) 732-662-7208 | (W) 732-549-2030 x 253 | (F) 732-549-5549
Data Specialist
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
Duties:
Updating the system to make corrections on provider data. Will be using QNXT.
Job Description:
Responsible for the timely and accurate entry of provider demographic, contract affiliation, and fee schedule information into the health plan system. Must be able to accurately interpret request and configure provider data in such a way that ensures accuracy and claims adjudication is optimized.
Key Responsibilities:
· Receives information from outside parties for update of information in computer system(s). Analyses by applying knowledge and experience to ensure appropriate information has been provided.
· Maintains department TAT standard for loading of provider demographic data with affiliation and fee schedule attachment.
· Maintains department quality standard for loading of provider demographic data with affiliation and fee schedule attachment.
· Works on projects as assigned and within parameters given. Knowledge/Skills/Abilities: Computer literacy and proficient in Microsoft Excel and Word. Excellent organizational skills
· Ability to interact well with both internal and external customers.
· Excellent verbal and written communication skills Ability to abide by Client's policies.
· Ability to maintain attendance to support required quality and quantity of work.
· Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
· Ability to establish and maintain positive and effective work relationships with co-workers, clients, members, providers and customers
Required Education:
High School Degree or equivalent GED
Required Experience:
0-2 years Managed Care experience in Claims, provider services, Provider Network Operations, hospital or physician billing, etc.
A minimum 1 year of data management experience, doesn't need to be healthcare related.
Must Haves:
Qualifications
Required Education:
High School Degree or equivalent GED
Required Experience:
0-2 years Managed Care experience in Claims, provider services, Provider Network Operations, hospital or physician billing, etc.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Java Programmer
Hilliard, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Title : Java Programmer
Duration : 6+ Months (Possibility of Extn.)
Location : Hilliard, OH
JOB DESCRIPTION:
• 8 plus years of experience in programming with emphasis to develop Server side Java on Linux, with strong emphasis on RMI, Oracle, PL/SQL.
• Strong background in Network Performance Management protocols including SNMP, Rest API, Netflow, IPFix, JVision, Telemetry.
• Skillset to include developing/deploying Linux based Java systems that interface with Enterprise Class Layer 2-3 SDN/NFV Network Devices, with a deep understanding of IP Networking, network concepts, TCP stack, routers/switches.
• Strong Linux skills a must with experience in DevOps toolchains, cloud technologies like Docker, AWS, Openstack, or other cloud solutions a definite plus.
• Strong capabilities in shell/bash and Perl scripting, IPlanet/Weblogic, MQ, Kafka experience helpful. Maven/Ant/Git/Stash experience helpful.
• Able to work independently and with a DevOps/Agile team as necessary.
RESPONSIBILITIES:
• Senior Developers participate in all phases of software development from inception to implementation and support.
• Collaborates with developers and clients to develop precise business logic.
• Participate in the training and support of lesser-experienced programmers.
• Assist the programmer in interpreting and implementing departmental standards and guidelines.
• Explain logical and technical situations so that the most efficient approach is taken; also explain the reasoning being the specified solution.
• Develop new complex computer applications and enhance existing systems according to assigned project requests, in accordance with established departmental standards and guidelines.
• Responsible for researching, analyzing, coding, and testing all changes, drawing on user and technical resources to successfully complete the request
Feel free to forward my email to your friends/colleagues who might be available.
Additional Information
Regards,
Sumit Kumar
Technical Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I
(Direct) 732-662-7005 | (W) 732-549-2030 x 249 | (F) 732-549-5549
Assistant Director of Nursing RN - Behavioral Health
Groveport, OH job
We are looking for dynamic and compassionate Assistant Director of Nursing (RN) to join our TEAM in Columbus, OH!
Are you looking for a rewarding nursing career serving patients with substance use disorders?
Look no further than The Recovery Village Columbus! Join us, Saving lives...it's what we do!
The Recovery Village Columbus Drug and Alcohol Rehab (RVC) is dedicated to connecting those struggling with substance use disorder to hope. We're here to help through every step of the process, from detox to discharge. Multidisciplinary treatment delivered by compassionate physicians, clinicians and addiction specialists help clients get to the root of their addictions, while first-rate amenities like yoga and art therapy promote mind and body healing.
The Recovery Village Columbus Drug and Alcohol Rehab is a premier treatment facility in the picturesque town of Groveport, Ohio. Our facility is close enough to airports and major roadways for convenience, but far enough away from the hustle and bustle of Columbus to encourage renewal and relaxation. RVC is a 80-bed facility offers a complete continuum of care, from medical detox and inpatient treatment to outpatient care and aftercare. Our care team of doctors, clinicians, counselors and addiction professionals at The Recovery Village Columbus Drug and Alcohol Rehab use their years of experience to provide high-quality and compassionate care to those seeking recovery.
