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Utilities Manager remote jobs

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  • RN Field Clinical Care Manager

    Unitedhealthcare 4.4company rating

    Remote job

    $7,500 SIGN ON BONUS FOR EXTERNAL APPLICANTS Coverage Area: Manhattan, Bronx and Westchester County New York At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. In this RN Field Clinical Care Manager role, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. There will be travel expectations throughout advertised boroughs. If you are located in New York state, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Perform the NYS UAS Assessment in the member's home at least twice per year and as needed Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license for the state of New York 2+ years of relevant clinical work experience 1+ years of experience of community case management experience coordinating care for individuals with complex needs Experience in long-term care, home health, hospice, public health or assisted living Proficiency with MS Word, Excel and Outlook New York state issued ID or ability to obtain one prior to hire Reside in New York state Ability to travel in assigned region to visit Medicaid members in their homes and/or other settings, including community centers, hospitals or providers' offices Preferred Qualifications: Behavioral health or clinical degree Experience with electronic charting Experience with arranging community resources Field based work experience Background in managing populations with complex medical or behavioral needs Proficient in use of UASNY *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $40.00 to $54.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #uhcpj At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $40-54 hourly Auto-Apply 1d ago
  • Epic Cadence Project Manager

    Onpoint Search Consultants 4.2company rating

    Remote job

    What you will find ... 100% REMOTE 6+ months) PTO days + 401K (auto 3% contribution) top ranked hospital in the U.S. What you will do ... Project Manager for Epic Cadence & Referrals Epic Cadence & Referral build validation Project Manage Referrals & Online Scheduling Identify potential roadblocks to project milestones & goals Organize project timelines, resources, and document progress Facilitate meetings for Epic Cadence analysts Liaison with Epic MyChart team to ensure project alignment Wish list ... 3+ years Epic Cadence build 2+ years Epic project management or team lead REQUIRED Epic Cadence Certification REQUIRED align with PST hours Epic Referrals design & build MyChart a plus
    $77k-118k yearly est. 1d ago
  • Project Manager

    Giuliani Construction & Restoration, Inc.

    Remote job

    Founded in 1991, Giuliani Construction & Restoration, Inc. has been committed to providing professional, timely, and personable services to its diverse clientele. Specializing in disaster mitigation and comprehensive repair services, the company aims to offer exceptional service, fair pricing, and a seamless experience. Operating across three prime locations-San Francisco, San Jose, and Concord-Giuliani Construction & Restoration has established itself as a trusted provider in the Greater Bay Area. The company is available 24/7 to deliver reliable and proven results to its clients. Role Description This is a full-time hybrid role for a Project Manager based in Concord, CA, with flexibility for remote work when appropriate. The Project Manager will oversee the planning, coordination, and execution of restoration and construction projects to ensure timely and successful completion. Responsibilities include managing project schedules, inspecting worksites, coordinating resources and logistics, and communicating effectively with clients, team members, and stakeholders. The role requires maintaining high standards in both project quality and client satisfaction while adhering to timelines and budgets. Qualifications Proficiency in Project Management and ability to oversee project timelines, budgets, and deliverables. Experience in Expediting and Expeditor tasks to ensure workflow efficiency and minimize delays. Strong Inspection skills to evaluate project progress and adherence to safety and quality standards. Familiarity with Logistics Management to coordinate materials, staff, and other essential elements for project completion. Excellent organizational and problem-solving skills with the ability to manage multiple projects simultaneously. Strong communication and interpersonal skills for effective collaboration with clients, contractors, and team members. Bachelor's degree in construction management, engineering, or related field, or equivalent work experience is preferred. Knowledge of construction and restoration processes, codes, and best practices is a plus.
    $88k-132k yearly est. 2d ago
  • Entry Level Project Manager (Remote)

    TBS Solutions LLC

    Remote job

    The entry level Project Manager role is responsible for leading, managing, and tracking project activities. The candidate is expected to manage customer expectations, provide project reporting and documentation, and promote collaboration among stakeholders. Ensure that the project goals and objectives are met within the planned scope, schedule, and cost. The person will handle decision-making and liaison with the project sponsor. RESPONSIBILITIES: Oversee and lead projects in a traditional waterfall and/or Agile project environment. Develop the project plan and schedule including tmelines, milestones, and resources Lead project meetings to achieve desired objectives and outcomes. Create applicable project deliverables and deliver reporting. Ensure project aligns with PMO guidelines, policies, and standards. Identify project risks and develop effective mitigation plans. Implement measures to ensure utmost quality of project deliverables. QUALIFICATIONS: A Bachelor's Degree with a major in Business, Marketing, Computer Science, Engineering, Accounting, Finance, Psychology, or other related discipline is preferred. Proven problem solving, negotiation, organizational, and time management skills. Good oral and written communication skills. Basic computing knowledge. WE OFFER: Flexibility to work remotely Positive and team-oriented work environment Attractive Salary Package (65K 90K) TRAINING PROCESS: 5 weeks online training Hands-on industry standard training experience Training start date: Friday July 18th, 2025 (starts 6pm EST) 2 days training schedule (Friday 6pm 8pm and Saturday 10am 1pm EST) Simulated case studies and real project examples Send resume to to apply. You may also contact us at ************. COMPANY DESCRIPTION TBS Solutions LLC is a fast-growing Information Technology and Business services company. We are the go-to Business Analysis, Project Management, and Agile Scrum professionals in the DMV area. We have many years of remarkable industry knowledge and experience that will help you realize your dreams of securing a profitable and sustainable career with a bright future.
    $77k-108k yearly est. 60d+ ago
  • Transportations Project Manager

    Us Tech Solutions 4.4company rating

    Remote job

    Warehousing Data Input Management on Smartsheet Key Responsibilities: Enter, update, and maintain warehousing and shipment data in Smartsheet. Review and edit transportation information, including shipment coordinates and status updates. Perform data validation and quality checks to ensure accuracy across all records. Use Excel to filter, sort, and apply basic formulas to analyze or clean data. Conduct web-based research to find, verify, or update shipment, vendor, or logistics information. Collaborate with program or operations teams to resolve data discrepancies. Support general supply chain documentation and reporting as requested. Required Qualifications: 1-2 years of experience in supply chain, logistics, warehousing operations, or related fields. Hands-on experience with Smartsheet for data entry, tracking, and updates. Strong Excel proficiency: filtering, sorting, basic formulas (VLOOKUP/SUMIF is a plus). Ability to work with transportation data, including coordinates and shipment information. Strong research skills and the ability to locate and verify information online. High attention to detail, accuracy, and consistency in data handling. Ability to work independently as a contractor and meet deadlines. Preferred Qualifications: Experience with logistics systems, TMS, or WMS platforms. Familiarity with shipment routing, freight terms, or transportation documentation. Strong communication skills and comfort working in a remote work environment. About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: Kavisha Email: ****************************** Internal Id: 25-54509
    $86k-124k yearly est. 23h ago
  • Manager, Utilization Management (Coordination)

