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Registered Nurse Med/Surg jobs at Acadia Healthcare

- 114 jobs
  • Admission RN

    Acadia Healthcare 4.0company rating

    Registered nurse med/surg job at Acadia Healthcare

    Mount Carmel Behavioral Health is hiring Admissions RN's! Available Shifts and Hours: 7p-7a with rotating weekends Sign on Bonus: Full Time Night: $10,000 Pay Range: $36.00 to $44.75 per hour (dependent on years of experience) Mount Carmel Behavioral Hospital is a renowned healthcare facility committed to providing exceptional mental health services to our community and in Intake and Admissions, you can make a real difference in the lives of our patients. Responsibilities Key Responsibilities: · Review medical documentation for all admissions, complete medication reconciliation, and obtain admission orders from physicians. · Facilitate emergency transfers for patients with medical conditions beyond our facility's capabilities. · Review referrals from hospitals, facilities, and community agencies, assessing medical and behavioral acuity and responding within designated timeframes. · Respond to inquiries about our facility, providing appropriate recommendations and information. · Conduct assessments to determine the appropriate level of care within our facility. · Collaborate with medical and psychiatric personnel to ensure appropriate recommendations and admissions. · Facilitate the admissions process, including assessment, consent, and inventory of patient belongings. · Perform insurance benefit verifications and secure initial pre-authorization for treatment and admission. · Monitor patient status throughout the admissions process, following facility policies and physician orders. · Utilize web-based programs to track and review referrals. · Communicate projected admissions promptly to designated internal representatives. · Ensure timely receipt of all clinical information, including medical comorbidity, from referral sources or patients. · Schedule and complete pre-admission assessments, consult with admitting physicians, and communicate disposition recommendations to patients or their families. · Prepare and maintain accurate medical record documentation to facilitate payor authorization at the requested level of care. · Complete initial pre-authorization for treatment and admission within payor timeframe guidelines. · Admit patients to the registration and accounting system, completing all necessary admission and consent forms. · Demonstrate a positive, empathetic, and professional attitude towards patients, prioritizing their safety and promptly addressing concerns or complaints. · Coordinate care for patients who are not being admitted, ensuring they receive appropriate follow-up care and referrals. · Conduct safety checks and provide supervision as required by special precautions and individualized guidelines. · Coordinate care for patients who are not being admitted, ensuring they receive appropriate follow-up care and referrals. · Conduct safety checks and ensure proper supervision according to special precautions and individualized guidelines. Qualifications We are seeking a motivated and detail-oriented individual who is passionate about providing exceptional patient care and ensuring smooth admissions processes. If you meet the qualifications and are committed to delivering high-quality services, we encourage you to apply. Qualifications: · Minimum of an Associate's degree in Nursing. · Minimum of one year of experience working with individuals in a clinical or observational capacity, preferably within the relevant area of specialty for the hiring facility. Licenses/Designations/Certifications: · Clear and active nursing license in the state. · CPR and de-escalation/restraint certification required (training available upon hire and offered by the facility). · First aid certification may be required based on state or facility requirements. We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws. AHRN #LI-MCBH #LI-SW2 Not ready to apply? Connect with us for general consideration.
    $17k-58k yearly est. Auto-Apply 15d ago
  • RN CRC Coding Auditor - Remote

