Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
The Clinical Reviewer will use clinical expertise for the review of medical records against appropriate criteria in conjunction with contract requirements, critical thinking, and decision-making skills to determine medical appropriateness while maintaining production goals and QA standards. Ensures day-to-day processes are conducted in accordance with NCQA, URAC, and other regulatory standards.
Responsibilities:
Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determine if the medical record documentation supports the need for services.
Determines approval or initiates a referral to the physician consultant and processes physician consultant decisions ensuring the reason for the denial is described in sufficient detail in correspondence.
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.
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.
Actively cross-trains to perform the duties of others within the Client network to provide a flexible workforce to meet client/consumer needs.
Requirements:
Active unrestricted license in Virginia: Psychiatric/Mental Health RN, Licensed Clinical Social Worker (LCSW), Licensed Mental Health Professional (LMHP), or Licensed Marriage and Family Therapist (LMFT),
Knowledge of InterQual or ASAM criteria
Knowledge of current NCQA/URAC standards
2+ years of Utilization Review and/or Prior Authorization experience
3+ years of direct experience in a clinical setting or other applicable State Clinical experience.
Experience in Community Mental Health, Crisis Mental Health, Residential Services, or Inpatient Behavioral health/Psychology
Required Skills:
Excellent verbal and written communication skills
Ability to problem solve.
Proficient computer skills, including Microsoft Office.
Ability to provide technical consultation and policy interpretation.
Excellent customer services
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!
Astyra is seeking a Provider Enrollment Agent who will be responsible for supporting provider enrollment/screening into the Virginia Medicaid program. Their primary responsibilities include:
Reviewing and processing Medicaid, provider enrollment applications according to Virginia Medicaid program approved enrollment guidelines, ACA, and other federal requirements and procedures.
Update and maintain accurate provider files which includes documenting information such as license, addresses, billing, and other provider demographic changes to the provider file.
Respond to written correspondence and incoming telephone inquiries received from providers relating to enrollment issues as needed.
Ensure all departmental and Virginia Medicaid program quality and quantity standards are met.
Upholds customer confidence and protects operations by keeping information confidential.
The role will require knowledge of Windows based programs and a familiarity with basic call center and office equipment. Position will allow for cross-training on the clerk and agent positions.
Knowledge and Skill Requirements:
2+ Years’ experience in Call Center/Healthcare environment
Proven customer service experience and professionalism in the workplace
Ability to perform extensive research independently
Ability to follow written policies, procedures, and guidelines, and give feedback to leadership.
Intermediate-level knowledge of operating systems.
Experience with MS Office Suites
Must have good decision making skills
Self-motivated with good time management and organizational skills.
Ability to read and interpret basic to moderately complex documents such as operating and maintenance instructions, procedure manuals, and government/healthcare guidelines.
Excellent written and verbal communication skills
Education:
HS Diploma or GED Required
Competitive benefits such as *Parking covered; Paid time off; Health, vision, and dental insurance options*
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! #AC
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
Business Systems Analyst *This is a remote position
Description:
The Business Systems Analyst will play a pivotal role in the successful implementation and support of the Cityworks AMS platform.
This position involves collaborating with stakeholders to analyze business processes, gather requirements, configure the Cityworks system, provide testing, and ensure it aligns with organizational objectives.
Responsibilities:
Gather and document business requirements for the Cityworks AMS implementation.
Review and provide feedback on system design, data conversion, and integration documents.
Conduct testing for system configurations, data conversions, and integrations.
Develop and deliver training materials and provide support during training sessions.
Maintain and update project documentation, including system design, test cases, and training materials.
Education:
Bachelor’s degree in Information Systems, Business Administration, or a related field.
Skills/Knowledge/Experience:
3+ years of experience in business analysis, system design, or a related role.
Experience with Cityworks AMS or other municipal asset management systems is preferred.
Prior experience working on projects in the water industry or with water utilities is a significant plus.
Familiarity with data conversion and system integration processes.
Experience with GIS systems and spatial data analysis is preferred
Familiarity with software development life cycle (SDLC) methodologies.
Proficiency in system configuration and documentation tools.
Familiarity with data mapping, conversion processes, and integration design
Knowledge of training development and delivery methods specific to municipal software.
Strong analytical skills to assess business needs and system requirements.
Proficiency in documenting meeting minutes, system designs, test cases, and training materials.
Excellent communication and collaboration skills to work with stakeholders and team members.
Experience with testing methodologies and tools for system configuration, data conversion, and integration testing.
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)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
Note: This position requires a licensed Clinician in Washington State (LCSW, LMFT, LMHC, or Psych RN)
Note: This position is remote.
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.
Responsibilities:
Responsible for self-scheduling all Level 2 evaluations.
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! #AC