    Alignment Healthcare 4.7company rating

    Remote job

    Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Manager, Utilization Management (UM) Coordination, oversees non-clinical inpatient and pre-service operations under the direction of the Director of Utilization Management. This role provides leadership to UM Supervisors and their coordinator teams to ensure timely, accurate, and compliant processing of authorizations and referrals in accordance with CMS and organizational standards. The Manager drives operational efficiency, staff development, and process improvement while collaborating with internal departments to support continuity of care and overall service quality. Job Responsibilities: Provide operational leadership and direction to two Utilization Management Supervisors overseeing non-clinical coordinator teams supporting both Inpatient and Pre-Service workflows. Lead the teams meet established turnaround times (TATs), quality, and productivity standards for authorization processing, referral routing, and related UM functions. Oversee staffing allocation, scheduling, and workload balancing between inpatient and pre-service units to maintain consistent service levels. Conduct regular one-on-one meetings with supervisors to review performance metrics, workflow barriers, and staff development needs. Own the daily operations to ensure timely and accurate completion of authorizations, correspondence, and documentation in compliance with CMS, NCQA, and organizational standards. Identify process inefficiencies and implement corrective actions to improve turnaround, accuracy, and staff productivity. Lead root-cause analyses for escalated operational issues and coordinate corrective action plans. Responsible for all the accuracy of all UM workflows, systems, and reporting dashboards to support data-driven decision making. Oversee the development and delivery of training materials, competency assessments, and reference guides to promote consistent and compliant practices. Mentor Supervisors to build leadership capacity, coaching them on staff management, delegation, and performance improvement techniques. Drive onboarding, cross-training, and refresher sessions are regularly conducted to support staff versatility across inpatient and pre-service functions. Manage all team activities adhere to CMS and organizational policies related to Utilization Management, confidentiality, and member communication standards. Oversee internal audit reviews and collaborate with the Quality and Compliance teams to address findings and implement improvement plans. Direct that all letters and communications use approved templates and standardized language for UM determinations and continuity-of-care requirements. Participate in internal and external audits, Medical Services Committee meetings, and other regulatory reviews as required. Review and analyze key performance indicators (KPIs), including volume, turnaround time, accuracy, and productivity reports; present trends and improvement strategies to leadership. Support the preparation and submission of monthly UM reports, dashboard summaries, and Medical Services Committee deliverables. Leverage data to identify training needs, process gaps, and operational trends impacting service delivery or compliance. Serve as a liaison between UM, Case Management, Provider Relations, and Claims departments to streamline interdepartmental communication and issue resolution. Collaborate with network providers and internal teams to clarify authorization processes and ensure alignment with benefit and policy criteria. Participate in internal workgroups or initiatives to improve system functionality, workflow automation, and reporting enhancements. Assist with the development, implementation, and monitoring of UM-related initiatives and special projects (e.g., claims review process, continuity-of-care tracking, or performance optimization programs). Evaluate and revise UM policies and procedures to align with evolving regulatory standards and organizational goals. Support readiness activities for CMS audits and other accreditation requirements. Perform other related functions and special assignments as directed by senior leadership. Core Competencies: Leadership & Talent Development - Demonstrates the ability to lead through others by developing and empowering supervisors and staff. Fosters a culture of accountability, engagement, and continuous improvement within the UM department. Operational Management - Applies strong organizational and analytical skills to oversee workflow execution, resource allocation, and performance metrics across inpatient and pre-service teams. Regulatory & Compliance Expertise - Maintains in-depth knowledge of CMS regulatory standards, confidentiality requirements, and UM protocols to ensure full compliance and audit readiness. Analytical Thinking & Decision-Making - Uses data to identify trends, evaluate outcomes, and implement process improvements that enhance accuracy, turnaround times, and service quality. Communication & Collaboration - Communicates clearly across all organizational levels; partners effectively with Clinical Operations, Provider Relations, Case Management, and Claims to resolve issues and align priorities. Process Improvement & Innovation - Continuously evaluates operational workflows and implements efficiency strategies that support organizational goals and member satisfaction. Member & Service Orientation - Demonstrates commitment to delivering high-quality service, ensuring that UM processes support positive member experiences and continuity of care. Change Management - Adapts to evolving regulatory, system, and organizational needs while leading teams through process transitions and new initiatives effectively. Supervisory Responsibilities: Oversees assigned staff. Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and performance management. Job Requirements: Experience Required: Minimum (4) years of related experience in a managed care setting and a minimum (3) years of recent and related supervisory experience Education Required: Highschool Diploma or GED Required Preferred: Bachelor's Degree or higher Other: Strong knowledge of Medicare Managed Care Plans Proficient in Microsoft Word, Excel, and Outlook; advanced Excel skills preferred (pivot tables, formulas, data visualization, and reporting functions for performance tracking and analysis). Experience leading and sustaining process improvement initiatives within healthcare operations to enhance efficiency, compliance, and service quality. Communication and Interpersonal Skills - Excellent written and verbal communication skills; able to build and maintain collaborative relationships with diverse teams, including leadership, staff, and external partners. Analytical and Reasoning Skills - Strong analytical thinking with the ability to define problems, collect and interpret data, establish facts, draw valid conclusions, and develop actionable solutions. Problem-Solving and Organizational Skills - Demonstrated ability to prioritize multiple tasks, manage time effectively, and maintain accuracy in a fast-paced, dynamic environment. Data and Report Analysis - Ability to interpret, analyze, and present statistical and operational reports to support decision-making and performance monitoring. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $70,823.00 - $106,234.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
    $70.8k-106.2k yearly Auto-Apply 15d ago
  • Utilities Title Manager - Remote - (1573)

    ORC 4.6company rating

    Remote job

    Schedule: Full-time, Exempt The Right Work. The Right People. The Right Culture. Right of Way is where infrastructure meets innovation-shaping roads, utilities, and communities for the future. At ORC, we offer more than a job-we offer purpose, stability, and growth. Join a team that values collaboration, respects your work-life balance, and empowers you to make a lasting impact. What We Offer Competitive base pay: $110,000 - $125,000 per year Bonus Opportunities Health, dental, and vision benefits 401(k) with company match and disability coverage Paid time off, sick time, and holidays Tuition reimbursement and professional training Recognition programs and growth opportunities Free Calm membership for you and up to five others What You'll Do Oversee the day-to-day management and overall success of title projects Build and maintain strong relationships with current clients while identifying new business opportunities Review scope of work, develop and monitor project schedules, manage budgets, and forecast staffing needs Conduct due diligence, compile pricing, and track project progress from start to finish Complete complex title projects and collaborate with Quality Control to review titles for accuracy Identify and implement process improvements within the department Provide technical assistance, troubleshoot issues, and resolve problems effectively Partner with the internal training team to assess title training needs and lead the development of new training programs Supervise and support a team of at least 9 staff members, managing workload, performance, and other personnel-related responsibilities We are looking for someone who Has the ability to successfully manage a project team Works efficiently and effectively under tight deadlines Can prioritize and balance multiple tasks Demonstrates strong organization and planning skills Is analytical, detail-oriented, and eager to learn Has excellent written and verbal communication skills Thrives in a fast-paced administrative setting Provides strong customer service experience Can adapt to new systems and software environments Minimum Requirements Minimum of 6 years of experience in the land title industry Must include 2 years managing project(s) Managed a team across various counties and states Understanding of complex title concepts Must be proficient with MS Office Suite, specifically Excel, Word, Dropbox, and Outlook Must have an iOS or Android smartphone to be able to access ORC's systems Valid Driver's License Bonus Points if you have Right of Way industry experience! Ready to Apply? Make your mark on projects that matter. Apply now to join a supportive team that invests in your future. Our job titles may span more than one career level. Compensation for this position is dependent upon many factors, such as training, transferable skills, work experience, business needs, and market demands. The base pay range is subject to change and may be modified in the future. This role may also be eligible for benefits and employee travel reimbursements. ORC is one of America's most respected right-of-way acquisition firms. Our services not only include providing outsourced right-of-way services to public agencies, but also electric transmission, oil and gas pipelines, fiber optic, and sewer and water infrastructure. We are excited to be part of the renewable energy forefront for wind and solar projects. Employees must avoid any relationship or activity that might impair, or even appear to impair, their ability to make objective and fair decisions when performing their jobs. To avoid conflicts of interest, employees are prohibited from performing any services for clients or perceived clients during nonworking time that are normally performed by ORC, including the sale of real estate. Physical Requirements: While performing the duties of this job, the employee is regularly required to clearly communicate and exchange information in person, via phone and email. Substantial repetitive movements of the wrists, hands and/or fingers due to high amounts of computer usage and typing. Expected to spend long spans of time in front of a computer screen. Able to read, understand and interpret department related documents and data. This is a largely sedentary role; however, the employee is occasionally required to move about inside the office to access files, office equipment and to interact with other members of the staff. This employee is required to occasionally travel to government buildings which involves time driving; sometimes for long durations.
    $110k-125k yearly 12d ago
  • Energy & Utilities Manager

    Terawatt Infrastructure

    Remote job

    The once in a century transition to autonomous and electric vehicles is underway and will require a multi-trillion-dollar investment in energy and charging infrastructure, and the real estate to site it on. Terawatt is the leader in delivering large scale, turnkey charging solutions for companies rapidly deploying AV and EV fleets. Whether it's an urban mobility hub, or a carefully located multi-fleet hub for semi-trucks, Terawatt brings the talent, capabilities, and capital to create reliable, cost-effective solutions for customers on the leading edge of the transition to the next generation of transport. With a growing portfolio of sites across the US in urban hubs and along key logistics and transportation corridors and logistics hubs, Terawatt is building the permanent transportation and logistics infrastructure of tomorrow through a robust combination of capital, real estate, development, and site operations solutions. The company develops, finances, owns, and operates charging solutions that take the cost and complexity out of electrifying fleets. At Terawatt, we execute humbly and with urgency to provide tailored solutions for fleets that delight our clients and support the transition of transportation. Role Description Terawatt Infrastructure seeks an Energy and Utilities Manager for its Energy & Utility team. The Energy and Utilities Manager is a critical, independent contributor role responsible for developing and executing comprehensive utility engagement strategies throughout the entire development lifecycle of Terawatt Infrastructure projects. This individual will serve as the primary point of contact and subject-matter expert for all utility-related matters, ensuring seamless coordination and alignment among internal teams, including real estate, Development, Design-Construction, and Business Development. During the crucial site evaluation phase, the Energy and Utilities Manager will proactively engage with relevant utility providers to assess infrastructure availability, capacity, costs, and potential risks. This involves conducting thorough due diligence, analyzing utility maps and data, and collaborating with development teams to determine optimal site selection based on utility feasibility and economic considerations. The role extends to project engineering, where the Energy and Utilities Manager will actively contribute to the customer and utility design process, ensuring that utility requirements and specifications are integrated into project plans. This includes collaborating with teams to develop detailed utility layouts, load calculations, and energization designs. Furthermore, this individual will create realistic project schedules incorporating utility timelines for service connections, upgrades, and relocations, effectively mitigating potential delays. Budgeting is another key area of responsibility, requiring the Energy and Utilities Manager to develop and manage comprehensive utility budgets that cover connection fees, infrastructure upgrades, and ongoing service charges. This involves cost estimation, financial forecasting, and proactive identification of cost-saving opportunities. A significant aspect of this role involves skillfully negotiating and executing complex utility agreements and contracts, ensuring favorable terms and conditions for the organization. This includes managing relationships with utility providers, resolving disputes, and staying abreast of utility changes and industry best practices.Core Responsibilities Own key project milestones and deliverables, and manage delivery dates Collaborate closely and guide the Site Acquisition, Project Development, and Construction teams regarding preliminary utility-related engineering, design, and construction timelines. Understand and make critical recommendations regarding timing, cost, and economic trade-offs involved with site energization or interconnection for behind-the-meter generation. Be the owner of the dry utility space: interpret Utility Design Standards and draft dry utility space design via Bluebeam design tools. Be a problem solver when utility bottlenecks or failures are causing project delays. Inform the Company's energy and energization strategy through collaboration with the Real Estate, Project Development, Design & Construction, and Business Development teams. Identify, hire, and manage utility consultants as needed for projects. Preferred Qualifications Experience working with regulated and municipal electrical utilities in major US metro areas. A strong understanding of utility distribution/transmission planning and design, and electrical design standards. Electrical and site design experience Experience with the complete utility coordination process, from application to design to energization. Strategic thinking skills regarding business, operations, and technical challenges, coupled with the technical skills to execute project schedules, contracts, initiatives, and team objectives. Experience in estimating utility service costs. Experience with project development from greenfield or brownfield site acquisition to operational assets. We are building a team that represents a variety of backgrounds, perspectives, and skills. At Terawatt, we continuously strive to foster inclusion, humility, energizing relationships, and belonging, and welcome new ideas. We're growing and want you to grow with us. We encourage people from all backgrounds to apply. If a reasonable accommodation is required to fully participate in the job application or interview process, or to perform the essential functions of the position, please contact ********************************* . Terawatt Infrastructure is an equal-opportunity employer.
    $60k-97k yearly est. Auto-Apply 14d ago
  • Utility 17