    Tenet Healthcare Corporation 4.5company rating

    Frisco, TX jobs

    The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and patterns to the CRC leadership. Provides expert application of evidence based medical necessity review criteria tool. Works collaboratively to review, evaluate and improve the denial appeal process. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Formulates and submits letters of appeal. Creates an effective appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines and coding guidelines, evidence-based medicine, community and national medical management and coding standards and protocols. * Performs reviews of accounts denied for DRG validation and DRG downgrades. * Documents in appropriate denial tracking tool (ACE). Maintains and distributes reports as needed to leadership. * Identifies payment methodology of accounts including Managed Care contract rates, Medicare and State Funded rates, Per-Diems, DRG's, Outlier Payments, and Stop Loss calculations. * Collaborates with Physician Advisors and CRC leadership when documentation-specific areas of concern are identified. * Maintains expertise in clinical areas and current trends in healthcare, inpatient coding and reimbursement methodologies and utilization management specialty areas. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Effectively organizes work priorities * Demonstrates compliance with departmental safety and security policies and practices * Demonstrates critical thinking, analytical skills, and ability to resolve problems * Demonstrates ability to handle multiple assignments and carry out work independently with minimal supervision * Demonstrates quality proficiency by maintaining accuracy at unit standard key performance indicator goals * Possesses excellent written and verbal communication skills * Detail oriented and ability to work independently and in a team setting * Moderate skills in MS Excel and PowerPoint, MS Office * Ability to research difficult coding and documentation issues and follow through to resolution * Ability to work in a virtual setting under minimal supervision * Ability to conduct research regarding state/federal guidelines and applicable regulatory guidelines related to government audit processes Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Includes minimum education, technical training, and/or experience required to perform the job. Education * Minimum Required: * Completion of BSN Degree Program or three years of experience and completion of BSN within five years of employment * RN License in the State of Practice * Current working knowledge of clinical documentation and inpatient coding, discharge planning, utilization management, case management, performance improvement and managed care reimbursement. * Preferred/Desired: * Completion of BSN Degree Program * CCDS certification or inpatient coding certification Experience * Minimum Required: * Three to Five years Clinical RN Experience * Three to Five years of Clinical Documentation Integrity experience * Must have expertise with Interqual and/or MCG Disease Management Ideologies * Strong communication (verbal/written) and interpersonal skills * Knowledge of CMS regulations * Knowledge of inpatient coding guidelines * 1-2 years of current experience with reimbursement methodologies * Preferred/Desired: * Experience preparing appeals for clinical denials related to DRG assignment. * Strong understanding of rules and guidelines, including AHA's Coding Clinics, American Association of Medical Audit Specialists (AAMAS), National Commission on Insurance Guidelines and Medicare Billing Guidelines (CMS), State Funded Billing Regulations (Arizona, California, Nevada) and grievance process; working knowledge of billing codes such as RBRVS, CPT, ICD-10, HCPCS CERTIFICATES, LICENSES, REGISTRATIONS * Required: * RN, * CCDS or other related clinical documentation specialist certification, and/or AHIMA or AAPC Coding Credential CCS, CCA, CIC, CPC or CPMA * Preferred: BSN PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to lift 15-30lbs * Ability to travel approximately 10% of the time; either to client sites, National Insurance Center (NIC) sites, Headquarters, or other designated sites * Ability to sit and work at a computer for a prolonged period of time conducting medical record quality reviews WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc. OTHER * Interaction with facility HIM and / or physician advisors * Must meet the requirements of the Conifer Telecommuting Policy and Procedure As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $56,784.00 - $85,176.00 annually. Compensation depends on location, qualifications, and experience. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $56.8k-85.2k yearly 28d ago
  • RN DRG Coding Auditor - Remote

