We are actively seeking a dedicated Intensive Care Manager with an active RN or LCSW license to join our expanding team on a full-time basis. In this role, you will play a crucial part in our mission to provide exceptional care to our clients. As a key member, you will assume a pivotal role in supporting the Provider Community and working with at-risk youth to prevent residential placement. If you are passionate about ensuring quality healthcare outcomes and skilled at working with at risk people we encourage you to apply for this opportunity!
Accountabilities
Conducting initial and concurrent reviews for individuals at risk of residential placement, ensuring alignment with their needs and expertise.
Overseeing mental health and substance abuse treatment services, verifying their medical necessity and effectiveness.
Participating in interdisciplinary team meetings to develop customized care plans and discharge strategies for each youth’s therapeutic journey.
Providing educational support and implementing interventions to enhance member care throughout the treatment process.
Collaborating with diverse stakeholders, including local departments of Social Services, Community Services Boards, schools, and service providers to ensure comprehensive support.
Actively engaging in quality improvement initiatives, including data collection, monitoring, and analysis, to enhance service delivery.
Contributing to network growth by identifying and recruiting high-quality providers as necessary.
Fulfilling other duties as assigned to support the overall objectives of the organization.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Knowledge, Skills, Abilities
Proficiency in InterQual or ASAM guidelines, ensuring adherence to industry standards.
Ability to effectively prioritize tasks, assign responsibilities, and meet required deadlines.
Strong problem-solving skills, capable of addressing complex issue and finding viable solutions.
Aptitude for providing technical consultation and interpreting policies accurately.
Exceptional customer service skills, committed to delivering high-quality support and assistance,
Excellent written and verbal communication abilities, facilitating clear and effective communication with stakeholders.
Basic proficiency in Microsoft Office applications to support administrative tasks and documentation needs.
Required Qualifications
Active unrestricted Licensed Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) in the State of Virginia.
Proficient clinical assessment and critical thinking skills.
A minimum of 2 years of hands-on experience in Intensive Care Management and post-degree in healthcare; behavioral health, psychiatric, and/or substance abuse healthcare settings.
Attention Applicants: Please be advised that proper email communication will only be sent from email addresses ending in @astyra.com. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. It is important to communicate within our guidelines and proper channels to expedite possible interview considerations.
Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
Troubleshoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
Has current knowledge or research availability of community resources and services and links members to appropriate services.
May assist in transitions in care for hospitalized patients and make appropriate placements, if needed.
Assumes responsibility for self-development and career progression.
Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role.
Assists in the mentoring and training of new Care Workers.
Remains responsible for updating self on ever-changing information to ensure accuracy when dealing with members and providers.
Coordinates and manages the distribution of correspondence and materials to enrollees and providers. Participates in operational activities, including data collection, tracking, and analysis.
Make outbound calls to various providers in California, coordinate with members, and provide scheduling assistance.
RESPONSIBILITIES:
Experience in a managed care environment, integrated medical and behavioral health care, and/or training in chronic pain management.
Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.
For roles supporting the Chronic Pain Management SBU, an understanding of Chronic Pain Management guidelines and workflows is also required.
Top 3 Must-Haves (Hard Skills):
Proficient in Microsoft (Word, Excel, Outlook, Excel)
Public Outreach experience
WORK EXPERIENCE:
Managed Care
EDUCATION:
Associates (Preferred)
High school diploma or GED required
6-month contract position
100% remote but MUST reside in California
Monday – Friday 8:30 AM – 5 PM
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
Work as part of a team to conduct on-site quality reviews for providers and municipalities serving infants and toddlers with disabilities as part of the Early Intervention Program
Conduct on-site environmental and record reviews
Identify gaps in compliance to regulations and assist in development of Corrective Action Plans
Provide Training and Technical Assistance as needed
Accurately assess compliance for Evaluations and Eligibility Determinations
Document all activities including use of standardized tools
Conduct interviews with parents, staff and related personnel as part of a compliance review
Manage of caseload of providers that are currently addressing required Corrective Action Plans as needed
Complete reviews, documentation and manage caseload in a timely manner as assigned with support from management
Required Certifications
You must hold one of the following NY state licenses:
Licensed Psychoanalyst
Licensed Creative Arts (art therapist)
Licensed Behavior Analyst
Certified Behavior Analyst Assistant
Students With Disabilities (Birth-Grade 2) Professional Certificate
Occupational Therapy Assistant
Physical Therapist Assistant
Requirements
Associate’s degree or higher required
At least one-year experience in the administration and/or fiscal management of organizations providing health and human services, preferably to young children with developmental delays and their families
At least one year of experience in the area of quality improvement (e.g., utilization review, performance-based monitoring, technical assistance)
Recognized as qualified personnel by the Early Intervention Program, as defined in Public Health Law, Section 2541, preferably with experience in the provision of developmental services/therapies to children ages birth to five years and their families strongly preferred
Valid driver’s license or ability to reach assigned locations via public transportation (ex. In New York City)
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
As an independent contractor, you will be responsible for conducting face-to-face SIS assessments of individuals with intellectual and developmental disabilities ages 14 and above. Although assessments are conducted at a variety of sites, there is no office you report to, affording you the opportunity to schedule, finalize and submit assessments from your home. Schedules are flexible and can, in most instances, be tailored to meet your availability.
