Buzzclan Jobs in Usa

Please find below the details:

Job Title: Occupational Therapist

Duration: 8 months Contract

Location: Hemet, CA 92545

Work Setting: Onsite – Sites may vary

Shift / Schedule: Day Shift | 5x8 Hours (Monday to Friday, 8:00 a.m. – 5:00 p.m.)

Student Caseload: Approximately 70–80 students

Student Age Group: K–12

Required Experience:

• Minimum 1 year of experience providing occupational therapy services for children ages 3–22
• Experience working with children with special needs is preferred

Knowledge & Skills:

• Understanding of sensory integration theory and its application in treating autism, PDD, and related regulatory disorders
• Knowledge of developmental and neurodevelopmental foundations related to learning and behavior
• Understanding the difference between educational and medical models in determining appropriate therapy services
• Familiarity with state and federal regulations, guidelines, and timelines

Education & Certifications:

• Bachelor’s degree or higher in Occupational Therapy
• Valid registration with AOTA and/or NBCOT

Please find below the details:

Position: Registered Nurse/RN

Department: BHI - BH Utilization Management

Location: Onsite – Orange, CA 92868

Duration: 6 months (Possibilities of extensions/conversion)

Shift: Day 5x8-Hour (40-hours)

Schedule : Monday to Friday, 7:00 a.m. - 3:30 p.m

Work Arrangement: Full Office

Position Summary:

This role focuses primarily on Utilization Management Services (85%), with additional administrative and project responsibilities. The Medical Case Manager will review medical requests for appropriateness and medical necessity using established clinical protocols while ensuring compliance, accuracy, and timely communication.

Key Responsibilities:

Utilization Management (85%)

• Review requests for medical necessity using established clinical guidelines.
• Screen inpatient and outpatient cases for Medical Director review.
• Gather pertinent medical documentation and communicate determinations.
• Mail rendered decision notifications to providers and members.
• Document all activity in the utilization management system.
• Complete authorization updates and required data entry.
• Review ICD-10, CPT-4, and HCPCS codes for accuracy and coverage.
• Participate in Transition Care Management (TCM) activities.
• Identify and report complaints or utilization concerns.
• Collaborate with internal teams to support departmental goals.

Administrative Support (10%)

• Assist with staff training needs.
• Maintain current data resources.
• Comply with tracking and reporting protocols.

Other Duties (5%)

• Complete additional projects and assignments as needed.

Minimum Qualifications:

• Current unrestricted California license (LCSW, LPCC, LMFT, or RN).
• Minimum 3 years of clinical experience.
• Utilization Management reviewer experience required.
• Equivalent combination of education and experience may be considered.

Preferred Qualifications:

• Managed care experience.
• Behavioral health clinical experience.

Required Skills & Abilities:

• Strong clinical judgment and independent decision-making skills.
• Excellent verbal and written communication skills.
• Ability to work in a fast-paced environment and manage multiple priorities.
• Analytical and problem-solving skills.
• Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint) and relevant systems.
• Ability to build rapport with diverse internal and external stakeholders.

Please find below the details:

Job Title: Speech & Language Pathologist (SLP)

Duration: 3 months Contract

Location: Onsite – Hemet, CA 92545

Shift / Schedule: Day 5x8-Hour (Monday to Friday, 8:00 a.m. – 5:00 p.m.)

Job Responsibilities:

• Assess, diagnose, and treat speech, language, communication, and swallowing disorders in students.
• Develop and implement individualized treatment plans based on student needs.
• Conduct speech and language evaluations and maintain accurate documentation of progress.
• Collaborate with teachers, special education staff, and parents to support student development.
• Participate in IEP meetings and contribute to goal development and progress reporting.
• Provide therapy services in accordance with school district and state guidelines.
• Maintain compliance with all documentation and reporting requirements.

Additional Information:

• Caseload and school site will be determined based on experience and placement after the interview.
• Daily start and end times may vary depending on the assigned location.

Job Title :- Medical Case Manager

BuzzClan is seeking an experienced and detail-oriented Medical Case Manager to support the BHI – BH Utilization Management department for our healthcare partner. This is a full-time, onsite opportunity for a licensed clinical professional with strong utilization management experience.

Position Details

• Department: BHI – BH Utilization Management
• Work Arrangement: Full Office (Onsite)
• Schedule: Monday through Friday, 8:00 a.m. – 5:00 p.m.

Position Summary

The Medical Case Manager is responsible for performing utilization management reviews, ensuring medical necessity determinations align with established clinical guidelines, and supporting care coordination efforts. This position plays a key role in maintaining a mission-driven culture focused on service excellence, accountability, dignity, and high-quality member care.

Duties & Responsibilities

85% – Utilization Management Services

• Participate in a high-performance, member-focused service culture.
• Collaborate with team members to support departmental goals and priorities.
• Review medical service requests using established clinical protocols to determine medical appropriateness and necessity.
• Mail decision notifications to providers and members as required.
• Screen inpatient and outpatient requests for Medical Director review.
• Gather relevant clinical documentation prior to submission.
• Communicate Medical Director determinations and document outcomes in the utilization management system.
• Complete documentation and authorization updates at the time of telephone or fax communication.
• Contact health networks and customer service departments regarding enrollments.
• Identify and report complaints through proper tracking systems or escalate urgent matters.
• Refer potential overutilization or underutilization cases to the Medical Director.
• Perform care coordination activities related to Transition Care Management (TCM).
• Review ICD-10, CPT-4, and HCPCS codes for accuracy and coverage compliance.

10% – Administrative Support

• Assist management in identifying staff training needs.
• Maintain updated departmental data resources.
• Ensure compliance with data tracking and reporting protocols.

5% – Additional Responsibilities

• Complete other duties and special projects as assigned.

Minimum Qualifications

• Current unrestricted California license (LCSW, LPCC, LMFT, or RN).
• Minimum of three (3) years of clinical experience.
• Utilization management reviewer experience required.
• Equivalent combination of education and experience may be considered.

Preferred Qualifications

• Managed care experience.
• Behavioral health clinical experience.

Required Licensure / Certifications

• Active and unrestricted California license (LCSW, LPCC, LMFT, or RN).

Knowledge, Skills & Abilities

• Ability to build strong professional relationships with internal and external stakeholders.
• Strong independent judgment and decision-making skills.
• Clear and concise verbal and written communication skills.
• Flexibility to work evenings or weekends if required.
• Strong analytical, organizational, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Experience leading or collaborating across multidisciplinary teams.
• Proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and utilization management systems.

Physical Requirements

• Ability to read information from computer screens and printed materials.
• Clear verbal communication and hearing ability.
• Manual dexterity for typing and documentation.
• Ability to sit for extended periods.
• Ability to lift 10–25 pounds when necessary.

Work Environment

Office or Remote Site

• Indoor, sedentary work environment.
• Moderate noise levels.
• Schedule variability and potential travel.
• No harmful environmental conditions.

Clinical Setting (PACE)

• Indoor clinical environment serving frail and elderly populations.
• Potential exposure to hazardous conditions.
• Moderate to loud noise levels.

Community Setting

• Indoor work with occasional outdoor responsibilities.
• Exposure to varied temperatures.
• Moderate to loud noise levels.
• Travel as required.