    Tenet Healthcare Corporation 4.5company rating

    Frisco, TX jobs

    The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and patterns to the CRC leadership. Provides expert application of evidence based medical necessity review criteria tool. Works collaboratively to review, evaluate and improve the denial appeal process. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Formulates and submits letters of appeal. Creates an effective appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines and coding guidelines, evidence-based medicine, community and national medical management and coding standards and protocols. * Performs reviews of accounts denied for DRG validation and DRG downgrades. * Documents in appropriate denial tracking tool (ACE). Maintains and distributes reports as needed to leadership. * Identifies payment methodology of accounts including Managed Care contract rates, Medicare and State Funded rates, Per-Diems, DRG's, Outlier Payments, and Stop Loss calculations. * Collaborates with Physician Advisors and CRC leadership when documentation-specific areas of concern are identified. * Maintains expertise in clinical areas and current trends in healthcare, inpatient coding and reimbursement methodologies and utilization management specialty areas. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Effectively organizes work priorities * Demonstrates compliance with departmental safety and security policies and practices * Demonstrates critical thinking, analytical skills, and ability to resolve problems * Demonstrates ability to handle multiple assignments and carry out work independently with minimal supervision * Demonstrates quality proficiency by maintaining accuracy at unit standard key performance indicator goals * Possesses excellent written and verbal communication skills * Detail oriented and ability to work independently and in a team setting * Moderate skills in MS Excel and PowerPoint, MS Office * Ability to research difficult coding and documentation issues and follow through to resolution * Ability to work in a virtual setting under minimal supervision * Ability to conduct research regarding state/federal guidelines and applicable regulatory guidelines related to government audit processes Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Includes minimum education, technical training, and/or experience required to perform the job. Education * Minimum Required: * Completion of BSN Degree Program or three years of experience and completion of BSN within five years of employment * RN License in the State of Practice * Current working knowledge of clinical documentation and inpatient coding, discharge planning, utilization management, case management, performance improvement and managed care reimbursement. * Preferred/Desired: * Completion of BSN Degree Program * CCDS certification or inpatient coding certification Experience * Minimum Required: * Three to Five years Clinical RN Experience * Three to Five years of Clinical Documentation Integrity experience * Must have expertise with Interqual and/or MCG Disease Management Ideologies * Strong communication (verbal/written) and interpersonal skills * Knowledge of CMS regulations * Knowledge of inpatient coding guidelines * 1-2 years of current experience with reimbursement methodologies * Preferred/Desired: * Experience preparing appeals for clinical denials related to DRG assignment. * Strong understanding of rules and guidelines, including AHA's Coding Clinics, American Association of Medical Audit Specialists (AAMAS), National Commission on Insurance Guidelines and Medicare Billing Guidelines (CMS), State Funded Billing Regulations (Arizona, California, Nevada) and grievance process; working knowledge of billing codes such as RBRVS, CPT, ICD-10, HCPCS CERTIFICATES, LICENSES, REGISTRATIONS * Required: * RN, * CCDS or other related clinical documentation specialist certification, and/or AHIMA or AAPC Coding Credential CCS, CCA, CIC, CPC or CPMA * Preferred: BSN PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to lift 15-30lbs * Ability to travel approximately 10% of the time; either to client sites, National Insurance Center (NIC) sites, Headquarters, or other designated sites * Ability to sit and work at a computer for a prolonged period of time conducting medical record quality reviews WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc. OTHER * Interaction with facility HIM and / or physician advisors * Must meet the requirements of the Conifer Telecommuting Policy and Procedure As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $56,784.00 - $85,176.00 annually. Compensation depends on location, qualifications, and experience. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $56.8k-85.2k yearly 28d ago
  • Registered Nurse FT Days!

    Kindred Healthcare 4.1company rating

    Dayton, OH jobs

    Registered Nurse FT Days! (Job Number: 549045) Description $15K SOB!At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job SummaryProvides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process. Essential FunctionsMaintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain Utilizes appropriate pain management techniques Educates the patient and family regarding pain management. Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age Receives physician's orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications EducationGraduation from an accredited Bachelor of Science in NursingAssociate Degree in Nursing or Nursing Diploma program Licenses/CertificationCurrent state licensure as Registered NurseBCLS certification required ACLS certifications preferred ExperienceMinimum six months' Medical/Surgical experience in an acute care setting preferred Job: RNPrimary Location: OH-Dayton-Kindred Hospital - DaytonOrganization: 4500 - Kindred Hospital - DaytonShift: Day
    $59k-80k yearly est. Auto-Apply 10d ago
  • Registered Nurse RN Weekend Night Option Program

    Kindred Healthcare 4.1company rating

    Lima, OH jobs

    Registered Nurse RN Weekend Night Option Program (Job Number: 540377) Description $20,000 Sign-on-Bonus!At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and EvaluationDevelops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate Participates in discharge planning process Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy. Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age Receives physician's orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications Education Graduation from an accredited Bachelor of Science in Nursing Associate Degree in Nursing or Nursing Diploma program Licenses/Certification Current state licensure as Registered Nurse BCLS certification required ACLS certifications preferred Experience Minimum six months' Medical/Surgical experience in an acute care setting preferred Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Night
    $59k-79k yearly est. Auto-Apply 60d+ ago
  • Registered Nurse/FT/Days

    Kindred Healthcare 4.1company rating

    Lima, OH jobs

    Registered Nurse/FT/Days (Job Number: 548657) Description $20,000 SIGN ON BONUS THROUGH JANUARY 2026At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process. Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain Utilizes appropriate pain management techniques Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age Receives physician's orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications EducationGraduation from an accredited Bachelor of Science in NursingAssociate Degree in Nursing or Nursing Diploma program Licenses/CertificationCurrent state licensure as Registered NurseBCLS certification required ACLS certifications preferred ExperienceMinimum six months' Medical/Surgical experience in an acute care setting preferred Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Day
    $59k-79k yearly est. Auto-Apply 60d+ ago
  • Registered Nurse/FT/Nights