Take the first step toward making a difference and saving lives.
Responsibilities
The Assistant Director of Nursing (RN) performs a wide variety of job duties during their shifts, caring for and educating patients about their medical and psychiatric conditions; establishing trust and building rapport with patients and their families are key elements of this position, and assists the Director of Nursing in the day to day management of the Nursing Department. The Assistant Director of Nursing is responsible for directing the day to day operations of the Nursing Staff on their assigned unit. The Assistant Director of Nursing may be required to function in the role of the Director of Nursing in the absence of or by directive from the Director of Nursing.
Core Job Duties:
Resolve pending issues from the previous shift, e.g., missed or incomplete labs or treatments, incomplete admissions or discharges, missing data for continuity of care.
Compliance Audit Related to Infection Control, e.g., glucometer, refrigerator, sharps containers, laboratory cleanliness, pests in facility, hand washing and flu campaign.
Medication storage, medication returns, medication destruction, calling pharmacy to resolve medication issues.
Order supplies, inventory management, maintain/organize supply room.
Monitor and track lab orders, monitor and track outside consults, track medical transfers.
Coordinate and plan the admission workflow, print Integra and Care 360 requisitions, assure collected samples are properly labeled.
Level of Care transfers in AVATAR.
Administrative functions, e.g., scanning documents into AVATAR, assisting with the work schedule, assisting BHT's with the creation/modification of observation sheets.
Admission and discharge audits. Check/audit the proper completion of any nursing procedure (at discretion of DON) to assure compliance.
Coordinate the Vivitrol program as directed by supervisor.
Is responsible for maintaining the daily scheduling of units according to approved ratios based on census.
Collaborates with other departments and agencies regarding resources and services for quality patient care delivery.
During State of Emergency, ensures appropriate nurse staffing levels are maintained at all times and may be required to remain onsite throughout the State of Emergency period.
What we offer:
Competitive Salary, based on experience.
Benefits begin on the 1st day of the month following date of hire.
Matching HSA - up to $1500/yr contribution from the company to your HSA
401(k), medical, dental, vision, and generous vacation time!
Employee Referral Bonus - you can earn up to $4000.
The Recovery Village Columbus Drug and Alcohol Rehab (advancedrecoverysystems.com)
#recoveryhotjobs #indnursinghiring
Qualifications
Minimum high school diploma or equivalent, licensed as a Registered Nurse as indicated in State law, higher education preferred
Minimum two years' experience as a Licensed Registered Nurse. Behavioral health experience preferred.
Licensed to practice in the State of Ohio.
Prior leadership/supervisor experience preferred.
Advanced Recovery Systems, a national integrated behavior healthcare management company dedicated to the treatment of addiction, substance abuse, eating disorders and mental health issues. We invite you to learn more about us at our website!
The Company complies with state and federal nondiscrimination laws and policies that prohibit discrimination based on age, color, disability, national origin, race, religion, or sex. It is unlawful to retaliate against individuals or groups based on the basis of their participation in a complaint of discrimination or on the basis of their opposition to discriminatory practices/EEO
We are proud to be a drug-free workplace.
Auto-ApplyCare Review Nurse
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Medicaid Division
Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care
Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications
Background
Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience)
Potential for longer term dependent on enrollment
Workers will be doing Concurrent Inpatient Review
MUST have one of the following AT LEAST
-Utilization Review in hospital setting
Nurses who are used to doing both production and review work
Additional Information
All your information will be kept confidential according to EEO guidelines.
License Practical Nurse
Columbus, OH job
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Duties:
Complete face to face visits with members in case management and as directed by the case manager. This role requires driving to multiple locations in a given day and will cover multiple counties. Case Manager will provide the series of questions that need to be asked. The goal is to educate members on their benefits and advise them on how they are utilize them to their fullest potential. Hands off care, more observing and documenting through computer. Candidate must be a self-starter.
Qualifications
Must Haves:
Active, unrestricted State Nursing License Practical Nurse, license in good standing for the State of Ohio.
5+years of LPN with home care experience.
Driving around the Columbus, OH area.
Required Education
:
Completion of an accredited Registered Nursing program. (a combination of experience and education will be considered in lieu of Registered Nursing degree).
Required Experience:
Minimum 0-2 years of clinical practice. Preferably hospital nursing, utilization
Required Licensure /Certification:
Active, unrestricted State Nursing (LPN) license in good standing.
Additional Information
All your information will be kept confidential according to EEO guidelines.