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Utilization Manager

New Directions Behavioral Health Birmingham AL, 35202

ESSENTIAL FUNCTIONS: * Provides utilization review activities for all levels of behavioral health care, including inpatient, resi...

Posted 4 days ago

ESSENTIAL FUNCTIONS: * Provides utilization review activities for all levels of behavioral health care, including inpatient, residential, partial hospitalization intensive outpatient and outpatient authorization requests with contacts to facilities and providers as needed to accomplish this task * Promotes and provides quality service delivery and effective discharge planning for optimal member health outcomes * Coordinates peer review with NDBH Physician consultants on clinical cases that are not meeting the medical necessity criteria * Demonstrates clinical expertise in response to a variety of circumstances ranging from crisis intervention to routine business matters * Coordinates treatment planning creation of crisis prevention plans with treatment team as needed as part of the utilization review process * Coordinates discharge planning, including ensuring follow up appointments for member's post discharge from inpatient care within 7 days * Participates in clinical staffing and other meetings and trainings upon management request * Presents clinical cases to staff and consulting providers upon request of supervisor and as required by policies, and procedures * Utilizes appropriate and standardized tools including but not limited to NDBH approved precertification, concurrent and discharge review forms, physician review tools, authorization screen, and other application and tools * Completes appropriate documentation in clinical systems in compliance with regulatory and accreditation standards * Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and New Directions services, policies and procedures and criteria * Coordinates consultations with member's provider, family and NDBH Physician consultants on clinical cases when necessary and appropriate to facilitate care and progress * Stays current with New Directions' technology, member Behavioral Health benefits, and non-health community resources * Provides follow-up and support calls to members and providers as needed and as assigned by Manager/Supervisor * Makes recommendations of programs and/or systems that create improved outcomes and timeliness of the utilization management department * Contributes to site specific audits/surveys/research projects that are relevant to care management process, policies, and procedures * Participates in on-going continuing education as required by professional licensure, certification, or as requested by New Directions and maintains clinical licensure and certifications * Participates in special committees or projects for program development as assigned by Manager/Supervisor EDUCATION & EXPERIENCE REQUIRED * Has a current, unrestricted license issued by a state or territory of the United States to practice independently as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or Registered Nurse in the state in which the business operation is located and/or other states as required by law, regulation or contract * Minimum of 3-5 years of direct clinical care experience with patients in facility-based and/or outpatient psychiatric or chemical dependency treatment; Preferred minimum of five (5) years post-licensure experience in direct clinical care with patients in facility-based and/or outpatient psychiatric or chemical dependence treatment * Strong clinical skills; Preferred previous experience in Utilization Review * Excellent verbal and written communication and interpersonal skills * Strong computer and keyboarding skills (Microsoft Outlook and Word), including the ability to document while simultaneously while taking information over the phone * Ability to comprehend medical policy and criteria to clearly articulate health information * Valid driver's license and proof of insurance mandatory for positions which require driving * Preferred experience as a Registered Nurse, a Bachelor's Degree in Nursing * Preferred experience and training in Motivational Interviewing

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Prevailing Wage/Payroll Accountant

Brasfield & Gorrie, LLC Birmingham AL, 35202

Responsibilities Brasfield & Gorrie, a recognized leader in the construction industry, has an exciting opportunity available fo...

