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Equiliem jobs

Vestal NY Can be full time or per diem based on availability

Orange CA The Medical Case Manager (LVN) (Pre-Authorization Nurse Reviewer) will be responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities and ancillary providers. The incumbent will be responsible for prior authorization and referral related processes, including on-line responsibilities and select off-line tasks. The incumbent will utilize CalOptima Health’s medical criteria, policies and procedures to authorize referral requests from medical professionals, clinical facilities and ancillary providers. The incumbent will directly interact with provider callers and serve as a resource for their needs.
 
Position Responsibilities:
85% - Medical Review Support
Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
Reviews requests for medical appropriateness.
Verifies and processes specialty referrals, diagnostic testing, outpatient procedures, home health care services and durable medical equipment and supplies via telephone or fax using established clinical protocols to determine medical necessity.
Screens requests for the Medical Director’s review, gathers pertinent medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director’s decision and documents follow-ups in the utilization management system.
Completes required documentation for data entry into the utilization management system at the time of the telephone call or fax to include any authorization updates.
Reviews International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT-4) and Healthcare Common Procedure Coding System (HCPCS) codes for accuracy and existence of coverage specific to the line of business.
Contacts the health networks and/or CalOptima Health’s Customer Service department regarding health network enrollments.
Identifies and reports any complaints to the immediate supervisor utilizing the call tracking system or verbal communication if the issue is urgent.
Refers cases of possible over/under utilization to the Medical Director for proper reporting.
Meets productivity and quality of work standards on an ongoing basis.
10% - Administrative Support
Assists the manager with identifying areas of staff training needs and maintains current data resources.
5% - Other
Completes other projects and duties as assigned.
 
Possesses the Ability to:
Demonstrate strong problem solving, organizational and time management skills along with the ability to work in a fast-paced environment.
Establish and maintain effective working relationships with CalOptima Health’s leadership and staff.
Communicate clearly and concisely, both orally and in writing.
Utilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment.
 
Experience &amp; Education
High School diploma or equivalent required.
Current, unrestricted Licensed Vocational Nurse (LVN) license to practice in the state of California required.
3 years of nursing experience required, 1 year of which must be as a nurse reviewer.
1 year of utilization management/prior authorization review experience required.
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
 
Preferred Qualifications
Active Certified Case Manager (CCM) certification.
Managed care experience.
 
Knowledge of:
Current CPT-4, ICD-10 and HCPCS codes and continual updates to knowledge base regarding the codes.
Medical terminology.
Medi-Cal and Medicare benefits and regulations.
 
#24-16452

Cincinnati OH 
Job Responsibilities:
-Checks daily assignment.
-Reviews surgical preference lists to clarify surgical routine and update preference lists as needed.
-Utilize resources to obtain needed supplies for the case.
-Checks table(s) for complete readiness for each procedure. Ensures all items needed for the case are present.
-Obtains physician’s special instruments and sutures prior to start of the case.
-Demonstrates knowledge and dexterity in handling of special supplies and equipment and assures its proper functioning.
-Knowledgeable of the specifics of the surgical procedure and able to perform these tasks in an organized and efficient manner.
-Under the surgeon’s supervision, assists with suctioning secretions, holding retractors, assisting with skin closure, cutting sutures and irrigating wounds.
-Circulates for operative procedures under supervision of R.N.
-At the end of procedure assist with site care.
-Cleanses operative site.
-Connects drainage tubes to appropriate devices.

Required Skills &amp; Experience:
-2 years of experience minimum.
-Has contact with physicians, families, and other hospital personnel related to care of assigned patients.
-Sound judgment and knowledge of scientific principles must be used.
-Competency in selected skills is required through hospital provided instruction.
-Frequent exposure to stressful patient situations requires the ability to maintain composure in order to respond swiftly and effectively to patient needs.
-The Surgical Technologists demonstrates the knowledge, abilities, and skills to provide age and culturally specific patient care and education.
-The ST effectively communicates with peers, utilizes appropriate channels of communication and maintains absolute confidentiality.
-The ST maintains competence and demonstrates evidence of continuing professional growth.
-The ST demonstrates the ability to accept and implement change and the ability to work in a culturally diverse setting.
-The ST is responsible for knowledge, use, care, and handling of surgical instruments.
Preferred Skills &amp; Experience:
-N/A
"
Schedule Notes:
Duration: 13 weeks Shift: Wed-Fri 12 hrs 6:15AM-6:45PM; Call every 5th-6th weekend, overnight call the week after weekend call. 1st call approx. one a week or every other week. Required: 2+ years of experience CVOR
Base Rate:
***

#24-16723

Phoenix AZ Summary of Need: Position: Mental Health Professional (MHP)
Coordinates regarding psychosocial treatment issues related to patient care. Presents relevant findings that pertain to mental status and patient risk in an acute environment. Prepares comprehensive bio-psychosocial assessments, mental status exams, treatment plans, and other clinical reports. Provides individual treatment and crisis intervention services. Facilitates therapeutic and psychoeducational group treatment. Conducts short-term, solution-focused therapy with the use of treatment plans, goals, and objectives. Develops treatment plans for patients with serious mental illness and co-occurring disorders. Maintains familiarity with mental health diagnoses that correspond to International Classification of Diseases (ICD) and Diagnostic and Statistical Manual (DSM). Coordinates treatment with office, courts, and community providers for continuity of care.