We are seeking candidates available to travel throughout the Northeast Allegheny/ Westmoreland area.
Accountabilities
Conducts assessments on individuals with IDD as assigned.
Ensures scheduling, administration and submission processes are conducted within identified performance standards, demonstrating fidelity to the assessment tool.
Uses independent judgment, clinical knowledge/competence, communication skills, problem-solving and conflict resolution to ensure optimal interviews for the individual, family and respondent teams.
Manages schedule and availability calendar, and ensures assessments are scheduled and completed in accordance with contract guidelines.
Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the completion and review of assessments.
Participates in regular quality calls, attends training and scheduled meetings and ensures maintenance and use of current/updated information as provided.
Maintains confidentiality of all scheduling and assessment materials at all times through proper use of computer passwords, maintenance of secured files and adherence to HIPAA polices.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that contract needs may dictate.
Qualifications
Bachelor’s Degree in Human Service Field
Minimum two years of direct experience working with adults with IDD required.
Basic computer/technology skills and MS Office proficiency required.
Knowledge, Skills, Abilities
Must have strong organizational skills and be able to meet required deadlines
Knowledge of medical terminology, behavioral supports and PA ODP waiver programs strongly desired.
Strong clinical/social assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to use independent judgment and discretion to address, resolve and process problems impeding assessment process/completion.
Proactively identify and resolves delays and obstacles.
Access to necessary technology – laptop (Processor: Intel Core i5 or newer; Operating System: Microsoft Windows 8 or newer; Memory: 4 GB RAM minimum, 6GB recommended; Internal Drive Storage: 250 GB minimum, 500 GB recommended; Free Hard Disk Space: 32 GB or greater), printer and scanner.
Must have broadband internet connection at home (no dial-up).
Must be willing to travel and have active, unrestricted license, reliable transportation and active auto insurance.
Must have dedicated home workspace committed to confidentiality of PHI.
As an independent contractor, you will be responsible for conducting face-to-face SIS assessments of individuals with intellectual and developmental disabilities ages 14 and above. Although assessments are conducted at a variety of sites, there is no office you report to, affording you the opportunity to schedule, finalize and submit assessments from your home. Schedules are flexible and can, in most instances, be tailored to meet your availability.
We are seeking candidates available to travel throughout the Lackawanna/Luzerene area.
Accountabilities
Conducts assessments on individuals with IDD as assigned.
Ensures scheduling, administration and submission processes are conducted within identified performance standards, demonstrating fidelity to the assessment tool.
Uses independent judgment, clinical knowledge/competence, communication skills, problem-solving and conflict resolution to ensure optimal interviews for the individual, family and respondent teams.
Manages schedule and availability calendar, and ensures assessments are scheduled and completed in accordance with contract guidelines.
Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the completion and review of assessments.
Participates in regular quality calls, attends training and scheduled meetings and ensures maintenance and use of current/updated information as provided.
Maintains confidentiality of all scheduling and assessment materials at all times through proper use of computer passwords, maintenance of secured files and adherence to HIPAA polices.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that contract needs may dictate.
Qualifications
Bachelor’s Degree in Human Service Field
Minimum two years of direct experience working with adults with IDD required.
Basic computer/technology skills and MS Office proficiency required.
Knowledge, Skills, Abilities
Must have strong organizational skills and be able to meet required deadlines
Knowledge of medical terminology, behavioral supports and PA ODP waiver programs strongly desired.
Strong clinical/social assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to use independent judgment and discretion to address, resolve and process problems impeding assessment process/completion.
Proactively identify and resolves delays and obstacles.
Access to necessary technology – laptop (Processor: Intel Core i5 or newer; Operating System: Microsoft Windows 8 or newer; Memory: 4 GB RAM minimum, 6GB recommended; Internal Drive Storage: 250 GB minimum, 500 GB recommended; Free Hard Disk Space: 32 GB or greater), printer and scanner.