Posted 3 days ago

Responsibilities Brasfield & Gorrie, a recognized leader in the construction industry, has an exciting opportunity available for a Payroll Accountant in Birmingham, Alabama. The Prevailing Wage/Payroll Accountant is responsible for processing weekly payroll with a primary focus on prevailing wage. This individual must demonstrate strong attention to detail and must be able to work individually and/or with a team. Responsibilities and Essential Duties include the following (other duties may be assigned): * Process payroll and corrections using JD Edwards Oracle Enterprise One * Set up prevailing wage jobs with the wage determination and federal sick pay requirements in JD Edwards and EMARS * Compare and validate timecards against daily reports (Brasfield & Gorrie and Subcontractors) * Answer inquiries, research and resolve payroll issues and discrepancies * Ensure that employee's timecards are properly approved * Report certified payroll * Support, coordinate, and provide reports and any other requested information for internal or external audits * Setup, identify, and correct federal, multi-state and local tax discrepancies * Assist with payroll tax preparation and filing * Set up and respond to wage attachments such as child support and garnishments * Serve as the point of contact for labor and burden questions * Correct labor and burden in job cost * Train project teams on prevailing wage and certified payroll requirements/processes Education - Skills - Knowledge - Qualifications & Experience * Bachelor's degree required * Three or more years of payroll or related experience required * Two years of prevailing wage payroll experience required * Must possess a thorough knowledge of federal and state prevailing wage laws * Knowledge of Oracle JD Edwards Enterprise One preferred but not required * Knowledge of EMARS preferred but not required * Strong customer service and interpersonal skills * Knowledge of payroll principles, practices, regulations and procedures * Excellent communication, analytical, mathematical and organizational skills * Intermediate Microsoft Excel required * Ability to learn new computer software * Ability to develop and build reports when needed The above description covers the principal duties and responsibilities of the job. The description shall not, however, be construed as a complete listing of all miscellaneous, incidental, or similar duties which may be required from day-to-day. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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Infant Teacher

Bright Horizons Altadena Ridge Estates AL, 35243

Experience the milestone moments As an infant teacher, you get to witness some of the most special achievements and milesto...

Posted 1 week ago

Job Description Experience the milestone moments As an infant teacher, you get to witness some of the most special achievements and milestones that occur in a child's first year of life. Being a part of this treasured and magical stage is a reward unto its own. As you experience their first steps, new discoveries and giggles of pure joy, your patience and enthusiasm will give them the confidence to discover a brave, new world. And, you'll share these moments with parents – showing them that your devotion and passion is helping to guide and shape their children, as they begin their journey to who they will become. At Bright Horizons, you'll also find opportunities to experience personal and professional breakthroughs of your own. As a company with a learning culture, you will discover your full potential through state-of-the-art online training, leadership development and tuition reimbursement, including the opportunity to earn your ECE college degree for FREE! Additionally, our company culture invites you to bring your whole self to work, because it is our unique attributes, perspectives and backgrounds that make us a stronger team. How will you nurture the growth of our future generation? What you will do as an Infant Teacher * Build a warm and stimulating environment that is filled with inviting sights, sounds, textures, and sensations to stimulate their mental and social growth * Ensure that fundamental care needs are met while engaging in one-on-one moments, play and communication * Collaborate with and be supported by a talented team of early childhood professionals * Be an ally and partner for parents, supporting, guiding and sharing in their child's growth and development * Nurture your own career aspirations and personal growth through unlimited opportunities * Be a positive role model for children each and every day * Live our HEART principles of Honesty, Excellence, Accountability, Respect, and Teamwork Click Here to View the Rewards and Realities of Being a Teacher at Bright Horizons Job Requirements Who we are looking for * Hold a High School Diploma/GED * Meet state educational licensing and additional center/school requirements * A passion for child care and making a difference in the lives of young children We do give preference to child care teachers with the following: * Related college-level or CDA course work * A CDA or working towards an Associate's or Bachelor's degree * 12 months of professional teaching experience Bright Horizons – A fresh perspective on learning In addition to being the leading provider of high quality child care and early education, Bright Horizons is the only child care company repeatedly named by FORTUNE as one of the "100 Best Companies to Work For". We are passionate about building an organization where you can make an impact on future generations. It begins with the educators that we hire, and by helping you grow with us. We support a well-rounded, individualized curriculum that is fully engaging and tailored to each child's developmental needs. This visionary approach helps craft enriching experiences, and empowers children to be confident and successful lifelong learners. Benefits we offerCompetitive salariesCareer path opportunitiesExtensive health benefitsComprehensive tuition reimbursement and the opportunity to earn your college degree for FREE through our Early Education Degree Achievement Plan401(k)Volunteer opportunities through the Bright Horizons Foundation for ChildrenCommuter benefitsHealth club discountsCell phone discounts and much more Additional Information Bright Horizons is dedicated to creating a workforce that promotes and supports diversity and inclusion. We provide equal employment opportunities to all individuals without discrimination. Bright Horizons complies with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW. Applicants requiring reasonable accommodation for any part of the application and hiring process should contact the recruitment helpdesk at 855-877-6866 or bhrecruit@brighthorizons.com. Determinations on requests for reasonable accommodation will be made on a case-by-case basis. Having technical issues with your online application? Contact us at bhrecruit@brighthorizons.com or 855-877-6866.