    Usabb ABB

    Remote job

    At ABB, we help industries outrun - leaner and cleaner. Here, progress is an expectation - for you, your team, and the world. As a global market leader, we'll give you what you need to make it happen. It won't always be easy, growing takes grit. But at ABB, you'll never run alone. Run what runs the world. This Position reports to: Manufacturing Manager - NEMA Your role and responsibilities (Mandatory) In this role, you will have the opportunity to operate process equipment or machinery to convert raw materials or semi-finished parts into components or finished parts for a final product at the right time and with the required quality. Each day, you will execute the assigned tasks according to agreed workflows and in accordance with ABB standard processes and safety guidelines and reports any non-compliance. You will also showcase your expertise by operating machines in accordance with the operating manual, work schedule, and/or production order instructions. The work model for the role is: {onsite/hybrid/remote} {insert Linkedin #} This role is contributing to the {insert product group/business area/division/function} in {insert region}. Main stakeholders are {insert main stakeholder groups if available}. You will be mainly accountable for: Performing routine machinery set-up, adjustments, and repairing and fitting simple replacement parts. Ensuring regular standard maintenance of the equipment, tools set-up, programming activities, and troubleshooting and reporting issues, if any; and maintaining detailed records of machinery set-ups, repairs, and maintenance activities. Keeping track of approved, defective units, and final products. Our team dynamics (Optional) You will join a {insert adjectives - e.g. dynamic, talented, high performing} team, where you will be able to thrive. Qualifications for the role (Mandatory) You are immersed in / engaged in / absorbed in / highly skilled in/ you enjoy working with {relevant tools and methodologies} and the {insert relevant industry/sector} market Ability to demonstrate your experience in / Have established skills / advanced skills / You have {insert number of years} years of experience in {insert relevant field} (OPTIONAL: working as {insert relevant role} with {insert relevant products or technologies}) Possess an enhanced knowledge of / You are qualified in / Highly adept in {insert specialized software/platforms} You are passionate about / you are captivated by / you are innovative around {insert relevant soft skills} and {insert relevant soft skills} Degree in / Have a demonstrated track record in / Extensive knowledge of / Proven experience of {insert specific degree, qualification} in {insert subject} You are at ease communicating in {insert required language skill(s)} You hold current {insert required licenses} valid in {insert job location} and {insert country-specific VISA/work permit} {where required} What's in it for you? (Optional) Benefits (Optional) We also offer our employees the following benefits: Benefit 1 Benefit 2 Benefit 3 Benefit 4 Benefit 5 Local Specific Benefits (Open Field below - Optional) Locally, you can count on {Add local perks and benefits in text format} More about us (Mandatory) {Insert specific business area/division/service function or corporate function paragraph from common source material} {Insert country/location -specific boilerplate (1-2 sentences only)} {optional} {Insert country-specific legal statement e.g.: EEO/data privacy} {where required} {Insert PES (Pre-employment screening) sentence} {when required} {Insert local TP or hiring manager contacts if necessary} Guidelines: Please be aware: All fields in yellow should be populated with relevant information (based on Job description and the Kick-off form). All other text can also be modified if necessary, within the given guidelines. Text in bold is fixed and should not be edited or removed Reporting Manager section is mandatory both internally and externally, to be posted via eRec functionality “Your role and responsibilities” should be plain text followed by maximum 4 additional bullet points The “Qualifications for the role” section should include no less than five and no more than seven bullet points. These bullet points should be listed in order of importance for the success in the role Indicate the required language knowledge in the “Qualifications for the role” section whenever it is mandatory and/or applicable Information about “Licenses and visa/work permit” is optional, use this sentence wherever it is required In the “More about us” section you can add further legal statements/PES indications or Talent Partner contacts, for example Read more about the guidelines in the Guidelines doc available in the SharePoint We value people from different backgrounds. Could this be your story? Apply today or visit *********** to read more about us and learn about the impact of our solutions across the globe.
    $60k-97k yearly est. Auto-Apply 15d ago
  • Utilization Management Manager - REMOTE - Pacific Region

    Scionhealth

    Remote job

    Education Associate degree required Bachelor's degree preferred Clinical area strongly preferred Licenses/Certifications Healthcare professional licensure preferred. In lieu of licensure, 3+ years of experience in relevant field required. Some states may require licensure or certification. Experience 3+ years of experience in a healthcare strongly preferred. Experience in managed care, case management, utilization review, or discharge planning a plus. At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. This position blends strong relationship-building skills with clinical knowledge to navigate complex payer requirements, streamline the authorization process, and support seamless patient transitions. From start to finish, this role drives the authorization process-reviewing prospective, retrospective, and concurrent medical records; coordinating with referring hospitals to secure prior authorizations; and partnering with case management teams at ScionHealth facilities to complete concurrent review authorizations. Acting as a navigator and liaison between Business Development, facility administration, managed care organizations, and payors, the specialist ensures determinations are communicated promptly and accurately to all relevant stakeholders. By combining attention to detail with proactive collaboration, the Utilization Management Manager safeguards revenue integrity, reduces delays, and supports the organization's mission of delivering exceptional patient care. This role actively contributes to quality improvement, problem-solving, and productivity initiatives within an interdisciplinary model, demonstrating accountability and a commitment to operational excellence. Essential Functions Extrapolates and summarizes essential medical information to obtain authorization for admission and continued stay to/at ScionHealth Level of Care. Prepares recommendations to sumbit timely request for reconsideration of denial determination in attempt to have denied authorization requests overturned. Ensures authorization requests are processed timely to meet regulatory timeframes. Reviews medical necessity assessments completed by case management, evaluating documentation for specific criteria related to severity of illness, and level of care appropriateness. Generates written appeals to medical necessity-based payor denials for denials prior to admission and concurrent review authorizations. Appeal letters may be processed on behalf of the physician, combining clinical and regulatory knowledge in efforts to have consideration of authorization. Documents authorization information in relevant tracking systems. Effectively builds relationships with business development team, admissions team/clinical staff and managed care team, to coordinate the patient admission functions in keeping with the mission and vision of the hospital. Supports review of patient referral for clinical and financial approval and/or escalation to leadership for approval following the Care Considerations grid. Coordinates and facilitates pre-admission Prior Authorizations for patients from the referral sources: Identifies /reviews medical record information needed from referring facility. Applies appropriate clinical guidelines to pre-authorization determination process. Communicates specific patient needs for equipment, supplies, and consult services as related to prior authorization requirements. Acts as a liaison with the Business Development team through every stage of the authorization process through determination. Initiates appeals process as appropriate. Facilitates and coordinates physician-to-physician communication as appropriate to support the denial management process. Communicates to appropriate teams, including business development and facility administration when clinical authorization and financial approval is complete, following standard authorization process. Provides hospital team with needed prior authorization information on pending / new admissions. Coordinate with managed care payor on all coverage issues and supports the LOA process as requested. Coordinates and facilitates Concurrent Review Authorizations for patients actively in-house at a ScionHealth facility Identifies /reviews medical record information needed from facility. Applies appropriate clinical guidelines to concurrent review authorization process. Review medical necessity review information provided by the case management team and communicates any additinoal questions or information requests Acts as a liaison with the Case Management team through every stage of the concurrent review authorization process through determination. Initiates appeals process as appropriate. Communicates with Medical Advisors or case managers of managed care company as necessary; including during Care Coordination / Managed Care calls Maintains a knowledge of areas of responsibility and develops and follows a program of continuing education. Participates in continuing education/ professional development activities. Learns and develops full knowledge of the CAAT Admission Processes and actively seeks to continuously improve them. Knowledge/Skills/Abilities/Expectations Strong relationship building skills and a spirit to serve to ensure effective communication and service excellence. Knowledge of regulatory standards and compliance guidelines. Working knowledge of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare and Medicaid rules, regulations, coverage guidelines, NCDs and LCDs. Working knowledge of Medicare, Medicaid and Managed Care payment and methodology. Extensive knowledge of clinical symptomology, related treatments and hospital utilization management. Excellent interpersonal, verbal and written skills to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers. Critical thinking, problem solving, and decision-making capabilities with the ability to discern, collect, organize, evaluate, and communicate pertinent clinical information with effective verbal and written skills. Technical writing skills for appeal letters and reports. Effective time management and prioritization skills. Computer skills with working knowledge of Microsoft Office (Word, Excel, PowerPoint, and Outlook), word-processing and spreadsheet software. Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members. Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards. Communicates and demonstrates a professional image/attitude for patients, families, clients, coworkers and others. Adheres to policies and practices of ScionHealth. Must read, write, and speak fluent English Must have good and regular attendance. Approximate percent of time required to travel\: N/A Pay Range\: $66,700-$100,050 ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness.
    $66.7k-100.1k yearly Auto-Apply 60d+ ago
  • Bid Manager and Writer

