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Role Overview We’re seeking experienced Utility Management Nurses to support a client’s healthcare product development by leveraging expertise in insurance coding and hospital revenue management workflows. This role involves collaborating with hospital systems to align medical documentation with insurance policies, ensuring accurate coding and optimal reimbursement outcomes. ### Key Responsibilities - Insurance Coding & Revenue Cycle Alignment: Review, audit, and optimize insurance coding practices across hospital systems to ensure compliance and maximize reimbursement accuracy. - Workflow Analysis: Evaluate existing revenue management workflows and recommend improvements tailored to client’s AI-driven documentation tools. - Clinical Data Interpretation: Translate complex clinical notes into standardized coding formats (ICD-10, CPT, HCPCS) aligned with payer policies. - Policy Matching: Assess coding accuracy against insurance guidelines and payer documentation requirements. - Product Development Collaboration: Work closely with client’s engineering and product teams to refine AI models that automate or assist with medical coding and documentation. - Compliance & Quality Assurance: Ensure alignment with HIPAA, CMS, and payer-specific coding regulations. ### Required Qualifications - Licensure: Registered Nurse (RN) or equivalent clinical background. - Experience: Minimum 3–5 years in medical coding, clinical documentation improvement (CDI), or revenue cycle management. - Certifications: CPC, CCS, or CRC certification preferred. - Domain Expertise: Familiarity with hospital billing systems, payer policy interpretation, and coding audit procedures. - Analytical Skills: Strong understanding of clinical documentation standards and payer logic. - Tech Savvy: Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software. ### Preferred Qualifications - Experience working within hospital revenue integrity teams or insurance utilization management. - Exposure to AI-powered healthcare documentation tools or automated coding systems. - Ability to identify and flag edge cases or policy exceptions in automated workflows. - Strong collaboration skills with cross-functional (engineering, compliance, and data) teams. ### Engagement Model - Contract / Part-time (Remote/In person) — Flexible hours with collaboration during U.S. business hours. In person in San Francisco is a plus

Job DescriptionBenefits: • Bonus based on performance, • Flexible schedule, • A competitive salary, • Flexible Schedules, • Casual Dress-code Job Summary Do you have a passion for nursing but are tired of the hectic, high-stress environment of a clinic or ER? This is your chance to take your career in an exciting, new direction. Restore is seeking an outgoing, experienced Nurse to join our team of wellness professionals on a mission to help people feel better so they can do more of what they love. Were the antithesis of a traditional medical office or clinic, offering innovative wellness services in a fun, comfortable environment. Our nurses have described working for Restore as the most fun you can have at a nursing job while still helping people in a meaningful way. This is your opportunity to take an active role in assisting individuals on their health and wellness journey and leading a team of nurses to support the Restore mission. Responsibilities Medical Operations & Clinical Duties • Administering IV Drip Therapy and Intramuscular Injections to deliver our menu of vitamins, minerals, and antioxidants to cleared guests., • Educating clients on the qualities and benefits of our medical services. Including but not limited to IVs, IM Shots, GLP1 Administration, Biomarker Assessments, MHBOT, blood draws, etc., • Administering Hyperbaric Oxygen Therapy sessions, • Utilize blood test offerings to help clients optimize their wellness, • Promote memberships and medical services based on client needs, • Document client visits via electronic medical records using web platforms provided, • Address and answer client questions using the Restore Nursing Reference Guide under the supervision of the Medical Director and network of licensed Advanced Practice Providers, • Communicate to the medical compliance team any issues or adverse effects clients experience, • Provide therapeutic communication along with exceptional customer service, • Assist staff with store services, • Assist with off-site nursing events and special projects, • Report directly to the Studio Manager, • Maintain a safe and clean working environment always, • Review and assess client health history for telemedicine calls with Nurse Practitioner, • Youre a licensed Registered Nurse (RN)., • You have at least two years of experience as a nurse in an acute care setting (ER, ICU, Med-Surg or similar)., • You are BLS (Basic Life Support) certified, • You have at least one year of experience administering injections., • Youre comfortable using electronic medical records to document client details., • You maintain a non-judgemental outlook and have a demonstrated ability to work with a diverse clientele., • Your verbal and written communication skills are on point., • You value ethics and integrity., • You embrace a team environment and also excel at working independently., • Youre willing to adhere to all policies and procedures and understand the importance of maintaining medical compliance.