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RN

Davita Birmingham AL, 35202

In Center- RN DaVita is seeking a Registered Nurse who is looking to give life in an outpatient dialysis center. You can make a...

Posted 4 days ago

In Center- RN DaVita is seeking a Registered Nurse who is looking to give life in an outpatient dialysis center. You can make an exceptional difference in the lives of our patients and their families dealing with end-stage renal failure or chronic kidney disease. If you haven't considered Nephrology before, read on as we think that you should. Dialysis Experience is NOT required. What you can expect: * Long term patient relationships. Build meaningful relationship with patients and their family in an intimate outpatient setting. * A team that feels and functions like a family. Staff RNs are a central part of a small interdisciplinary team of clinicians. Work alongside technicians, nurses, dietitians, social workers, physicians and the center manager. * Fun is one of our core values. Happier nurses = healthier patients. * Specialized, complex care. RNs deliver care to patients who are often dealing with multiple co-morbidities which require unique treatment plans and the ability to leverage a broad range of nursing skills and knowledge. * Fast paced. Our RNs oversee up to 12 patients at a given time, and up to 3 Patient Care Technicians who assist with patient observations, measuring stats and machine set-up. You will work hard with your head, heart and hands each day. * Schedule. Shifts are typically 12 hours, 3 days/week, Mon-Sat (closed Sundays). Schedule times will vary by location but most of our RNs work early morning or day shifts between 4am-10pm. Some holidays required. * Clinical leader: DaVita has the highest percentage of facilities meeting or exceeding CMS's standards in the government's two key performance programs. We expect our nurses to commit to improving patient health through clinical goal setting and quality improvement initiatives. What we'll provide: * In-classroom and hands on training: if you are new to dialysis, we'll provide a 9-12 week paid training and the support to guide you through to becoming a nephrology nurse. * Opportunity for a nursing career for a lifetime. DaVita is committed to providing robust development and experience for nurses. Whether you chose to remain in a patient facing/caregiving role or grow (leadership operations, corporate functions, integrated care, clinical research), we can guide you on that journey. * Education assistance and license reimbursement: annual $3,000 tuition reimbursement and potential $25,000 scholarship opportunity. CNN and CDN certification reimbursement. * 3000+ locations across the U.S. for wherever life may take you. * Comprehensive benefits package: including medical, dental, vision, 401k plan, $2,500 cash gift for new parents, back-up child and elder care and so much more Some details about this position: * Your 9-10 weeks of training will include a combination of classroom and hands-on learning, through DaVita's award-winning training programs * Training may take place in a facility or a training clinic with a class of new teammates other than your assigned home clinic * Hours of work may vary during the training period; however, you will typically be working between 32-40 hours per week during training * You must be flexible on the final home clinic placement it may be in a different location; there is also the potential to float to various clinics during and after your training * You must have a flexible schedule and be able to work mornings, evenings, weekends, and holiday * Current Registered Nurse (RN) license in the state of practice; Graduate Nurse pre-licensure available in some locations * A desire to deliver care in an empathetic, compassionate way. You know, the way you'd want your own care to be * Experience assessing, trouble shooting and making sound recommendations in stressful situations * Excellent communication skills to listen and communicate with patients and teammates * Associates Degree in Nursing (A.D.N) from accredited school of nursing required; Bachelor of Science in Nursing (B.S.N); three-year diploma from accredited diploma program may be substituted for nursing degree * Basic computer skills and proficiency in MS Word and Outlook You might also have (a.k.a. nice-to-haves): * Intensive Care Unit (ICU), Critical Care Unit (CCU), Emergency Room (ER), or Medical Surgical (Med Surg) experience * Certified Nephrology Nurse (CNN) or Certified Dialysis Nurse (CDN) Ready to make a difference in the lives of patients? Take the first step at https://careers.davita.com

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Driver

Learning Care Group Birmingham AL, 35202

Our school is seeking warm, fun and friendly staff to join our awesome team! La Petite Academy of Birmingham, AL is HIRING! ...

Posted 1 week ago

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Services Specialist 9/10/P11 Gogebic County (Case Manager/ Investigator)

State Of Michigan Bessemer AL, 35021

This is an immediate vacancy and all qualified Applicants are encouraged to apply Michigan Families need your help...... ...