Experience:
Minimum two years of past work experience in this position.

Education Requirement:
Diploma/transcripts to support graduation with a master's degree behavioral health, social services, or related field.

Additional Requirements:
A current, valid, unrestricted license as a Licensed Clinical Social Worker (LCSW) - OR - Licensed Professional Counselor (LPC) issued by the Arizona State Board of Behavioral Health Examiners.
Current, completed PSV from the Arizona State Board of Behavioral Health Examiners obtained via the following link: https://www.azbbhe.us .

Equiliem Healthcare specializes in staffing clinical, non-clinical, and allied personnel. We excel in all levels, disciplines, and specialties within the healthcare spectrum. Our projects range from short to long term local and travel assignments. Equiliem has been recognized as a certified small business enterprise. In addition, we are proud that we have earned the prestigious Joint Commission accreditation for staffing firms and have been awarded Best in Staffing 4 years running by our employees and client partners.

Benefits offered to our workers include the following:
Medical Insurance
Vision &amp; Dental insurance
Life Insurance
401K
Commuter Benefits
Employee Discounts &amp; Rewards
Payroll Payment Options

#24-11012

Cincinnati OH 

Job Description:
Assists in examination and treatment of patients under direction of physician.
Responsibilities:
Maintains patient flow during clinic hours. Documents review of systems; measures vital signs such as pulse rate*** respirations, blood pressure, weight and height; updates past and current medical, social and family history; reviews medications and updates medication list at each visit. Correctly records patient information in the electronic medical record (EMR). May assist in training of new employees.
Prepares patient charts in EMR for visits by scanning, abstracting, and reviewing to make certain that all diagnostic test results, hospital reports and other medical records necessary to help the physician care for the patient are in the patient's chart. Accesses and navigates websites or calls outside facilities to obtain necessary information. May act as Super User for Electronic Medical Record.
Refills medications and pre-authorizes medications including communicating with the patient, pharmacy, or insurance company as needed to complete the task. Maintains recording of patient samples and other medications and disposes expired medications. Prepares treatment rooms for examination of patients; maintains clean, fully supplied exam rooms. Orders medical supplies as needed. Completes patient assistance paperwork/requests as needed.
Obtains pertinent medical information from patients to facilitate medical decision making per specific office protocol procedures. Returns calls as needed. Responds to MyChart as needed. Works in-baskets, daily work flow logs, and work queues in EMR/Practice Management system. May coordinate/oversee work queues in office. Answers incoming calls, schedules appointments, checks-in and out patients, and completes pre-certifications for prescriptions, procedures, and surgeries as needed.
Operates EKG, cardiac monitors, and other equipment to administer routine diagnostic tests as needed and other clinical duties such as administering vaccinations, phlebotomy and cast removal as assigned.
Maintains safe, secure, and healthy work environment by following and enforcing standards and procedures; complying with legal regulations. Maintains patient confidence and protect operations by keeping patient care information confidential. Understands and adheres to the legal responsibilities and requirements with the medical assistant role. Demonstrates comprehension and support of quality measures and patient experience.

Required Skills &amp; Experience:
-Excellent computer skills (Microsoft Outlook, Excel, EMR and scheduling systems).
-Strong verbal and social skills to facilitate working respectfully with patients, physicians, visitors, co-workers, and drug reps in person or by telephone.
-Ability and willingness to travel to other physician offices as requested or needed.
Preferred Skills &amp; Experience:
-Two (2) to five (5) years of Medical Assistant or other relevant experience.
-Practice in different care settings (eg. Primary care, Speciality, EMT, etc.).
-Complementary clinical skills such as phlebotomy, performing EKGs, stiches removal, splinting, etc.
Schedule Notes:
Flu Shot Required Travel to Anderson, TCH Main Campus, and Mongomery locations required. Must attend orientation at 2100 Sherman Ave, Norwood 45212 Shift Schedule: M-F 7:30-4:30 Required experience: New patients, injections, follow-up testing &amp; post-op for joint replacement patients, rooming patients, clinical intake Preferred: 1+ year experience, Epic experience
Base Rate:
***
#24-17424

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