    System-C

    Remote job

    at System C At System C, we create software that helps drive 21st century health and social care in the UK. Using leading-edge technology and data, our systems are trusted by hundreds of health and social care organisations, our work impacts millions of lives every day. What we do matters. The Bid Manager and Writer will be responsible for managing and writing high-quality, compelling bids, from opportunity identification through to submission. They create persuasive content while coordinating timelines, compliance, and team inputs. This hybrid role combines bid strategy, content authorship, and project delivery. Key Responsibilities: Opportunity Identification: Scan NHS procurement portals and frameworks to identify relevant tenders aligned to business priorities. Bid Strategy & Storyboarding: Define win themes, pricing narratives, and content structure in collaboration with sales and product teams. Content Creation: Write and edit tailored responses, ensuring clarity, accuracy, and alignment with the evaluation criteria. Proposal Management: Oversee the bid lifecycle - assign tasks, track timelines, facilitate all process reviews, and ensure final submission. Compliance: Ensure responses meet all legal, commercial, and buyer-specific requirements. Collaboration: Work cross-functionally with SMEs, sales, legal, pricing and delivery colleagues to shape responses and gather inputs. Content Library Development: Maintain and update reusable content, case studies, and past responses. Manages 2-3 live bids/month. Contributes to bid/no-bid recommendations and process improvements. Required Skills: Persuasive writing, editing, and storytelling NHS/public sector procurement knowledge Bid planning, task management, and review cycle facilitation Content design and document compliance (RFP/ITT structures) Stakeholder engagement and SME coordination Proficiency in MS Office and submission portals (e.g. Atamis, Bravo) Experiences: Delivering complete NHS bids as lead writer and manager Collaborating with cross-functional teams to shape strategy and pricing Managing bid reviews (pink/red) and coordinating SME contributions Writing winning proposals in a regulated environment Maintaining proposal libraries and governance records
    $83k-120k yearly est. Auto-Apply 47d ago
  • Behavioral Health Care Manager, BCBA (4/10 weekends) - Remote

    IEHP 4.7company rating

    Remote job

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Behavioral Health Care Manager, SKI (Specialty Kids Intervention) BCBA is responsible for all aspects of services to IEHP members with autism, developmental disabilities, and/or intellectual disabilities and children with severe behavioral needs. The Behavioral Health Care Manager, SKI BCBA will also be responsible for reviewing requests for services, applying clinical criteria, applying clinical expertise to review treatment plans and authorizing services to ensure quality care coordination. This position ensures effective call support, case management as needed, care coordination as needed, and referral support. Under the direction of department leadership, the Behavioral Health Care Manager, SKI BCBA position works collaboratively with members of their own team, IEHP members and families, community agencies, and with the designated health care organization (HCO) medical team. This position is expected to model IEHP principles of relationship-based care, as well engage in promoting education and understanding of behavioral health and its importance in whole health, to those within IEHP and in the community. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Hybrid schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Adhere to the ethical guidelines of the BACB Board. Provide support to the SKI team to ensure implementation of timely processes, follow-through of calls, task completion, and case management functions. Provide guidance in the realm of autism, developmental disabilities, and behavior analytic practices for the SKI team and all departments, when needed. Work with BHT providers and other providers (Primary Care, Speech Therapist, etc) within the IEHP network; develop genuine and effective relationships with providers. Participate in clinical review meetings for Members regarding behavioral concerns, barriers to treatment or treatment progress, as needed. Ensure treatment plans are updated, assessment results are updated, the treatment goals align to the assessment results and that goals meet medically necessary criteria. Become proficient in all electronic medical management systems (e.g. Cisco, MedHOK, HSP, Super Search and Web Portal) to assist in training of new staff members. Review requests for services, apply clinical criteria, and apply clinical expertise to review treatment plans and authorizing services. Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members. Participate in other committees as needed, Interdisciplinary Care Conferences, and any other meetings as required or directed by department managers or Directors. Work with a caseload of Members with developmental delays as needed. In conjunction with department leadership, provide consultation for the non-certified/licensed team members when discussing tasks of a clinical nature. Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirements Three (3) years of experience working in a setting offering services to individuals with autism, developmental or intellectual disabilities required Significant experience reviewing Behavioral Health Treatment Plans and Behavior Intervention Plans (BIPs) Experience in leading a team is preferred Experience in an HMO or experience working in psychiatric facility or county hospital facility preferred Master's degree in Social Work/Psychology or related field from an accredited institution with ABA specialization required Possession of an active, unrestricted, and unencumbered Board-Certified Behavior Analyst (BCBA) certification issued by the Behavior Analyst Certification Board required Key Qualifications Deep knowledge and skills in Autism; Applied Behavioral Analysis, Special Education skills in engaging and serving families Familiarity with Managed Care and discharge planning is preferred Knowledgeable and skilled in evidenced-based communication such as Motivational Interviewing, or similar empathy-based communication strategies Understanding of and sensitivity to multi-cultural communities Deep understanding and knowledge of mental health Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both Must have knowledge of whole health and integrated principles, theories, and practices Knowledge of community resources and health plan benefits Bilingual written and verbal is highly preferred Skillful at telephonic information delivery and counseling support to Members, their caregivers, and their families Effective reasoning and problem-solving skills Excellent relationship, communication (written and verbal), and interpersonal skills, including conflict resolution Must have resiliency to tolerate, adapt, and manage effective use of a high level of ambiguity around new team models, new models of care, and new care management practices Proficient in the use of computer software to include but not limited to: (e.g. Microsoft Word and Excel, Power Point) for use in all aspects of an office environment Excellent organizational skills while effectively multi-tasking on various projects Ability to undertake and write telephonic clinical mental health assessments which meet specified regulatory standards. Ability to interview, assess, and coordinate care Skilled in researching applicable resources for members Demonstrated proficiency with all electronic medical management systems (e.g., Cisco, MHK/Care Prominence, MediTrac, SuperSearch and Web Portal) is preferred Proven ability to: Work as a member of a highly autonomous team, executing job duties and making skillful decisions as an independent team member within one's scope Show desire and develop genuine, effective relationships with members, co-workers, supervisors, and community/HCO partners at all levels Support others to utilize telephonic means to engage, assess and assist members is required Provide vision, leadership, and support to a team Communicate and work effectively with a variety of providers and maintain positive working relationships with internal and external contacts at all levels Show a high degree of patience Learn new computer systems Prioritize multiple tasks as well as identify and resolve problems Have effective time management and the ability to work in a fast-paced environment Have timely turnaround of assignments expected To form cross-functional and interdepartmental relationships Work Location is dependent on department leadership and business need. Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership) Pay Range USD $91,249.60 - USD $120,910.40 /Yr.
    $91.2k-120.9k yearly Auto-Apply 4d ago
  • Remote Utilization Manager - Inpatient

    Allhealth Network 3.8company rating

    Remote job

    Join Our Team as a Utilization Review Manager (RN or Social Worker) Are you a compassionate nurse or social worker looking to make a real difference in behavioral health? AllHealth Network is seeking a dedicated Utilization Review Specialist to help ensure clients receive the care they need while collaborating with a team that values your expertise and commitment. Why AllHealth Network? * Work in a supportive, interdisciplinary environment that values your professional judgment * Enjoy opportunities for ongoing learning, growth, and advancement * Make a tangible impact on client outcomes and community well-being * Be part of a mission-driven organization dedicated to high-quality, client-centered care What You'll Do: * Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations * Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization Units * Collaborate with nurses, social workers, case managers, and other healthcare professionals * Ensure quality care by coordinating with payers, treatment teams, and billing staff * Maintain accurate records and use your problem-solving skills to navigate challenging cases What We're Looking For: * Registered Nurse (BSN/RN) or Master's in a human services field * Clinical license (LPC, LCSW) required * Minimum 2 years' experience in behavioral health utilization management, care coordination, or case management * Strong communication, organization, and advocacy skills * Experience with insurance processes, electronic records, and multidisciplinary teamwork Ready to take your career to the next level with a team that cares as much as you do? Apply today and help us transform lives-one client at a time. $72,000 - $80,000 annually AllHealth Network also provides a 10% compensation differential for individuals who are bilingual in English and Spanish (language proficiency testing required). The base salary range represents the low and high end of the AllHealth Network hiring range for this position. Actual salaries will vary and may be above or below the range based on various factors including but not limited to experience, education, training, merit, and the ability to embody the AllHealth Network mission and values. The range listed is just one component of AllHealth Networks' total compensation package for employees. Other rewards may include short-term and long-term incentives as well as a generous benefits package detailed below.
    $72k-80k yearly 38d ago
  • Enterprise Account Director, Government Utilities