Posted 2 weeks ago

Job Description This is an immediate vacancy and all qualified Applicants are encouraged to apply Michigan Families need your help...... JOB SUMMARY: The Services Specialist will utilize child welfare practice skills to ensure children are protected from abuse and neglect. When child abuse or neglect is indicated, specialists work closely with families and the legal system toward a goal of reunification, independent living, or other permanent living situation. ESSENTIAL DUTIES/RESPONSIBILITIES MAY INCLUDE: * Assessing allegations of child abuse or neglect and taking necessary steps to protect children. This could mean removing a child from a family. * Developing working relationships with people who strongly dislike DHHS because of their personal history or the reputation of child protective agencies in general. * Learning about cultures, traditions, and lifestyles different from your own and developing cultural competencies to understand how to determine child safety and well-being within that context. Comprehending the impact of historical trauma, and observing protocols of differing cultures. * Maintaining objectivity and empathy for families living in stressful situations. * Preparing comprehensive and accurate court documents. Testifying in court, including defending your actions which will be questioned by defense attorneys and other parties to the case. * Working under deadlines that require prioritizing efforts with constant pressure created by the nature and volume of the cases, documentation and working flexible hours. * This position may be required to work evenings, weekends, and other non-standard work hours as needed and could be placed on a rotating on-call roster. See complete position description here: Position Description View the Job Specification View the 13 minute video "Is This Job For Me?" at https://www.youtube.com/watch?v=8gtBuckURPk&feature=youtu.be prior to applying for this position. Required Education and Experience Education Possession of a bachelor's or master's degree with a major in one of the following human services areas: social work, sociology, psychology, family ecology, community services, family studies, family and/or child development, guidance/school counseling, counseling psychology, criminal justice or human services. Experience Services Specialist 9 No specific type or amount is required. Services Specialist 10 One year of professional experience providing casework services to socially and economically disadvantaged individuals equivalent to a Services Specialist 9. Services Specialist P11 Two years of professional experience providing casework services to socially and economically disadvantaged individuals equivalent to a Services Specialist, including one year equivalent to a Services Specialist 10. Additional Requirements and Information When you apply, your application is valid for 6 months. After 6 months, you MUST reapply for continued consideration.

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Entry Level Medicare Sales Representative – Nationwide Openings Available

Humana Inc. Birmingham AL, 35202

Description The MarketPoint Sales Representative sells individual health plan products and services in a field setting. The Mar...

Posted 2 weeks ago

Description The MarketPoint Sales Representative sells individual health plan products and services in a field setting. The MarketPoint Sales Representative work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Responsibilities Role: Medicare Sales Representative – Entry Level Assignment: MarketPoint (Medicare Sales Organization) Location: Nationwide opportunities available (Relocation Assistance Available) This position is entry-level targeting fall 2018 or spring 2019 college graduates Assignment Capsule Humana is seeking a motivated, self -starting individual to sell the Humana Medicare Advantage Plans as well as other insurance lines to include life, annuity, indemnity, dental, vision and more. Cultivate and maintain relationships with Humana's customers, external business partners and within the community. * Meet with eligible participants with the goal of enrollment and presenting product information for Medicare Advantage product portfolio * Market and promote products to the Medicare population. * Conduct individual and group presentations to promote brand awareness. * Self-generate sales leads from various community engagement initiatives within defined territory. Humana Perks: Full time associates enjoy competitive pay and a comprehensive benefits package that includes * Medical, Dental, Vision and a variety of supplemental insurances * Paid time off & Paid Holidays * 401(k) retirement savings plan * Well-being programs where you can earn additional money, gift cards, or prizes for healthy behavior and wellness activities. * Basic Life Insurance * Volunteer Day Off * Education reimbursement and/or scholarships for qualifying dependent children * Parental leave include maternity, paternity and child adoption leave * Caregiver leave Reporting Relationship * You will report to a Market Manager Role Essentials * This position is for entry-level college recruitment and we are seeking upcoming graduates planning to graduate in fall 2018 or spring 2019. * Valid driver's license * Excellent written and verbal communication skills * Relationship building skills * This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. * Ability to obtain Health & Life insurance licenses – Humana will guide students through this process * AHIP certification (or the ability to pass prior to hire date – Humana will guide students through this process) Role Desirables * Previous experience with health and life insurance, long-term care and/or annuity products * Current active Health and Life Insurance licenses * Bilingual * Ability to relocate to high demand markets * Previous internship and/or work experience a plus * Overall GPA of 3.0 or higher * Be actively involved on-campus and/or in the community with verifiable extracurricular activities and/or clubs * Strong interest in the Healthcare industry with a passion for helping others Scheduled Weekly Hours 40