Must have broadband internet connection at home (no dial-up).
Must be willing to travel and have active, unrestricted license, reliable transportation and active auto insurance.
Must have dedicated home workspace committed to confidentiality of PHI.
Work as part of a team to conduct on-site quality reviews for providers and municipalities serving infants and toddlers with disabilities as part of the Early Intervention Program
Conduct on-site environmental and record reviews
Identify gaps in compliance to regulations and assist in development of Corrective Action Plans
Provide Training and Technical Assistance as needed
Accurately assess compliance for Evaluations and Eligibility Determinations
Document all activities including use of standardized tools
Conduct interviews with parents, staff and related personnel as part of a compliance review
Manage of caseload of providers that are currently addressing required Corrective Action Plans as needed
Complete reviews, documentation and manage caseload in a timely manner as assigned with support from management
Required Certifications
You must hold one of the following NY state licenses:
Licensed Psychoanalyst
Licensed Creative Arts (art therapist)
Licensed Behavior Analyst
Certified Behavior Analyst Assistant
Students With Disabilities (Birth-Grade 2) Professional Certificate
Occupational Therapy Assistant
Physical Therapist Assistant
Requirements
Associate’s degree or higher required
At least one-year experience in the administration and/or fiscal management of organizations providing health and human services, preferably to young children with developmental delays and their families
At least one year of experience in the area of quality improvement (e.g., utilization review, performance-based monitoring, technical assistance)
Recognized as qualified personnel by the Early Intervention Program, as defined in Public Health Law, Section 2541, preferably with experience in the provision of developmental services/therapies to children ages birth to five years and their families strongly preferred
Valid driver’s license or ability to reach assigned locations via public transportation (ex. In New York City)
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
As an independent contractor, you will be responsible for conducting face-to-face SIS assessments of individuals with intellectual and developmental disabilities and/or Autism ages 14 and above. Although assessments are conducted at a variety of sites, there is no office you report to, affording you the opportunity to schedule, finalize and submit assessments from your home. Schedules are flexible and can, in most instances, be tailored to meet your availability.
We are seeking candidates available to travel throughout the Indiana/Clarion area.
Accountabilities
Conducts assessments on individuals with IDD and/or Autism as assigned.
Ensures scheduling, administration and submission processes are conducted within identified performance standards, demonstrating fidelity to the assessment tool.
Uses independent judgment, clinical knowledge/competence, communication skills, problem-solving and conflict resolution to ensure optimal interviews for the individual, family and respondent teams.
Manages schedule and availability calendar, and ensures assessments are scheduled and completed in accordance with contract guidelines.
Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the completion and review of assessments.
Participates in regular quality calls, attends training and scheduled meetings and ensures maintenance and use of current/updated information as provided.
Maintains confidentiality of all scheduling and assessment materials at all times through proper use of computer passwords, maintenance of secured files and adherence to HIPAA polices.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that contract needs may dictate.
Qualifications
Bachelor’s Degree in Human Service Field
Minimum two years of direct experience working with individuals with IDD/Autism required.
Basic computer/technology skills and MS Office proficiency required.
Knowledge, Skills, Abilities
Must have strong organizational skills and be able to meet required deadlines
Knowledge of medical terminology, behavioral supports and PA ODP waiver programs strongly desired.
Strong clinical/social assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to use independent judgment and discretion to address, resolve and process problems impeding assessment process/completion.
Proactively identify and resolves delays and obstacles.
Access to necessary technology – laptop (Processor: Intel Core i5 or newer; Operating System: Microsoft Windows 8 or newer; Memory: 4 GB RAM minimum, 6GB recommended; Internal Drive Storage: 250 GB minimum, 500 GB recommended; Free Hard Disk Space: 32 GB or greater), printer and scanner.
Must have broadband internet connection at home (no dial-up).
Must be willing to travel and have active, unrestricted license, reliable transportation and active auto insurance.
Must have dedicated home workspace committed to confidentiality of PHI.
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
As an independent contractor, you will be responsible for conducting face-to-face SIS assessments of individuals with intellectual and developmental disabilities ages 14 and above. Although assessments are conducted at a variety of sites, there is no office you report to, affording you the opportunity to schedule, finalize and submit assessments from your home. Schedules are flexible and can, in most instances, be tailored to meet your availability.
We are seeking candidates available to travel throughout the Cumberland County area.
Accountabilities
Conducts assessments on individuals with IDD and/or Autism as assigned.
Ensures scheduling, administration and submission processes are conducted within identified performance standards, demonstrating fidelity to the assessment tool.