    Open 3.9company rating

    Remote job

    About InvoiceCloud: InvoiceCloud is a fast-growing fintech leader recognized with 20 major awards in 2025, including USA TODAY and Boston Globe Top Workplaces, multiple SaaS Awards wins for Best Solution for Finance and FinTech, and national customer service honors from Stevie and the Business Intelligence Group. Judges also highlighted our mission to reduce digital exclusion and restore simplicity and dignity to how people pay for essential services, as well as our leadership in AI maturity and responsible innovation. It's an award-winning, purpose-driven environment where top talent thrives. Job Details InvoiceCloud is experiencing rapid growth and seeking an Enterprise Account Director to expand our presence in the Government and Utility sectors. In this role, you will lead complex enterprise sales cycles, engage high-profile stakeholders, and position InvoiceCloud as a strategic partner for organizations seeking modern, customer-friendly billing and payment solutions. You will bring deep industry expertise, exceptional relationship skills, and a consultative mindset to advance digital transformation across essential public service organizations. Success requires strategic thinking, strong business acumen, and the ability to influence senior decision-makers in long-cycle public sector sales environments. Success Profile: Success in this role is anchored in InvoiceCloud's Core Competencies. These competencies reflect the mindsets and behaviors that define success in this role. We outline how each competency translates into real-world actions and outcomes specific to this role. Customer Centric Cultivates trusted, consultative relationships with government and utility decision-makers, including C-level leaders, elected officials, and operational stakeholders. Demonstrates understanding of public sector and utility billing workflows, regulatory considerations, procurement cycles, and customer experience priorities. Uncovers client needs through deep discovery, translating challenges into solutions using InvoiceCloud's platform. Positions InvoiceCloud as a long-term partner by sharing industry insights, best practices, and strategies that enhance operational efficiency and customer satisfaction. Represents the voice of the customer internally, influencing product roadmap conversations and cross-functional alignment. Results Driven Drives new enterprise revenue by prospecting, qualifying, and closing opportunities within target markets and territories. Leads complex sales cycles end-to-end, from discovery through negotiation and contracting, navigating public sector processes effectively. Designs data-driven account strategies that accelerate pipeline velocity, expand market penetration, and exceed annual quota targets. Leverages competitive intelligence and market analysis to position InvoiceCloud's value clearly and compellingly. Attends industry conferences, trade shows, and networking events to build presence, identify opportunities, and accelerate relationship development. Takes Ownership Manages assigned territory and pipeline with discipline, accuracy, and accountability, ensuring predictable forecasting and execution. Leads all aspects of the sales process, working independently while coordinating closely with marketing, product, alliances, and customer success teams. Demonstrates strong negotiation capabilities, structuring agreements that create mutual value while safeguarding long-term client success. Maintains detailed records of activity, opportunities, conversations, and decisions in CRM systems. Adapts quickly to changing client needs, market shifts, and internal priorities, demonstrating resilience and sound judgment. Drives Efficiency Uses CRM dashboards, reporting tools, and automated workflows to manage pipeline efficiently and prioritize high-impact activities. Organizes deal cycles to streamline communication across internal stakeholders, reducing friction and accelerating time-to-close. Applies structured territory planning, ensuring consistent outreach, prospecting, and market coverage. Refines sales processes by identifying bottlenecks, improving handoffs, and applying lessons learned to future engagements. Communicates clearly and concisely with both technical and non-technical audiences, ensuring alignment throughout the sales lifecycle. Innovative Employs a consultative sales approach to reimagine digital billing and payment experiences for public sector and utility organizations. Brings creative deal strategies, messaging, and value engineering techniques that differentiate InvoiceCloud in competitive environments. Leverages AI-assisted tools for research, proposal development, content creation, and sales analysis to enhance productivity and impact. Shares innovative ideas and market insights that help shape InvoiceCloud's go-to-market strategy and product direction. Identifies emerging trends and technologies that influence customer expectations and industry transformation. Requirements 10+ years of enterprise sales experience, preferably within government or utility sectors Strong understanding of public sector procurement processes, budget cycles, and enterprise sales dynamics Proven success selling SaaS or technology solutions in long-cycle, consultative environments Exceptional communication, presentation, and interpersonal skills with the ability to influence C-level executives Demonstrated ability to build strategic relationships and manage complex stakeholder landscapes Strong business acumen and ability to translate client challenges into actionable solutions Expertise in negotiation, deal structuring, and navigating complex contractual processes Proficiency with CRM systems and Microsoft Office Suite Bachelor's degree in Business, Sales, Marketing, or related field; MBA preferred Travel: Travel to client sites, industry conferences, and regional meetings as required. Benefits We offer a competitive benefits program including: Medical, dental, vision, life & disability insurance 401(k) plan with company match Flexible Time Off (FTO), wellbeing days, paid holidays, and summer Fridays Mental health resources Paid parental leave & Backup Care Tuition reimbursement Employee Resource Groups (ERGs) Base salary is one component of total compensation. Employees may also be eligible for an annual bonus or commission. Some roles may also be eligible for overtime pay. The above represents the expected base compensation range for this job requisition. Ultimately, in determining your pay, we'll consider many factors including, but not limited to, skills, experience, qualifications, geographic location, and other job-related factors. Base Compensation Range$140,000-$150,000 USD InvoiceCloud is an Equal Opportunity Employer. InvoiceCloud 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. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. If you have a disability under the Americans with Disabilities Act or similar law, or you require a religious accommodation, and you wish to discuss potential accommodations related to applying for employment at our company, please contact *********************. Click here to review InvoiceCloud's Job Applicant Privacy Policy. To all recruitment agencies: InvoiceCloud does not accept agency resumes. Please do not forward resumes to our job's alias, employees, or any other organization location. Invoice Cloud is not responsible for any fees related to unsolicited resumes.
    $140k-150k yearly Auto-Apply 1d ago
  • Behavioral Health Care Manager

    Amplifier Health

    Remote job

    The Mission: Powering Proactive, Reimbursable Behavioral Healthcare. Millions of patients with behavioral health needs go undetected and untreated within primary care. While new reimbursement models exist to integrate behavioral health (BHI), the operational burden on clinics to run these programs effectively is immense, leading to clinician burnout and program failure. Amplifier Health solves this. Our AI-native platform automates the patient identification and engagement work, allowing our clinical team to focus 100% on what they do best: providing high-quality, compassionate care. We are seeking experienced and forward-thinking clinicians to join our team and deliver a new, more sustainable model of behavioral healthcare. About the Role: A Clinical Expert, Augmented by AI. This is not a traditional care management role. You will not spend your days chasing charts, making cold calls, or drowning in administrative tasks. As a Behavioral Health Care Manager at Amplifier, you will leverage our powerful platform to manage a panel of patients efficiently and effectively. You will act as a clinical expert, analyzing rich, multi-modal data-including patient assessments, conversational insights, and acoustic patterns-to make informed decisions and guide patient care plans. This role allows you to practice at the top of your license, focusing on clinical judgment and patient support, not paperwork. What You'll Do: Manage a Patient Panel: Oversee the behavioral health journey for a designated group of patients enrolled in our BHI program. Analyze Rich Data: Review comprehensive patient data packages delivered by the Amplifier platform to assess progress, identify risks, and inform care plan adjustments. Develop & Update Care Plans: Use your clinical judgment to create, review, and modify person-centered behavioral health care plans in collaboration with the patient's primary care provider. Ensure Compliance and Quality: Meticulously document all clinical activities to meet the requirements for CPT 99484 reimbursement and maintain the highest standards of care. Collaborate with Clinical Partners: Serve as the key clinical point of contact, providing updates and collaborating with primary care providers to ensure integrated, whole-person care. Provide Patient Support: Engage directly with patients when necessary to provide support, conduct clinical check-ins, and offer guidance as outlined in their care plan. Requirements What You'll Bring (Qualifications): Clinical Licensure: You must hold an active, unrestricted license as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Practical Nurse (LPN), or be a Certified/Registered Medical Assistant (CMA/RMA) with significant behavioral health experience. Clinical Experience: A minimum of 2 years of experience in behavioral health, psychiatric care, case management, or a related field. Tech-Savvy Mindset: You are comfortable and enthusiastic about using new technologies, software platforms, and digital health tools to deliver care. Deep Understanding of BHI: Strong knowledge of Behavioral Health Integration, the Collaborative Care Model (CoCM), and measurement-based care principles. Exceptional Documentation Skills: You have a keen eye for detail and an ability to produce clear, concise, and compliant clinical documentation. Remote Work Ready: You are a self-starter, highly organized, and have a proven ability to work effectively in a fully remote environment. Benefits Why Join Amplifier Health? Practice at the Top of Your License: Focus on what you were trained to do-exercising clinical judgment and supporting patients-while our platform handles the administrative lift. Avoid Burnout: Our model is designed for sustainability. By automating low-value tasks, we empower our clinicians to have a greater impact without being overworked. Shape the Future of Care: Be part of a pioneering team that is defining a new, tech-enabled standard for how behavioral healthcare is delivered in the primary care setting. Work Remotely: Enjoy the flexibility and autonomy of working from anywhere in the U.S. Competitive Compensation & Benefits: We offer a competitive salary, comprehensive benefits package, and opportunities for professional growth. To Apply: If you are a passionate and innovative clinician ready to join a mission-driven company, we want to hear from you. Please send your resume and a brief cover letter outlining your clinical experience and your interest in this unique role to ************************. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis
    $48k-76k yearly est. Auto-Apply 60d+ ago
  • Behavioral Health Care Manager (BHCM) - Remote