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Payroll Specialist

Books-A-Million, Inc. Birmingham AL, 35202

They Payroll Specialist plays a key role in the Payroll Department. Reporting to the Payroll Manager, this role is responsible...

Posted 2 weeks ago

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Entry Level Medicare Sales Representative – Nationwide Openings Available

Humana Inc. Homewood AL, 35209

Description The MarketPoint Sales Representative sells individual health plan products and services in a field setting. The Mar...

Posted 2 weeks ago

Description The MarketPoint Sales Representative sells individual health plan products and services in a field setting. The MarketPoint Sales Representative work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Responsibilities Role: Medicare Sales Representative – Entry Level Assignment: MarketPoint (Medicare Sales Organization) Location: Nationwide opportunities available (Relocation Assistance Available) This position is entry-level targeting fall 2018 or spring 2019 college graduates Assignment Capsule Humana is seeking a motivated, self -starting individual to sell the Humana Medicare Advantage Plans as well as other insurance lines to include life, annuity, indemnity, dental, vision and more. Cultivate and maintain relationships with Humana's customers, external business partners and within the community. * Meet with eligible participants with the goal of enrollment and presenting product information for Medicare Advantage product portfolio * Market and promote products to the Medicare population. * Conduct individual and group presentations to promote brand awareness. * Self-generate sales leads from various community engagement initiatives within defined territory. Humana Perks: Full time associates enjoy competitive pay and a comprehensive benefits package that includes * Medical, Dental, Vision and a variety of supplemental insurances * Paid time off & Paid Holidays * 401(k) retirement savings plan * Well-being programs where you can earn additional money, gift cards, or prizes for healthy behavior and wellness activities. * Basic Life Insurance * Volunteer Day Off * Education reimbursement and/or scholarships for qualifying dependent children * Parental leave include maternity, paternity and child adoption leave * Caregiver leave Reporting Relationship * You will report to a Market Manager Role Essentials * This position is for entry-level college recruitment and we are seeking upcoming graduates planning to graduate in fall 2018 or spring 2019. * Valid driver's license * Excellent written and verbal communication skills * Relationship building skills * This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. * Ability to obtain Health & Life insurance licenses – Humana will guide students through this process * AHIP certification (or the ability to pass prior to hire date – Humana will guide students through this process) Role Desirables * Previous experience with health and life insurance, long-term care and/or annuity products * Current active Health and Life Insurance licenses * Bilingual * Ability to relocate to high demand markets * Previous internship and/or work experience a plus * Overall GPA of 3.0 or higher * Be actively involved on-campus and/or in the community with verifiable extracurricular activities and/or clubs * Strong interest in the Healthcare industry with a passion for helping others Scheduled Weekly Hours 40

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Assistant Center Director

Learning Care Group Birmingham AL, 35202

Our organization prides itself on excellence, putting the education and development of our children first and foremost. When you c...

Posted 4 weeks ago

Utilization Manager

Prevailing Wage/Payroll Accountant

Infant Teacher

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RN

Driver

Services Specialist 9/10/P11 Gogebic County (Case Manager/ Investigator)

Entry Level Medicare Sales Representative – Nationwide Openings Available

Payroll Specialist

Entry Level Medicare Sales Representative – Nationwide Openings Available

Assistant Center Director

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Utilization Manager

Prevailing Wage/Payroll Accountant

Infant Teacher

Boost your job search productivity with our free Chrome Extension!

RN

Driver

Services Specialist 9/10/P11 Gogebic County (Case Manager/ Investigator)

Entry Level Medicare Sales Representative – Nationwide Openings Available

Payroll Specialist

Entry Level Medicare Sales Representative – Nationwide Openings Available

Assistant Center Director

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Get better job matches!

Drag & Drop your file here

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