Job Description CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Folsom, CA. Work from home, and on the road. Monday – Friday, regular business hours. As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source, • Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans, • Provides assessment, planning, implementation, and evaluation of patient’s progress, • Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness, • Attends doctors, other providers, home and in some cases, attorney’s visits, • Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy, • Conducts home visit for initial evaluation, • Implements care such as negotiating the delivery of durable medical equipment and nursing services, • This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month, • This role may require overnight travel, • Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”), • Additional duties as required KNOWLEDGE & SKILLS: • Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment, • Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers, • A cost containment background, such as utilization review or managed care is helpful, • Strong interpersonal, time management, and organizational skills, • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets, • Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: • Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred, • Graduate of accredited school of nursing, • Current RN Licensure in state of operation, • Certification as a CCM, CIRS, or other Case Management certifications preferred, • A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $29.95 - $44.77 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 3500 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Job Description CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Folsom, CA. Work from home, and on the road. Monday – Friday, regular business hours. As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source, • Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans, • Provides assessment, planning, implementation, and evaluation of patient’s progress, • Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness, • Attends doctors, other providers, home and in some cases, attorney’s visits, • Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy, • Conducts home visit for initial evaluation, • Implements care such as negotiating the delivery of durable medical equipment and nursing services, • This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month, • This role may require overnight travel, • Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”), • Additional duties as required KNOWLEDGE & SKILLS: • Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment, • Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers, • A cost containment background, such as utilization review or managed care is helpful, • Strong interpersonal, time management, and organizational skills, • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets, • Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: • Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred, • Graduate of accredited school of nursing, • Current RN Licensure in state of operation, • Certification as a CCM, CIRS, or other Case Management certifications preferred, • A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $31.46 - $47.59 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL – Medical Case Managers: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Job Description Counselor Full-time (M-F from 7:00 a.m. - 3:30 p.m.) Pinnacle’s Voice: A Tale of Transformation & Recovery “I found myself like a lot of people in a position I never thought I would be in. I needed help bad… It all started with a call… one of the easiest and hardest things I’ve ever done. Every day I wake up and think how good it feels and how lucky I am to have found this place.” -Patient, Pinnacle Treatment Centers About Us: Pinnacle Treatment Centers is a leading provider of comprehensive addiction treatment services, committed to transforming lives through compassionate care. Our approach is rooted in evidence-based practices, focusing on the holistic well-being of our patients, and treating our teammates with the same level of individualized compassion and empathy. We believe in providing a supportive and inclusive environment for both our patients and our dedicated team of professionals. Pinnacle transforms the lives of more than 35,000 individuals daily resulting in a network of care spanning across the country. Position Overview: As a Counselor, you will play a crucial role in the recovery journey of our patients. Pinnacle’s unique approach combines compassionate care with innovative treatment methods to address the diverse needs of individuals seeking help for substance use disorders. Join us in making a positive impact on the lives of those we serve. Teammate Appreciation Benefits: At Pinnacle Treatment Centers, we value our teammates and offer a variety of benefits to support their personal and professional growth. 1. Variable Pay Structure: Competitive compensation based on experience, education, and licensure., 2. Defined Career Pathing: Clear advancement opportunities through our Counselor Tier Program, designed to reward achievement in education, licensure, and credentials., 3. Bonus Incentives: Recognizing and rewarding quality patient care with monthly performance-based bonuses., 4. STAR LRP Eligibility: 90% of our facilities are eligible for the Student Loan Repayment Program. This federal program selects applicants to forgive 100% of their student loans., 5. Continuing Education: Free access to over 600 CEU courses to enhance your skills and knowledge., 6. Paid Time Off: 18 days of PTO, sick leave, and 8 paid holidays to maintain a healthy work-life balance., 7. Diversity, Equity, and Inclusion Initiatives: Be part of a workforce that reflects the diversity of our patient population., 8. Free Clinical Supervision: Available based on licensure and availability to support your professional growth. Key Responsibilities: • Provides orientation to new patients to the programs’ rules, policies, procedures, and patients' rights., • Conduct Intakes, Discharge Planning, Initial Assessments, and Initial Treatment Plans