    Kindred Healthcare 4.1company rating

    Lima, OH jobs

    Registered Nurse/FT/Nights (Job Number: 550110) Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process. Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department. Directs, supervises, provides and evaluates nursing care provided to patients. Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated. Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications. Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies. Performs assessment on all patients on admission and reassessments as per policy. Makes referrals to other disciplines based on assessment. Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team. Assesses and reassesses pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management. Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness. Performs patient care responsibilities considering needs specific to the standard of care for patient's age. Receives physician's orders, ensures transcription is accurate and documents completion. Administers medication utilizing the five rights of medication administration reducing the potential for medication errors. Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate. Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice. Performs treatments and provides services to level of licensure. Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families. Functions as liaison between administration, patients, physicians, and other healthcare providers. Interacts professionally with patient/family and involves patient/family in the formation of the plan of care. Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group. Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors. Initiates or assists with emergency measures for sudden adverse developments in patients' condition. Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate. Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs. Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off. Communicates appropriately and clearly to management, co-workers, and physicians. Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs. Participates in orientation, instruction/training of new personnel. Manages and operates equipment safely and correctly. Knowledge/Skills/Abilities/Expectations Knowledge of medications and their correct administration based on age of the patient and their clinical condition. Basic computer knowledge. Able to organize tasks, develop action plans, set priorities and function under stressful situations. Ability to maintain a good working relationship both within the department and with other departments. Approximate percent of time required to travel: 0% Must read, write and speak fluent English. Must have good and regular attendance. Performs other related duties as assigned. Qualifications Education Graduation from an accredited Bachelor of Science in Nursing, Associate Degree in Nursing or Nursing Diploma program. Licenses/Certification Current state licensure as Registered Nurse. BCLS certification required. ACLS certifications preferred. Experience Minimum six months' Medical/Surgical experience in an acute care setting preferred. Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Night
    $59k-79k yearly est. Auto-Apply 1d ago
  • Clinic Registered Nurse (RN) Care Manager

    Primary Health Solutions 4.1company rating

    Middletown, OH jobs

    Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R - Respect I - Innovation S - Stewardship E - Excellence Registered Nurse (RN) Summary Assists in examination and treatment of patients under a Provider's direction by performing the following duties. A Day in the Life This reflects management's assignment of essential functions. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time. Customer care: · Conducts outreach to patients for Annual Wellness Visits (AWVs), chronic care management, and preventive health screenings. · Educates patients and families on self-management strategies, chronic disease care, and lifestyle modifications to support overall wellness. · Triages patient calls and walk-ins, addresses routine concerns, and escalates clinical issues as appropriate. · Documents all patient interactions and communications in the electronic medical record (EMR) with accuracy and timeliness. · Encourages patients to stay current with preventive services, immunizations, and chronic condition management. Clinical: · Conducts Medicare Annual Wellness Visits and other preventive health assessments, documenting findings and collaborating with Providers to establish or update care plans. · Administers vaccines and injections, including psychotropic medications, per Provider direction and organizational protocols. · Assists Providers with clinical procedures, medication administration, and vital sign collection. · Closes care gaps by ensuring patients receive recommended screenings, labs, immunizations, and follow-up visits. · Reviews and reconciles medications during patient visits; provides education on medication adherence and side effects. · Tracks and follows up on diagnostic tests, referrals, and abnormal results as directed by the Provider. · Assists in the management of patients with complex or chronic conditions, ensuring continuity and coordination of care. · Documents all procedures, education, and communications in the EMR in compliance with quality and regulatory standards. · Participates or directly manages quality initiatives with special populations e.g. 0-2 years receive recommended vaccinations Operations: · Prepares, cleans and sterilizes equipment and exam rooms as established by standard safety and clinical protocols. · Participates in huddles, pre-visit planning, and team meetings to identify patients due for preventive services or follow-up care. · Supports health initiatives, including tracking and reporting of quality metrics (e.g., immunizations, screenings, chronic disease management measures). · Collaborates with care coordinators and Providers to address barriers to care and improve patient outcomes. · Participates in staff education, training, and quality improvement initiatives. · Properly handles the disposal of infectious/hazardous waste, according to OSHA guidelines. · Inventories and requests supplies. · Responsible for performing health and team based care related services within the guidelines of the state of Ohio Board of Nursing. · Support a shared goal model in order to achieve high-quality care that is patient and family centered. · Facilitates coordination of care following hospital, ER utilization or follow up from specialty providers. · May participate in team meetings and quality improvement activities as necessary. · Performs all other duties and tasks as assigned. Requirements Core Competencies · Customer Service: Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met. · Communication: Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills. · Dependability: Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements. · Quality: Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems. · Productivity: Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time well, and handles information flow. Success Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience Graduation from an accredited school of nursing. Bachelor's program preferred. Language Skills Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have the ability to gain knowledge of current practice management system, electronic medical record, Microsoft Word, text paging, Internet, and Intranet. Certificates, Licenses, Registrations RN License. Must hold a current, valid license to practice nursing in the state of Ohio. Other Applicable Requirements Ability to speak Spanish desirable. Knowledge of examination, diagnostic, and treatment room procedures. Knowledge of medical equipment and instruments to administer patient care. Skill in taking vital signs. Skill in maintaining records and recording test results. Skill with geriatric patients and patients in lower socio-economic sectors of the community. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee are occasionally exposed to fumes or airborne particles; toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate. Affirmative Action/EEO Statement It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
    $46k-67k yearly est. 34d ago
  • Call Center Nurse RN - Part Time - Remote