Uses independent judgment, clinical knowledge/competence, communication skills, problem-solving and conflict resolution to ensure optimal interviews for the individual, family and respondent teams.
Manages schedule and availability calendar, and ensures assessments are scheduled and completed in accordance with contract guidelines.
Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the completion and review of assessments.
Participates in regular quality calls, attends training and scheduled meetings and ensures maintenance and use of current/updated information as provided.
Maintains confidentiality of all scheduling and assessment materials at all times through proper use of computer passwords, maintenance of secured files and adherence to HIPAA polices.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that contract needs may dictate.
Qualifications
Bachelor’s Degree in Human Service Field
Minimum two years of direct experience working with adults with IDD required.
Basic computer/technology skills and MS Office proficiency required.
Knowledge, Skills, Abilities
Must have strong organizational skills and be able to meet required deadlines
Knowledge of medical terminology, behavioral supports and PA ODP waiver programs strongly desired.
Strong clinical/social assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to use independent judgment and discretion to address, resolve and process problems impeding assessment process/completion.
Proactively identify and resolves delays and obstacles.
Access to necessary technology – laptop (Processor: Intel Core i5 or newer; Operating System: Microsoft Windows 8 or newer; Memory: 4 GB RAM minimum, 6GB recommended; Internal Drive Storage: 250 GB minimum, 500 GB recommended; Free Hard Disk Space: 32 GB or greater), printer and scanner.
Must have broadband internet connection at home (no dial-up).
Must be willing to travel and have active, unrestricted license, reliable transportation and active auto insurance.
Must have dedicated home workspace committed to confidentiality of PHI.
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Who we need:
Join our team as a (PASRR) Preadmission Screening and Resident Review Clinical Evaluator and be an instrumental force in reshaping healthcare and enriching the lives of patients in our communities.
In this role, you will lead the charge by performing comprehensive, clinical assessments on individuals dealing with mental illness and intellectual disabilities. As a trusted expert, you will have the autonomy to evaluate their care needs and provide invaluable determinations and recommendations for their ongoing level of care, helping to improve patient’s well-being and enhance their quality of life.
**We are seeking candidates available to travel throughout the Clallam County area**
Responsibilities:
Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the medical record documentation supports the need for services.
Abstracts review related data/information accurately and timely on appropriate review tools by the appropriate means. Accurate and timely submission of all administrative and review-related documents to appropriate parties.
Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.
Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
Maintains medical records confidentiality at all times through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Client policies, procedures, and guidelines.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Qualifications
Active license in good standing in the Washington State (LCSW, LMFT, LMHC, RN)
Graduation from an accredited College with a relevant Degree Program.
At least three (3) years of mental health experience within the past five (5) years involving direct patient care presenting a mental health diagnosis is required.
Knowledge, Skills, Abilities
Medical record abstracting skills are required.
Knowledge of the organization of medical records, medical terminology, and disease processes is required.
Strong clinical assessment and critical thinking skills are required.
Excellent verbal and written communication skills are required.
Ability to work in a team environment.
Flexibility and strong organizational skills are needed.
Must be proficient in Microsoft Office and Internet/web navigation
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Who we need:
Join our team as a (PASRR) Preadmission Screening and Resident Review Clinical Evaluator and be an instrumental force in reshaping healthcare and enriching the lives of patients in our communities.
In this role, you will lead the charge by performing comprehensive, clinical assessments on individuals dealing with mental illness and intellectual disabilities. As a trusted expert, you will have the autonomy to evaluate their care needs and provide invaluable determinations and recommendations for their ongoing level of care, helping to improve patient’s well-being and enhance their quality of life.
**We are seeking candidates available to travel throughout the Yakima County area**
Responsibilities:
Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the medical record documentation supports the need for services.
Abstracts review related data/information accurately and timely on appropriate review tools by the appropriate means. Accurate and timely submission of all administrative and review-related documents to appropriate parties.
Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.
Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
Maintains medical records confidentiality at all times through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Client policies, procedures, and guidelines.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Qualifications
Active license in good standing in the Washington State (LCSW, LMFT, LMHC, RN)
Graduation from an accredited College with a relevant Degree Program.
At least three (3) years of mental health experience within the past five (5) years involving direct patient care presenting a mental health diagnosis is required.
Knowledge, Skills, Abilities
Medical record abstracting skills are required.
Knowledge of the organization of medical records, medical terminology, and disease processes is required.
Strong clinical assessment and critical thinking skills are required.
Excellent verbal and written communication skills are required.
Ability to work in a team environment.