    Cerula Care

    Remote job

    Cerula Care is the first digital health company focused on providing integrated behavioral health (BH) services to people living with cancer. More than 22M people living with cancer have behavioral health needs such as anxiety, depression, substance use disorder, and PTSD. We integrate with oncology practices and health systems through the Collaborative Care Model (CoCM) to wrap our members with a behavioral health team, care programming, and outcomes analysis. The Collaborative Care Model is an evidence-based clinical model that has been shown to successfully improve mild to moderate behavioral health needs more effectively than the current standard of care. Our care team enhances the traditional CoCM care team by adding a Health Coach (i.e., a health coach focused on holistic behavioral health), given our strong conviction in the benefit of health coaching and wellness in this population. With the right coaching program customized to our members, we will be able to improve our members' behavioral health above and beyond traditional CoCM models. Why Choose Cerula Care We understand choosing a place to work or consult is a really important decision, and we want you to know that we do not take it lightly on your behalf - we welcome all your questions as you go through the decision process! A few things to know about working at Cerula Care: Our culture is very collaborative, transparent, supportive, and feedback-driven. All of us (yes all of us - including and especially our co-founders) are open to receiving and giving feedback in a helpful way to ensure we each grow and learn every day and importantly are always improving for the sake of our members and each other. We have a big mission to accomplish and we want people who believe in that mission to join us. However, in joining our mission, we are not asking you to give up other parts of your life - we all have our lives outside work, and we absolutely respect each other's needs. Behavioral Health Care Manager role: The BHCM is a core member of Cerula Care's collaborative care team. Cerula Care's team includes a BHCM, a Consultative Psychiatrist, and a Health Coach. The BHCM is critical to collaborating between external specialists (e.g., oncologists) and the internal care team; the role is partly clinical and partly operational. Key Traits: Experienced and passionate about interacting with and helping members with cancer; strong ability to engage members through telehealth Exceptionally organized and able to keep track of all care coordination tasks Highly adaptable, with interest or experience in start-up environment Key Responsibilities: Engage in an initial clinical member biopsychosocial intake including a safety screen and administering BH assessments (PHQ-9, GAD-7, etc.) Engage in follow-up visits and asynchronous interactions, including brief interventions (e.g., behavioral activation, mindfulness, psychoeducation, etc.) Be the key care coordinator and act as a liaison between the referring specialist and the practice, ensuring if there is a member question or administrative question, it is answered or triaged to the appropriate team within Cerula Care Lead the interdisciplinary team meetings on a weekly basis with the Consulting Psychiatrist and Health Coach, ensuring all high-risk members are discussed and all new psychiatric recommendations are documented in the chart Communicate closely on an ongoing basis with the Cerula Care behavioral health care team (Coaches and Psychiatrist) Document member progress in a HIPAA-compliant electronic medical record system and client registry provided by Cerula Care Identify patients who are not improving and may need more intensive mental health care and report any concerns to the medical provider and the Consulting Psychiatrist Facilitate referrals for clinically indicated services outside of Cerula Care under the supervision of the BHCM Lead (e.g., SMI). Educational, Certification, and Experience Requirements: Bachelor's Degree Required in nursing, social work, or other health and human services disciplines from an accredited college or university. Experience as a Certified Case Manager (CCM), Community Health Worker (CHW) or Peer Support Specialist (PSS), or Accredited Case Manager (ACM) preferred Qualified applicants must have at least one year of clinical care management experience, with some part of the experience directly working with people with cancer or advanced illness (e.g., Cancer coaching, Palliative Care, etc.) Time Commitment, Start Date, Compensation: Time commitment: Full-time Start date: We are evaluating candidates on a rolling basis Hourly rate: Discussed during interview
    $48k-76k yearly est. Auto-Apply 6d ago
  • Care Manager II - Adult Health Homes - Livingston, Genesee, Orleans Counties

    Hillside Enterprises 4.1company rating

    Remote job

    The Care Manager II services youth and adults in their community setting with the goal of reducing and preventing emergency room visits, hospitalizations, and decreasing overall Medicaid costs as a lead member of the team responsible for the client. This role utilizes assessments, care planning, linkage to services and community resources, advocacy, and support to coordinate services for adults, youth, and families using person centered and family driven care strategies. This is a Monday-Friday, full-time (40 hours) position with a flexible schedule based on client/staff needs. After an initial training period, this role can be a hybrid mobile/on the road & remote/work from home blend. The area of coverage is Livingston, Genesee, and Orleans counties. Essential Job functions Responsible for, but not limited to comprehensive assessments, outreach and engagement, service and treatment linkage and coordination for assigned youth, adults and families. Partner with referral sources to engage youth, adults and families and build an interdisciplinary care team to support the member in meeting their needs. Facilitate monthly face-to-face visits with adults, youth, family, and their interdisciplinary care team, for assigned caseload. Conduct initial and ongoing assessments to assist with accomplishing member's goals and needs within program requirements. Create, implement, evaluate, and modify, as required and needed, individual service plans to meet assessed client's unique needs as a member of a multi-disciplinary team. Refer members to applicable agency services and community programs, such as outpatient counseling, dental provider, and primary care providers. Support members who transition between systems and services (i.e. hospitalizations, inpatient stays, residential settings, housing needs, etc.). Establish and maintain productive working relationships with community service providers to facilitate referrals and service evaluations. Maintain required contact with members, families, and the interdisciplinary team and facilitate team meetings. Serve as a liaison between the program and other internal and external resources, ensuring information is shared with the Care Team. Maintain and update all necessary records, forms, reports, and summaries in member files according to agency and funders standards. Travel across different counties within respective region to serve members, as required. While this job description covers many aspects of the role, employees may be required to perform other duties as assigned. Education & Experience Bachelor's degrees required. Minimum 2 years of experience working in a human services or related position supporting youth, adults and families required. SPECIAL REQUIREMENTS Unrestricted, valid NYS driver's license for minimum of 1 year with a clean driving record and minimum insurance coverage that meets agency standards. Children's Health Home only : Must receive CANS (Child and Adolescent Needs and Strengths Assessment) certification score of 70 within 3 months of hire and annually thereafter. Knowledge, Skills & Abilities In addition to demonstrating the Hillside Professional Competencies of Communicates Effectively, Personal Excellence, Cultural Competence, Builds and Leverages Relationships, and Optimizes Decision Making, the following occupational competencies must be demonstrated: Demonstrate the highest standards for ethical and professional conduct at all times Knowledge of all federal, state, and local statutes, regulatory agency standards and Hillside policies. Ability to manage multiple tasks and large caseloads simultaneously. Ability to manage scheduling visits with high volume caseload and complete tasks by funder deadlines. Ability to de-escalate and manage crisis situations both in-person and by phone. Physical Demands & Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to work a variable scheduling including evenings and weekends The following daily physical demands are required: Sitting (up to 6 hours) Occasional standing (up to 2 hour) Occasional walking (up to 2.5 hours) Driving (several times a week up to 6 hours) Continuous balancing (up to 8 hours) Occasional balancing, bending, stooping, climbing, kneeling, pushing, pulling, reaching forward or down, reaching overhead, running, and twisting (up to 2.5 hours) Weekly lifting up to 10-15 lbs. on a daily basis Manual dexterity is required, including the frequent ability to grasp in both hands and continuous use of fine manipulation skills in both hands (approximately 1-2.5 hrs.) Occasional exposure to dust, fumes, gases, chemicals, or smoke is apparent Ability to change positions as needed SPECIAL CONSIDERATIONS While Hillside is a restraint free environment, there may be times in a “life or limb” situation, that staff may be required to physically restrain clients weighing between 50 lbs. and 300 lbs. and guide them safely to the floor. In some circumstances, restraints can last up to 15 minutes and may require repetition as necessary. $21.40 Minimum pay rate, $31.00 Maximum pay rate, based on experience.
    $21.4-31 hourly Auto-Apply 11d ago
  • Director of Data Utilization (Hybrid)

