Licensed Care Plan Reviewer Jobs

State - specific Medicaid services (e.g. Psychosocial Rehabilitation, Targeted Case Management, Home Based Habilitation, Supported Employment, etc.)

Experience working in a managed care setting

3+ years of post - licensure experience

Computer skills, including facility with Windows OS, Outlook, Word, Teams and Excel

ASPPB Certificate of Professional Qualification (CPQ)

Experience with Commercial, Medicaid and Medicare lines of business

Supervises, plans, and organizes the work of single-family residential plan reviews

Conducts plan reviews for residential and commercial construction projects

Develops and presents training seminars for design professionals, contractors, owners, and inspectors as it relates to single-family plan reviews

Responds to questions, comments, and requests in a courteous, timely manner

Communicates and coordinates regularly with others to maximize the effectiveness and efficiency of interdepartmental operations and activities

Performs other directly related duties consistent with the role and function of the classification

Annotate any changes to drawings and communicate to Project Management Team.

5 years of commercial construction experience required; prefer experience with commercial concrete, rebar and other related specialty construction

Mathematics – knowledge of arithmetic, algebra and geometry and the ability to apply them in the proper applications.

Blueprint Reading and Interpretation – knowledge of building plans and symbols and the ability to interpret the intended construction methods.

Strong and consistent communication skills, including emotional awareness, active listening, respectful language, constructive feedback, and collaborative problem solving.

Comfortable and proficient learning new technical systems as needed; knowledge of Procore a plus.

Experience utilizing Anchorage's Current Title 23.10, the Administrative Chapter of the Building Code.

Minimum Qualifications / Substitutions / Preferences

Valid State of Alaska driver's license by the time of hire.

Flexible Spending Accounts – Health and Dependent Care

State of Alaska Public Employee Retirement System (PERS) Program

401(k) and 457 Savings Plans

Considerable para-professional engineering experience applying land use planning policy and/or zoning practices policy and procedures.

Completing review and follow up of building permits associated with Special Exception projects including Site Plans, Use-permits, and Variances;

Briefing Zoning Enforcement inspectors on site plan, use permit, and Form-Based Code conditions relative to the inspection of projects; and

Providing guidance and consultation to the public and the development community on zoning and permitting issues.

Associate degree in Architecture, Planning, Civil Engineering, or a related field; and

Construction site plan condition compliance or surveying;

Applies clinical knowledge to work with facilities and providers for care coordination.

Educates the member about plan benefits and contracted physicians, facilities and healthcare providers.

Refers treatment plans/plan of care to peer clinical reviewers in accordance with established criteria/guidelines and does not issue medical necessity non-certifications.

Facilitates accreditation by knowing, understanding, and accurately applying accrediting and regulatory requirements and standards.

Job Family: Medical and Clinical

Date Posted: Apr 20, 2023

Performs computer data entry for plan review projects.

Must obtain 5 trade plans examiner ICC certifications within 36 months from date of hire.

Interacts with other divisions, both within and outside the department, in the facilitation of the plans review and permitting processes.

Monitors work scheduling, on-time performance, and accuracy of work assignments.

Preference given for architectural, structural, mechanical, electrical, and civil engineering degrees. Conditionally accepting May/June 2023 graduates.

QUESTIONS REGARDING AVIATION POSITIONS SHOULD BE DIRECTED TO THE AVIATION DEPARTMENT AT 816-243-3010.

3 years clinical experience as a Licenses Practical Nurse

Diploma or Associate's Degree accredited LPN program

Input of MDS/care plan into EMR system.

Lead weekly task oriented staffing meeting involving all disciplines involved in MDS completion.

Report to DON/ADON any omissions/trends with MDS/Care Plan process involving other departments. Collaboration with ADON for RN signatures weekly on MDS.

Completion of ancillary forms as needed (restraint use, psychoactive med use, self admin. of med, etc.).

Oversees and effectively manages work assigned and conducted by assigned care support team

License and Certifications - Required

License and Certifications - Preferred

Provides telephone triage, crisis intervention and prior authorizations as assigned for select members stratified as high and moderate member need.

Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.

Acts as an advocate for members' care needs by identifying and addressing gaps in care.

A minimum of 2 years of experience in video content creation and project management.

Project management of video campaigns from start to finish, including planning, scheduling, and coordinating all aspects of the project.

Creating video briefs and examples as needed, ensuring that they meet the specific requirements of each project.

Strong knowledge of social media platforms and their respective video features.

Excellent communication skills, both written and verbal.

Ability to work independently and collaboratively in a remote environment.

2 years’ experience in Utilization Management, Medical Management, Case Management

We are looking for a Care Manager, Medical Management, to join us in leading our organization forward.

This is a fully remote position.

Associate degree in nursing, health care, or related field.

Understanding of claims administration, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc.

Daily Work Times: 8:30 am - 5:00 pm