Flexibility and strong organizational skills are needed.
Must be proficient in Microsoft Office and Internet/web navigation
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
Are you an RN ready to make a difference in the lives of North Carolinians?Astyra is looking for passionate Home Health Registered Nurses to join our team statewide! Keep reading to see if this is the right fit for you:
Why us? This opportunity is a chance to change your career and own your schedule. There is an added opportunity for growth within an innovative, person-centric healthcare organization.
We have engaged with Acentra Health Formerly Kepro to support NorthCarolina Medicaid Linking individuals & Families for Long Term Services and Supports (NC LIFTSS) project. NC LIFTSS was created to streamline access to LTSS programs. It covers a variety of services:
Process referrals and perform option counseling
Conduct assessments and quality assurance reviews
Provide service plan management and customer service
Conduct provider training for the following LTSS programs: State Plan Personal Care Services (PCS), Community Alternatives Program for Children (CAP/C) and Community Alternatives Program for Disabled Adults (CAP/DA).
This exciting role requires you to travel within your region to conduct assessments, as well as, work out of your home office when needed. This offers flexibility in your weekly schedule. As part of the Personal Care Services (PCS) program, you’ll provide vital services to NC Medicaid Beneficiaries with medical conditions, cognitive impairments, or disabilities, ensuring they receive the hands-on assistance they need for daily living activities (ADLs). As a PCS Home Health Registered Nurse, you’ll play a crucial role in determining needs-based eligibility for Medicaid-funded personal care services, whether in-home, adult care, or supervised living homes. This role is documentation-intensive to meet the needs of beneficiaries. Join us in this rewarding opportunity to help our community thrive and make a significant impact on the lives of those in need. What you’ll need:
Registered Nurse, licensed by the state of North Carolina
Minimum of two years’ experience in home care setting is required.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work is required
Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
Experience with OASIS tool (or similar) highly preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual highly desired
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT highly desired
What you’ll do:
Conducts assessment to determine whether the beneficiary meets eligibility, using state-approved standardized assessment tool(s).
Ensures that PCS are provided on a “needs basis” in quantities appropriate to the Beneficiary’s unmet need for services based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
Ensures that the privacy and dignity of individuals receiving assessment for PCS is maintained at the highest standards.
Ensures that new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments are conducted within established timeframes.
Include an interview with family members and informal caregivers who are present at the time of the assessment.
Provide the Beneficiary with guidance and assistance, as necessary, to select PCS providers.
Conduct service plan reviews as needed.
Submit the completed assessments using state-approved interface
Participate in the Beneficiary’s mediation and appeal processes.
Respond to state inquiries regarding assessments conducted.
Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
Develops level of care recommendations based upon clinical evaluations.
Participates in training of PCS stakeholders as needed.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work.
Skills & Abilities:
Insightful Understanding of public sector services and supports.
Interactand Collaborate with various office staff as needed to support necessary workflows, as well as healthcare professionals, patients, their families and other supports.
Effective Communication to individuals and groups through spoken, written and electronic media.
Attention to Detail and Highly Organized in documentation to effectively prioritize and execute tasks in a timely manner.
Person-Centered thinking, planning, and competency in awareness of the needs of persons with disabilities.
If this opportunity sounds like a bullseyes, apply today!
Mileage reimbursement at the ready for all travel.
Note: This is position requires licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Who we need:
Join our team as a (PASRR) Preadmission Screening and Resident Review Clinical Evaluator and be an instrumental force in reshaping healthcare and enriching the lives of patients in our communities.
In this role, you will lead the charge by performing comprehensive, clinical assessments on individuals dealing with mental illness and intellectual disabilities. As a trusted expert, you will have the autonomy to evaluate their care needs and provide invaluable determinations and recommendations for their ongoing level of care, helping to improve patient’s well-being and enhance their quality of life.
**We are seeking candidates available to travel throughout Kitsap County area**
Responsibilities:
Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the medical record documentation supports the need for services.
Abstracts review related data/information accurately and timely on appropriate review tool by the appropriate means. Accurate and timely submission of all administrative and review-related documents to appropriate parties.
Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.
Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
Maintains medical records confidentiality at all times through proper use of computer passwords, maintenance of secured files, adherence to HIPAA policies.
Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Client policies, procedures, and guidelines.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Qualifications
Active license in good standing in the Washington State (LCSW, LMFT, LMHC, RN)
Graduation from an accredited College with a relevant Degree Program.
At least three (3) years of mental health experience within the past five (5) years involving direct patient care presenting a mental health diagnosis is required.