    Globe Life Inc. 4.6company rating

    Remote job

    Primary Duties & Responsibilities At Globe Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help Make Tomorrow Better. Role Overview: Could you be our next Director of Data Utilization? Globe Life is looking for a Director of Data Utilization to join the team! In this role, you will be responsible for representing all data related items for Liberty National Division. This role will understand all currently available data and its sources, identify additional data needs, when existing reports/dashboards are not available perform create high value ad hoc reporting and provide Liberty centric insights. In addition, this role will be instrumental in modeling changes to the business model, compensation, incentives, recognition or other business drivers to help determine feasibility and trade-offs prior to working with partners to implement. This person must have a strong understanding of data and analytics, business case modeling, and be able to visualize and present data in easy actionable ways in support of executive decision making. They will work closely with peers and partners to enable internal data initiatives as well as guide partners in the prioritization of Liberty's data needs. They will identify trends, measure performance and KPIs, and suggest optimizations to improve overall efficiency and strategy. Lastly, as part of the technology team, they provide technological support such as technology testing, supporting rollouts, perform tool administration, and other support duties as assigned. This is a hybrid position located in McKinney, Texas (WFH Monday & Friday, In Office Tuesday-Thursday). What You Will Do: * Serve as the primary person for all of Liberty National's data needs and utilization. * Act as the primary liaison to Home Office and the field force on data needs and issues (reporting, dashboards). * Act as the primary liaison for key home office departmental partners in related to Liberty data. * Develop and maintain any source data outside of current systems. * Aggregate data and perform analysis and visualizations in support of executive requests. * Produce reports, dashboards and presentations. * Maintain data quality and integrity. * Work closely with peers and the field to assess and then advocate for additional data needs. * Develop, oversee, and communicate key initiatives to the VP of Sales Operations. * Assist with piloting and rollout of new technologies company-wide. * Utilize AI to achieve goals and gain insights when appropriate. What You Can Bring: * Bachelor's or master's Degree preferred in technology. * 5+ years of insurance industry experience. * Data Analytics and Visualization related courses and certifications. * Understanding of life insurance industry. * Understanding of Liberty's drivers of growth: recruiting, training, and leadership development. * Ability to clearly communicate data into actionable insights. * Strong organizational and communication skills, both verbal and written. * Strong critical thinking and analytical skills. * Ability to work under pressure and on tight deadlines. * Ability to change directions quickly when needed and to think independently. * Proficient in data analytic and visualization tools (strong preference for Tableau). * SQL and other skills needed to aggregate and display data. * Proficient in relational databases, pivot tables, form set ups. * Proficient in Microsoft Office (Powerpoint, Excel, Work, Outlook) and Salesforce. * Capacity to pick data skills up if deficient in any area. Applicable To All Employees of Globe Life Family of Companies: * Reliable and predictable attendance of your assigned shift. * Ability to work designated hours based on the position specifications. How Globe Life Will Support You: Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don't just work, but thrive at Globe Life: * Competitive compensation designed to reflect your expertise and contribution. * Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance. * Robust life insurance benefits and retirement plans, including company-matched 401 (k) and pension plan. * Paid holidays and time off to support a healthy work-life balance. * Parental leave to help our employees welcome their new additions. * Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals. * Company-paid counseling for assistance with mental health, stress management, and work-life balance. * Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career. * Discounted Texas Rangers tickets for a proud visit to Globe Life Field. Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At Globe Life, your voice matters. Location: 7677 Henneman Way, McKinney, Texas
    $101k-122k yearly est. 1d ago
  • Onondaga county Health Homes Care Manager- $10,000 sign- REMOTE

    Glove House Inc. 3.8company rating

    Remote job

    Job DescriptionDescription: $500 Referral Bonus $10,000 sign on bonus with current CHUNNY experience The Care Manager will work closely with the Health Homes Care Management Department, the Department of Health, contracted Care Management Agencies (such as CHHUNY), ancillary providers, youth, and family members to successfully carry out care management tasks that link, advocate, and support the overall health and wellness of youth in our comm unities. The Care Manager is responsible for providing linkage and care management support to the youth and family and will be required to complete multiple assessments as required by CHHUNY and the Department of Health including, but not limited to a Plan of Care, Safety, Crisis, and Emergency Plan, Comprehensive Assessment, CANS-NY Assessment, and facilitation of Interdisciplinary Team Meetings. The Care Manager may be required to evaluate, coordinate, and provide necessary referrals for services and/or treatment as described, complete required assessments, and assist youth and families by helping to articulate goals and providing needed information. This person works closely in partnership with the families, foster families, County workers and other community partners. Primary Job Functions Provide overall support to youth to ensure that they are getting the services need to meet the overall health and wellness goals. Demonstrates understanding of the four dimensions of safety and can identify gaps. Demonstrates and models sensitivity to the cultural background of children, families and co-workers. Assures that job-related activities are in compliance with Glove House policies and procedures, Department of Health, Care Management Agencies, State and Federal regulations, and relevant professional association, ethical standards, accreditation standards, and the law. Perform care management tasks as defined by the Department of Health and contracted Care Management Agencies (i.e. CHHUNY) (may include assessments, goal plans, safety plans, and other assessments). Link, advocate, and support youth and families by identifying current strengths and barriers while providing referrals and other interventions to assist with current needs such as psychosocial supports and linkages with medical, dental, and behavioral health care providers, as well as, educational, employment, transportation community resources. Participate as a team member of Health Homes Department and the Finger Lakes Regional Office, supporting other teams when necessary. Coordinate services with other professionals and paraprofessionals and liaise with outside social service agencies and other organizations, where appropriate. Provide comprehensive, client-centered, trauma-informed, collaborative care planning for the development and management with the youth and parent/guardian to assist in the integration of medical and behavioral health services, and social health services. Build and use effective communications strategies among peers, medical staff, addiction and mental health providers, and other community agencies using electronic assisted devices including Telehealth and other interactive technology. Help improve, measure, monitor, and sustain quality outcomes that focus on clinical indicators/performance measures, patient satisfaction, and plan adherence. Participate in interdisciplinary team meetings and conduct regular face-to-face contact with youth and families. May monitor interns and/or volunteers. Develop and maintain records and program documentation, such as assessments, care plans, visitation plans, progress notes and summaries, according to contract and Glove House standards. Generate and maintain necessary reports and paperwork (i.e., Quality Assurance and program reports). Assures all documentation is completed in a timely fashion (within 48 business hours for contacts) Assures that program staff are up to date with any concerns or needs of your case load. Requirements: Bachelor's degree required, CHUNNY certification preferred Experience Minimum 2+ years' experience working with children and families in residential, group, or counseling child welfare capacity.
    $43k-57k yearly est. 25d ago
  • Care Manager - LP (Rowan County, NC)