professionally and within time guidelines as required by applicable federal and state regulation, CARF guidelines and Pinnacle Policies., • Involve patients in the assessment, treatment planning, and intervention aspects of treatment, which provides the patient with a sense of entitlement to their own recovery., • Administer the biopsychosocial assessment, which evaluates all areas of patients' lives, including their addictions, medical and mental health history, socioeconomics, legal, etc. at intake and on an ongoing basis., • Recognize and utilize patients’ Strengths, Needs, Ability, and Preferences (SNAP), to develop and implement individualized Treatment Plans that effectively help patients to meet their short & long-term goals. • Determine the clinical necessity of counseling services based on the clinical assessment and evaluation of the patients., • Monitor closely, and document any change of circumstances with the patients, especially as it relates to matters that may affect their recovery, identifying and addressing relapse indicators to promote relapse prevention interventions in an early stage., • Comply with and implement the Medical Q.A (Quality Assurance) and Clinical Risk Management Policies, including:, • Evaluate the patients for any high-risk conditions (e.g., liver failure, pregnancy, overdose, bipolar, schizophrenia, etc.), which may endanger the patient (suicidal) or other parties (homicidal)., • Administer the BAM-R, C-SSRS, GAD-7, and PHQ-9 screening tools to determine the severity of the patient's mental/emotional status., • Evaluate the risk factors concerning each such case, considering the appropriateness of, and professionalism in treating such individuals in an OTP in comparison to treatment in a residential facility or other treatment modalities., • Review and ask about other practitioners' involvement in the treatment of these high-risk conditions. Recommend immediate referral to such a specialist in case of need. Request the patient sign a waiver for release of information which will allow communication with the other practitioner in case of need (e.g., deterioration of the patient’s condition)., • Flag high-risk patients to the Medical Directors, Physician Extenders, and Regional Clinical Leadership (RCL) and highlight the conditions concerned., • Refer such patients to the Medical Directors, Physician Extenders or RCLs (Regional Clinical Leadership) based on the urgency, utilizing the informal Referral Policy or the scheduled Treatment Team/Case Conference session., • Review physician notes, following the Medical Directors or Physician Extenders’ session with the patient, verifying that they noted and addressed the high-risk factor, or otherwise bring it immediately to the attention of the supervising counselor, as well as the clinic manager, until the matter’s proper and professional handling by the physician or physician extender., • Advise, in writing, other staff members (including the clinic manager, supervising counselor, dispensing nurse and front office) of high-risk patients and their condition. Maintain and circulate minutes from treatment team/case conference sessions to the other staff members., • Provide professional counseling and referral services by:, • Addressing patients’ clinical and special needs by maintaining referrals to specialized (“second tier”) services rendered by physicians, physician extenders and counselors within Aegis, as well as referrals to Keys to Recovery (or other twelve-step) support groups, and other community resources (e.g., agencies and practitioners outside of Aegis), acting as a liaison to these agencies, as necessary., • Providing individual and group counseling as clinically necessary, to address the problem issues identified in the Initial Assessment and Treatment Plans. The counseling service will include protocols for the treatment of Relapse Prevention, Peer Pressure, Anger Management, Domestic Violence, Parenting, Family Preservation, Vocational Rehabilitation, etc., • Utilizing advanced counseling techniques such as Cognitive Behavioral Therapy, Motivational Interviewing, etc., • Scheduling regular counseling sessions with patients; issue patient appointment cards and record scheduled or rescheduled sessions in EHR scheduler., • Documenting counseling entries, including signature and date, as required by applicable federal and state regulations, CARF guidelines and Pinnacle policies., • Engaging in Community Relations and Outreach efforts., • Attending all recommended training including Physician Training of Counselors, RCL training, and case conferences with the program physicians and physician assistants., • Collecting research data when requested., • Observing the collection of patients’ urine samples when required, • Attend team meetings and complete all training courses timely as required. Counselor I: $20/hour to $21/hour • Possess an associate degree in relevant field and has the registration/credentials necessary to provide counseling services to our patient population., • Possess an associate degree in a relevant field or a majority of approved counselor certification courses, license, or certification necessary to provide counseling services to our patient population. Kern County requires a bachelor's degree or 75% of required counselor certification courses), • Possess counselor registration/certification by a “Certifying Organization: recognized by the Department of Alcohol and Drug Programs. Proof of registration is required immediately once employed with a California Alcohol and Drug Program certifying body. Employees must be registered prior to providing any counseling services per the DHCS (Department of Health Care Services)., • Degrees must include being licensed, licensed eligible, or certified. Clinical skills must be effective in complex cases. Along with the below:, • Possess certification as an Alcohol and Other Drug Counselor with a CA approved certification agency or current credentials as licensed or license-eligible with the Board of Behavioral Sciences or the Board of Psychology. If license-eligible, must maintain the Board’s requirements to be able to practice including receiving the necessary amount of clinical supervision by a Board approved supervisor. INDCA123