Knowledge, Skills, Abilities
Medical record abstracting skills required.
Knowledge of the organization of medical records, medical terminology, and disease process required.
Strong clinical assessment and critical thinking skills are required.
Excellent verbal and written communication skills are required.
Ability to work in a team environment.
Flexibility and strong organizational skills are needed.
Must be proficient in Microsoft Office and internet/web navigation
Are you an RN ready to make a difference in the lives of North Carolinians? Astyra is looking for passionate Home Health Registered Nurses to join our team statewide! Keep reading to see if this is the right fit for you:
Why us? This opportunity is a chance to change your career and own your schedule. There is an added opportunity for growth within an innovative, person-centric healthcare organization.
This position supports the NorthCarolina Medicaid Linking individuals & Families for Long Term Services and Supports (NC LIFTSS) project. NC LIFTSS was created to streamline access to LTSS programs. It covers a variety of services:
Process referrals and perform option counseling
Conduct assessments and quality assurance reviews
Provide service plan management and customer service
Conduct provider training for the following LTSS programs: State Plan Personal Care Services (PCS), Community Alternatives Program for Children (CAP/C) and Community Alternatives Program for Disabled Adults (CAP/DA).
This exciting role requires you to travel within your region to conduct assessments, as well as, work out of your home office when needed. This offers flexibility in your weekly schedule. As part of the Personal Care Services (PCS) program, you’ll provide vital services to NC Medicaid Beneficiaries with medical conditions, cognitive impairments, or disabilities, ensuring they receive the hands-on assistance they need for daily living activities (ADLs). As a PCS Home Health Registered Nurse, you’ll play a crucial role in determining needs-based eligibility for Medicaid-funded personal care services, whether in-home, adult care, or supervised living homes. This role is documentation-intensive to meet the needs of beneficiaries. Join us in this rewarding opportunity to help our community thrive and make a significant impact on the lives of those in need. What you’ll need:
Registered Nurse, licensed by the state of North Carolina
Minimum of two years’ experience in home care setting is required.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work is required
Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
Experience with OASIS tool (or similar) highly preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual highly desired
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT highly desired
What you’ll do:
Conducts assessment to determine whether the beneficiary meets eligibility, using state-approved standardized assessment tool(s).
Ensures that PCS are provided on a “needs basis” in quantities appropriate to the Beneficiary’s unmet need for services based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
Ensures that the privacy and dignity of individuals receiving assessment for PCS is maintained at the highest standards.
Ensures that new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments are conducted within established timeframes.
Include an interview with family members and informal caregivers who are present at the time of the assessment.
Provide the Beneficiary with guidance and assistance, as necessary, to select PCS providers.
Conduct service plan reviews as needed.
Submit the completed assessments using state-approved interface
Participate in the Beneficiary’s mediation and appeal processes.
Respond to state inquiries regarding assessments conducted.
Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
Develops level of care recommendations based upon clinical evaluations.
Participates in training of PCS stakeholders as needed.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work.
Skills & Abilities:
Insightful Understanding of public sector services and supports.
Interactand Collaborate with various office staff as needed to support necessary workflows, as well as healthcare professionals, patients, their families and other supports.
Effective Communication to individuals and groups through spoken, written and electronic media.
Attention to Detail and Highly Organized in documentation to effectively prioritize and execute tasks in a timely manner.
Person-Centered thinking, planning, and competency in awareness of the needs of persons with disabilities.
If this opportunity sounds like a bullseyes, apply today!
Mileage reimbursement at the ready for all travel.
Are you an RN ready to make a difference in the lives of North Carolinians?Astyra is looking for passionate Home Health Registered Nurses to join our team statewide! Keep reading to see if this is the right fit for you:
Why us? This opportunity is a chance to change your career and own your schedule. There is an added opportunity for growth within an innovative, person-centric healthcare organization.
This position supports the NorthCarolina Medicaid Linking individuals & Families for Long Term Services and Supports (NC LIFTSS) project. NC LIFTSS was created to streamline access to LTSS programs. It covers a variety of services:
Process referrals and perform option counseling
Conduct assessments and quality assurance reviews
Provide service plan management and customer service
Conduct provider training for the following LTSS programs: State Plan Personal Care Services (PCS), Community Alternatives Program for Children (CAP/C) and Community Alternatives Program for Disabled Adults (CAP/DA).
