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885522: NP / PA / Independent Reviewer UAS Contractors (New York State)
Med-Scribe, Inc. is a healthcare staffing service recruiting top-notch employees all throughout New York State for over 30 years! We are partnered with a large multi-national company dedicated to strengthening communities and improving the lives of those they serve by facilitating connections to government health and human services.
We are in search of experienced clinicians to join a UAS Home Care Project. In this role, you will be responsible for independent review and evaluation of completed UAS reassessments for appropriateness of long-term care services for consumers, in accordance with Medicare and Medicaid guidelines.
These are contractor positions ? which allow for flexibility in scheduling, at your own pace training, and pay at $100/hr.
In this role, you will be scheduled for in person appointments with members of the long term care population, who are applying for Managed Long Term Care services (MLTC). Your clients will have already completed a UAS evaluation with a Registered Nurse, and your role will be to determine whether MLTC and home care services are adequate for the patient?s care, or if they should instead be admitted to a supportive facility. Each appointment will last approximately 1.5 hours ? 30 minutes of preparation time, 30 minutes meeting with the member, and 30 minutes completing and submitting your determination. Additional compensation is offered for longer appointments.
Schedules are arranged according to your availability; however hours are not guaranteed. You must be willing to work at least 9 hours weekly, within operation hours which run Monday ? Friday 8AM ? 7PM, and Saturday between 10AM-6PM. Candidates who are unable to work during these operation hours, or who cannot commit to 9 hours weekly will not be considered.
Expect to travel! Appointments will be scheduled anywhere within the county or counties of your choice, based on your availability. Candidates covering multiple counties will receive more hours. Please note, you must choose one full county to be considered!
Current openings include:
- Albany County
- Schenectady County
Minimum Qualifications:
- NYS Certified Nurse Practitioner License plus 3600 hours of experience OR
- NYS Certified Physician Assistant License
- An active NYS Medicaid number
- 2 years of prior experience within home care, geriatrics, or community health populations
- Willing to travel for in person appointments, with reliable transportation
Contractors will be compensated for each completed assessment, and will receive partial compensation for interrupted assessments.
These roles are 1099 contractor positions, and do not include benefits.
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To be considered, please visit our website at and reference job number 885522.
Med-Scribe is an equal opportunity employer. In accordance with anti-discrimination law, it is the purpose of this policy to effectuate these principles and mandates. Med-Scribe prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Med-Scribe conforms to the spirit as well as to the letter of all applicable laws and regulations.
#ESJ123
Job Type: Contract
Pay: $100.00 per hour
People with a criminal record are encouraged to apply
Application Question(s):
- Do you currently have an active NYS Medicaid Provider Number?
Experience:
- geriatric, community health, or home care: 1 year (Required)
License/Certification:
- NYS Nurse Practitioner or Physician Assistance License (Required)
Work Location: Hybrid remote in Albany, NY 12202
The challenges of affordable healthcare continue to create new opportunities.
Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs.
These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Supervises the assessment of all acute and sub-acute inpatient care for appropriateness of setting and services, according to pre-established criteria and guidelines and ensure a 95% compliance or greater.
Supervises the assessment and coordination of the members physical, psychosocial and discharge planning needs through communication with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners.
Assures appropriate staffing to support departmental/agency services.
Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education.
Correctly interprets and applies all Human Resources policies and procedures relative to discipline, recruitment and selection, performance appraisals, salary reviews and staffing.
Bachelor's Degree in Nursing.
Minimum one to three years previous management experience preferred.
Previous managed care experience in the areas of utilization management and/or case management required.
Working knowledge of Windows, Word, Excel.
Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Care Management Supervisor of Quality Review & Staff Education is responsible for quality assurance, accuracy, and overall integrity of the care management records completed by Care Management staff. This role is to ensure compliance with NYS DOH and CMS regulations through development of auditing tools and data validation. This Supervisor will analyze collected audit data, identify trends for staff re-training, and implement corrective action plans in collaboration with Clinical Management and Staff Education. They will oversee and conduct orientation, training, and education to all members of the Care Management team. Provides support to Director and Managers of Coordinated Care to ensure that all reporting requirements are prepared, submitted, and maintained in a professional and well-coordinated manner.
- Baccalaureate Nursing Degree from an NLN-Accredited School of Nursing
- Experience and knowledge of Managed Care: A minimum of two years nursing experience in Community Health or related field and/or minimum of two years of progressive job-related experience, including care management and coordination, education and supervision
- Demonstrates strong critical-thinking, problem-solving skills, and knowledge of Medicare and Medicaid
- Effective communication skills both written and oral
- Possesses strong critical thinking skills and knowledge of Medicare and Medicaid regulations
- Excellent analytical skills, interpretation of data
- Ability to set priorities and to handle multiple assignments
- Working knowledge of audit techniques and methodologies
- Secures relevant information to identify potential problems and makes recommendations for appropriate solutions
- Work effectively within interdisciplinary team environment
- Computer literate, Windows, Excel, Word, Visio and data base programs required. PowerPoint preferred
- Working knowledge of State and Federal regulations
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity.
Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making.
Provides support for claim appeals in relation to medical necessity.
Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards.
Facilitates member second level appeal process.
Graduate from an accredited school of professional nursing is required.
BSN preferred.
Minimum 2 years acute care experience or managed care experience is required.
Basic knowledge of Medicaid, Medicare preferred.
Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required.
Active Certification in Case Management (CCM) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity.
Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making.
Provides support for claim appeals in relation to medical necessity.
Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards.
Facilitates member second level appeal process.
Graduate from an accredited school of professional nursing is required.
BSN preferred.
Minimum 2 years acute care experience or managed care experience is required.
Basic knowledge of Medicaid, Medicare preferred.
Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required.
Active Certification in Case Management (CCM) is preferred.
$26.61 - $39.92 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Quality Review Sterile Processing Tech ? Sterile Processing -Mid shift
Position Highlights:
- Position: Quality Review Sterile Processing Tech
- Location: Elmhurst, IL
- Full Time/Part Time: Full time
- Hours: Monday-Friday, 12:00noon-8:30pm, must be flexible to travel to other Endeavor Health locations.
What you will do:
- Ensures daily operational compliance with the standards governing sterile processing activities from such agencies as The Joint Commission, OSHA, AORN, AAMI; as well as state and local ordinances
- Assists in coordination, facilitation and monitoring of new and existing sterile processing staff education, training and orientation via one-on-ones, huddles, staff meetings, in-services and formal orientation in collaboration with department leadership
- Assists with the maintenance, inventory, and implementation of newly acquired and existing instrument trays/sets, instruments, and supplies
- Collaboratively works with the appropriate staff to maintain accurate instrument count sheets and make revisions as necessary
- Provides analysis of reported data and recommendations for improvement
- Assists with identification of staff educational needs and development of programs
What you will need:
- Education: Highschool or GED required, Bachelors Degree Preferred
- Certification: Certified Sterile Processing and Distribution Technician (CSPDT) - Certification Board for Sterile Processing and Distribution (CBSPD) or Certified Registered Central Service Technician (CRCST) ? Healthcare Sterile Processing Association (HSPA), formerly IAHSCMM)
- Experience: 2 years? experience in health care sterile processing (or procedural area) and environment AND experience in project management and staff education
Benefits (For full time or part time positions):
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, Pet and Vision options
- Tuition Reimbursement
- Free Parking
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off and Holiday Pay
- Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to ?help everyone in our communities be their best?.
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack University Medical Center.
These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities below.
Education, Knowledge, Skills and Abilities Required: 1.