    Vaya Health 3.7company rating

    Remote job

    LOCATION: Remote - must live in or near Rowan County, North Carolina. The person in this position is required to maintain residency in North Carolina or within 40 miles of the North Carolina border. This position requires travel. GENERAL STATEMENT OF JOB The Care Manager Licensed Professional (“Care Manager - LP”) is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients (“members”) to ensure that these individuals receive appropriate assessment and services. The Care Manager - LP works with the member and care team to identify and alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services needed by the member across the MH, SU, intellectual/ developmental disability (“I/DD”), traumatic brain injury (“TBI”) physical health, pharmacy, long-term services and supports (“LTSS”) and unmet health-related resource needs networks. Care Manager - LP supports and may provide clinical transition planning assistance to state, and community hospitals and residential facilities and track individuals discharged from facility settings to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization. This is a mobile position with work done in a variety of locations, including members' home communities. The Care Manager - LP also works with other Vaya staff, members, relatives, caregivers/ natural supports, providers, and community stakeholders. The Care Manager - LP also utilizes licensed clinical knowledge and skills to assess needs, inform care planning development, provide clinical consultation, and offer recommendations for appropriate care. As further described below, essential job functions of the Care Manager - LP includes, but may not be limited to: Utilization of and proficiency with Vaya's Care Management software platform/ administrative health record (“AHR”) Outreach and engagement Compliance with HIPAA (Health Insurance Portability and Accountability) requirements, including Authorization for Release of Information (“ROI”) practices Performing Health Risk Assessments (HRA): a comprehensive bio-psycho-social assessment addressing social determinants of health, mental health history and needs, physical health history and needs, activities of daily living, access to resources, and other areas to ensure a whole person approach to care Adherence to Medication List and Continuity of Care processes Participation in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management Transitional Care Management Diversion from institutional placement This position is required to meet NC (North Carolina) Residency requirements as defined by the NC Department of Health and Human Services (“NCDHHS” or “Department”). This position is required to live in or near the counties served to effectively deliver in-person contacts with members and their care teams. ESSENTIAL JOB FUNCTIONS Clinical Assessment, Care Planning, and Interdisciplinary Care Team: Ensures identification, assessment, and appropriate person-centered care planning for members. Links members with appropriate and necessary formal/ informal services and supports across all health domains (i.e., medical, and behavioral health home) Meets with members to conduct the HRA and gather information on their overall health, including behavioral health, developmental, medical, and social needs. Administers the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings based on member's needs. The Care Manager - LP uses these screenings to provide specific education and self-management strategies as well as linkage to appropriate therapeutic supports. The assessment process includes reviewing and transcribing member's current medication and entering information into Vaya's Care Management platform, which triggers the creation of a multisource medication list that is shared back with prescribers to promote integrated care. Supports the care team in development of a person-centered care plan (“Care Plan”) to help define what is important to members for their health and prioritize goals that help them live the life they want in the community of their choice. Ensure the Care Plan includes specific services to address mental health, substance use, medical and social needs as well as personal goals Ensure the Care Plan includes all elements required by NCDHHS Use information collected in the assessment process to learn about member's needs and assist in care planning Ensure members of the care team are involved in the assessment as indicated by the member/LRP and uses clinical skills to evaluate and incorporate other available clinical information into the assessment as necessary Work with members to identify barriers and help resolve dissatisfaction with services or community-based interventions Uses clinical skills and expertise to review clinical assessments conducted by providers to ensure all areas of the member's needs are addressed. Care Manager - LP reviews for clinical accuracy and may provide consultation and technical support to providers as needed based on reviews. Interprets and analyzes clinical assessments to draw clinical conclusions to support care management activities. Engages with provider clinical staff to determine clinical appropriateness and course of action when assessments present a wide array of treatment options and members present with complex needs. Helps members refine and formulate treatment goals, identifying interventions, measurements, and barriers to the goals Ensures that member/legally responsible person (“LRP”) is/are informed of available services, referral processes (e.g., requirements for specific service), etc. Provides information to member/LRP regarding their choice of service providers, ensuring objectivity in the process Works in an integrated care team including, but not limited to, an RN and pharmacist along with the member to address needs and goals in the most effective way ensuring that member/LRP could decide who they want involved Supports and may facilitate care team meetings where member Care Plan is discussed and reviewed Solicits input from the care team and monitor progress Ensures that the assessment, Care Plan, and other relevant information is provided to the care team Reviews assessments conducted by providers and consult with clinical staff as needed to ensure all areas of the member's needs are addressed Provide clinical assessment in situations where the member's lack of clinical home or available network provider creates significant risk to member well-being (e.g., need for time sensitive placement/ discharge from inpatient setting) Updates Care Plans and Care Management assessment at a minimum of annually or when there is a significant life change for the member Supports and assists with education and referral to prevention and population health management programs. Works with the member/LRP and care team to ensure the development of a Care Management Crisis Plan for the member that is tailored to their needs and desires, which is separate and complementary to the behavioral health provider's crisis plan Ensures the crisis plan includes problem definition, physical/cognitive limitations, health risks/concerns, medication alerts, baseline functioning, signs/symptoms of crisis (triggers), de-escalation techniques. Provides crisis intervention, coordination, and care management if needed while with members in the community. Supports Transitional Care Management responsibilities for members transitioning between levels of care Coordinates Diversion efforts for members at risk of requiring care in an institutional setting Consults with care management licensed professionals, care management supervisors, and other colleagues as needed to support effective and appropriate member care. Collaboration, Coordination, Documentation: Utilizes advanced knowledge in their work which requires use of their advanced degree and licensure to be able to participate and initiate independent decisions with matters of significance and drive positive clinical outcomes for Vaya members. Executes independent discretion and engages in business decisions for the Vaya Care Management Department that support initiatives to promote Vaya's integrated, whole-person care model for members. Serves as a collaborative partner in identifying system barriers through work with community stakeholders. Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate. Works in partnership with other Vaya departments to identify and address gaps in services/ access to care within Vaya's catchment. Participates in cross-functional clinical and non-clinical meetings and other projects as needed/ requested to support the department and organization. Participates in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CMs (Care Manager) and receiving support and feedback regarding CM interventions for clients' medical, behavioral health, intellectual /developmental disability, medication, and other needs. Participates in other high risk multidisciplinary complex case staffing as needed to include Vaya CMO/ Deputy CMO, Utilization Management, Provider Network, and Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system. Monitors provision of services to informally measure quality of care delivered by providers and identify potential non-compliance with standards. Ensures the health and safety of members receiving care management, recognize and report critical incidents, and escalate concerns about health and safety to care management leadership as needed. Supports problem-solving and goal-oriented partnership with member/LRP, providers, and other stakeholders. Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues. Supports and assists members/families on services and resources by using educational opportunities to present information. Verifies member's continuing eligibility for Medicaid, and proactively responds to a member's planned movement outside Vaya's catchment area to ensure changes in their Medicaid county of eligibility are addressed prior to any loss of service. Proactively and timely creates and monitors documentation within the AHR to ensure completeness, accuracy and follow through on care management tasks. Maintains electronic AHR compliance and quality according to Vaya policy. Ensures all clinical and non-clinical documentation (e.g. goals, plans, progress notes, etc.) meet all applicable federal, state, and Vaya requirements, including requirements within Vaya's contracts with NCDHHS. Participates in all required Vaya/ Care Management trainings and maintains all required training proficiencies. Participates in Vaya committees, workgroups, and other efforts that require clinical knowledge, as requested, and identified. Other duties as assigned. KNOWLEDGE, SKILLS, & ABILITIES Ability to express ideas clearly/concisely and communicate in a highly effective manner Ability to drive and sit for extended periods of time (including in rural areas) Exceptional interpersonal skills and ability to represent Vaya in a professional manner Ability to initiate and build relationships with people in an open, friendly, and accepting manner Strong attention to detail and superior organizational skills Ability to make prompt independent decisions based upon relevant facts. Well-developed capabilities in problem solving, negotiation, arbitration, and conflict resolution, including a high level of diplomacy and discretion to effectively negotiate and resolve issues with minimal assistance. A result and success-oriented mentality, conveying a sense of urgency and driving issues to closure Comfort with adapting and adjusting to multiple demands, shifting priorities, ambiguity, and rapid change Thorough knowledge of standard office practices, procedures, equipment, and techniques and intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.), and Vaya systems, to include the care management platform, data analysis, and secondary research Must be highly skilled at shifting between macro and micro level planning, maintaining both the big picture, and seeing that the details are covered. Ability to use higher-level clinical training and licensure to perform clinical assessments, drive positive outcomes for members, support care management colleagues, and offer clinical assistance to providers. Highly skilled at performing clinical assessments of members and identifying member needs. Extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) within their scope and have considerable knowledge of the MH/SU/IDD/TBI service array provided through the network of Vaya providers. Experience and knowledge of the NC Medicaid program, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements are preferred. Ability to complete and maintain all trainings and proficiencies required by Vaya, however delivered, including but not limited to the following: BH I/DD Tailored Plan eligibility and services Whole-person health and unmet resource needs (ACEs, trauma-informed care, cultural humility) Community integration (independent living skills; transition and diversion, supportive housing, employment, etc.) Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc.) Health promotion (common physical comorbidities, self-management, use of IT, care planning, ongoing coordination) Other care management skills (transitional care management, motivational interviewing, person-centered needs assessment and care planning, etc.) Serving members with I/DD or TBI (understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.) Serving children (child-and family-centered teams, Understanding the “System of Care” approach) Serving pregnant and postpartum women with SUD or with SUD history Serving members with LTSS needs (Coordinating with supported employment resources Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position. EDUCATION & EXPERIENCE REQUIREMENTS Master's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. For incumbents with a Master's Degree in a Human Services Area besides Nursing, one of the following required years of experience: Serving members with BH conditions: Two (2) years of experience working directly with individuals with BH conditions Serving members with LTSS needs Two (2) years of prior Long-tern Services and Supports and/or Home Community Based Services coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working directly with individuals with BH conditions, an I/DD, or a TBI, described above For incumbents with a Master's Degree in Nursing, four years of full-time accumulated experience in mental health with the population served is required. Experience can be before or after obtaining RN licensure. *Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G .0104 Licensure/Certification Required: Valid licensure required. Acceptable license for incumbents with a Master's Degree in nursing is Registered Nurse (RN). Acceptable licenses for incumbents with a Master's Degree in a field related to health, psychology, sociology, social work, or another relevant human services field include Licensed Clinical Social Worker (LCSW), Licensed Clinical Social Worker Associate (LCSWA), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Clinical Mental Health Counselor Associate (LCMHCA), Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), Licensed Psychological Associate (LPA), Health Services Professional Psychological Associate (HSP-PA), Licensed Clinical Addiction Specialist (LCAS), Licensed Clinical Addiction Specialist Associate (LCASA), Licensed Marriage and Family Therapist (LMFT) or Licensed Marriage Family Therapist Associate (LMFTA). *Due to the multi-disciplinary nature of the LME/MCO business, care managers must operate within their scope of practice, and must engage and leverage other disciplines outside of their own training and credentials. Preferred work experience: Experience working directly with individuals with I/DD or TBI PHYSICAL REQUIREMENTS Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading. Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time. Mental concentration is required in all aspects of work. Ability to drive and sit for extended periods of time (including in rural areas) RESIDENCY REQUIREMENT: The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border. SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation. DEADLINE FOR APPLICATION: Open Until Filled APPLY: Vaya Health accepts online applications in our Career Center, please visit ****************************************** Vaya Health is an equal opportunity employer.
    $39k-49k yearly est. Auto-Apply 22d ago

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