This exciting role requires you to travel within your region to conduct assessments, as well as, work out of your home office when needed. This offers flexibility in your weekly schedule. As part of the Personal Care Services (PCS) program, you’ll provide vital services to NC Medicaid Beneficiaries with medical conditions, cognitive impairments, or disabilities, ensuring they receive the hands-on assistance they need for daily living activities (ADLs). As a PCS Home Health Registered Nurse, you’ll play a crucial role in determining needs-based eligibility for Medicaid-funded personal care services, whether in-home, adult care, or supervised living homes. This role is documentation-intensive to meet the needs of beneficiaries. Join us in this rewarding opportunity to help our community thrive and make a significant impact on the lives of those in need. What you’ll need:
Registered Nurse, licensed by the state of North Carolina
Minimum of two years’ experience in home care setting is required.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work is required
Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
Experience with OASIS tool (or similar) highly preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual highly desired
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT highly desired
What you’ll do:
Conducts assessment to determine whether the beneficiary meets eligibility, using state-approved standardized assessment tool(s).
Ensures that PCS are provided on a “needs basis” in quantities appropriate to the Beneficiary’s unmet need for services based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
Ensures that the privacy and dignity of individuals receiving assessment for PCS is maintained at the highest standards.
Ensures that new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments are conducted within established timeframes.
Include an interview with family members and informal caregivers who are present at the time of the assessment.
Provide the Beneficiary with guidance and assistance, as necessary, to select PCS providers.
Conduct service plan reviews as needed.
Submit the completed assessments using state-approved interface
Participate in the Beneficiary’s mediation and appeal processes.
Respond to state inquiries regarding assessments conducted.
Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
Develops level of care recommendations based upon clinical evaluations.
Participates in training of PCS stakeholders as needed.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work.
Skills & Abilities:
Insightful Understanding of public sector services and supports.
Interactand Collaborate with various office staff as needed to support necessary workflows, as well as healthcare professionals, patients, their families and other supports.
Effective Communication to individuals and groups through spoken, written and electronic media.
Attention to Detail and Highly Organized in documentation to effectively prioritize and execute tasks in a timely manner.
Person-Centered thinking, planning, and competency in awareness of the needs of persons with disabilities.
If this opportunity sounds like a bullseyes, apply today!
Mileage reimbursement at the ready for all travel.
Are you an RN ready to make a difference in the lives of North Carolinians?Astyra is looking for passionate Home Health Registered Nurses to join our team statewide! Keep reading to see if this is the right fit for you:
Why us? This opportunity is a chance to change your career and own your schedule. There is an added opportunity for growth within an innovative, person-centric healthcare organization.
This position supports the NorthCarolina Medicaid Linking individuals & Families for Long Term Services and Supports (NC LIFTSS) project. NC LIFTSS was created to streamline access to LTSS programs. It covers a variety of services:
Process referrals and perform option counseling
Conduct assessments and quality assurance reviews
Provide service plan management and customer service
Conduct provider training for the following LTSS programs: State Plan Personal Care Services (PCS), Community Alternatives Program for Children (CAP/C) and Community Alternatives Program for Disabled Adults (CAP/DA).
This exciting role requires you to travel within your region to conduct assessments, as well as, work out of your home office when needed. This offers flexibility in your weekly schedule. As part of the Personal Care Services (PCS) program, you’ll provide vital services to NC Medicaid Beneficiaries with medical conditions, cognitive impairments, or disabilities, ensuring they receive the hands-on assistance they need for daily living activities (ADLs). As a PCS Home Health Registered Nurse, you’ll play a crucial role in determining needs-based eligibility for Medicaid-funded personal care services, whether in-home, adult care, or supervised living homes. This role is documentation-intensive to meet the needs of beneficiaries. Join us in this rewarding opportunity to help our community thrive and make a significant impact on the lives of those in need. What you’ll need:
Registered Nurse, licensed by the state of North Carolina
Minimum of two years’ experience in home care setting is required.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work is required
Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
Experience with OASIS tool (or similar) highly preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual highly desired
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT highly desired
What you’ll do:
Conducts assessment to determine whether the beneficiary meets eligibility, using state-approved standardized assessment tool(s).
Ensures that PCS are provided on a “needs basis” in quantities appropriate to the Beneficiary’s unmet need for services based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
Ensures that the privacy and dignity of individuals receiving assessment for PCS is maintained at the highest standards.
Ensures that new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments are conducted within established timeframes.
Include an interview with family members and informal caregivers who are present at the time of the assessment.
Provide the Beneficiary with guidance and assistance, as necessary, to select PCS providers.
Conduct service plan reviews as needed.
Submit the completed assessments using state-approved interface
Participate in the Beneficiary’s mediation and appeal processes.
Respond to state inquiries regarding assessments conducted.
Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
Develops level of care recommendations based upon clinical evaluations.
Participates in training of PCS stakeholders as needed.
Computer proficiency in Microsoft Excel, Word and Outlook and the ability to utilize computer equipment and web-based software to conduct work.
Skills & Abilities:
Insightful Understanding of public sector services and supports.
Interactand Collaborate with various office staff as needed to support necessary workflows, as well as healthcare professionals, patients, their families and other supports.
Effective Communication to individuals and groups through spoken, written and electronic media.
Attention to Detail and Highly Organized in documentation to effectively prioritize and execute tasks in a timely manner.
Person-Centered thinking, planning, and competency in awareness of the needs of persons with disabilities.
If this opportunity sounds like a bullseyes, apply today!
Mileage reimbursement at the ready for all travel.
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Who we need:
Join our team as a (PASRR) Preadmission Screening and Resident Review Clinical Evaluator and be an instrumental force in reshaping healthcare and enriching the lives of patients in our communities.
In this role, you will lead the charge by performing comprehensive, clinical assessments on individuals dealing with mental illness and intellectual disabilities. As a trusted expert, you will have the autonomy to evaluate their care needs and provide invaluable determinations and recommendations for their ongoing level of care, helping to improve patient’s well-being and enhance their quality of life.
**We are seeking candidates available to travel throughout the King County area**
Responsibilities:
Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the medical record documentation supports the need for services.
Abstracts review related data/information accurately and timely on appropriate review tools by the appropriate means. Accurate and timely submission of all administrative and review-related documents to appropriate parties.
Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.
Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
Maintains medical records confidentiality at all times through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Client policies, procedures, and guidelines.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Qualifications
Active license in good standing in the Washington State (LCSW, LMFT, LMHC, RN)
Graduation from an accredited College with a relevant Degree Program.
At least three (3) years of mental health experience within the past five (5) years involving direct patient care presenting a mental health diagnosis is required.
Knowledge, Skills, Abilities
Medical record abstracting skills are required.
Knowledge of the organization of medical records, medical terminology, and disease processes is required.
Strong clinical assessment and critical thinking skills are required.
Excellent verbal and written communication skills are required.
Ability to work in a team environment.
Flexibility and strong organizational skills are needed.
Must be proficient in Microsoft Office and Internet/web navigation
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
As an independent contractor, you will be responsible for conducting face-to-face SIS assessments of individuals with intellectual and developmental disabilities ages 14 and above. Although assessments are conducted at a variety of sites, there is no office you report to, affording you the opportunity to schedule, finalize and submit assessments from your home. Schedules are flexible and can, in most instances, be tailored to meet your availability.
We are seeking candidates available to travel throughout the Montgomery/ Northeast Philly area.
Accountabilities
Conducts assessments on individuals with IDD and/or Autism as assigned.
Ensures scheduling, administration and submission processes are conducted within identified performance standards, demonstrating fidelity to the assessment tool.
Uses independent judgment, clinical knowledge/competence, communication skills, problem-solving and conflict resolution to ensure optimal interviews for the individual, family and respondent teams.
Manages schedule and availability calendar, and ensures assessments are scheduled and completed in accordance with contract guidelines.
Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the completion and review of assessments.
Participates in regular quality calls, attends training and scheduled meetings and ensures maintenance and use of current/updated information as provided.
Maintains confidentiality of all scheduling and assessment materials at all times through proper use of computer passwords, maintenance of secured files and adherence to HIPAA polices.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that contract needs may dictate.
Qualifications
Bachelor’s Degree in Human Service Field
Minimum two years of direct experience working with adults with IDD required.
Basic computer/technology skills and MS Office proficiency required.
Knowledge, Skills, Abilities
Must have strong organizational skills and be able to meet required deadlines
Knowledge of medical terminology, behavioral supports and PA ODP waiver programs strongly desired.
Strong clinical/social assessment and critical thinking skills required.
Excellent verbal and written communication skills required.
Ability to use independent judgment and discretion to address, resolve and process problems impeding assessment process/completion.
Proactively identify and resolves delays and obstacles.
Access to necessary technology – laptop (Processor: Intel Core i5 or newer; Operating System: Microsoft Windows 8 or newer; Memory: 4 GB RAM minimum, 6GB recommended; Internal Drive Storage: 250 GB minimum, 500 GB recommended; Free Hard Disk Space: 32 GB or greater), printer and scanner.
Must have broadband internet connection at home (no dial-up).
Must be willing to travel and have active, unrestricted license, reliable transportation and active auto insurance.
Must have dedicated home workspace committed to confidentiality of PHI.