    Unitedhealth Group Inc. 4.6company rating

    Fort Pierce, FL jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Call Center Nurse RN is responsible for providing comprehensive clinical services to our customers located throughout the U.S. and may require multiple licenses to practice across various states. Services provided to our customers include but are not limited to the following telephonic services: clinical triage, transitions of care, medication adherence and reconciliation, management of gaps in care, and other care extension services. The Call Center Nurse assists and guides patients toward self-management and behavior modifications that result in improved patient outcomes. The Call Center Nurse is the primary point of contact for multiple disciplines. Success is measured in terms of improved patient outcomes, prevention of patient adverse events and satisfied customers, meeting or exceeding quality measures, producing consistent and high-quality work, and collaboration with other care team members. The Call Center Nurse is an experience nurse, able to perform tasks independently and once trained, without guidance. This person can provide education to patients, deploying best practices and standard workflow in their daily activities with the ability to apply their expertise across the various areas of responsibility, understanding how their interactions with patients affect customer satisfaction and can make recommendations to improve processes. Positions in this family require a current, unrestricted nursing license (RN) in the applicable state, as indicated in the function description and/or title. This is a PART TIME position working 7:30am - 6pm Eastern 2 days per week - either Mon and Friday OR Wednesday and Thursday. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Provide remote telephonic nursing support to patients, caregivers, and healthcare providers * Assess and triage patient calls to determine urgency of medical needs * Offer medical advice, guidance, and education to patients and caregivers regarding treatment plans, medication management, and self-care techniques * Collaborate with healthcare professionals to coordinate patient care and follow-up * Document patient interactions, assessments, and recommendations accurately and timely in electronic health records systems * Adhere to established protocols, guidelines, and best practices for telephonic nursing * Maintain patient confidentiality and privacy in accordance with HIPPA regulations * Participate in ongoing training and professional development activities to stay updated on medical advancements and best practices in telehealth * Contribute to quality improvement initiatives to enhance the delivery of telephonic nursing services * Provide exceptional customer service and support to ensure a positive experience for patients and clients * Ability to adapt nursing interventions and care plans to meet the individualized needs and preferences of diverse patients across the continuum of care * Demonstrates the ability to meet deadlines independently and efficiently, requiring minimal to no supervision * Actively engage in collaborative efforts within nursing team to ensure seamless communication, shared knowledge, and coordinated patient care delivery * Utilizes extensive expertise in chronic illnesses and medication management to effectively treat diseases * Works with supervisors to solve more complex problems You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Registered Nurse (RN) with a current, active, and unrestricted RN License in PA (state specific or compact) * 3+ years of clinical nursing experience * Experience with electronic medical records system(s) * Proven proficiency using MS Office Suite (i.e. Teams, Outlook, Word, Excel) * Ability to work PT hours (7:30am - 6PM EST) on either Monday and Friday OR Wednesday and Thursday Preferred Qualifications: * Telehealth nursing experience * Experience with Cerner * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.6-56.1 hourly 60d+ ago
  • Behavioral Health Registered Nurse FT Weekends!

    Kindred Healthcare 4.1company rating

    Dayton, OH jobs

    Behavioral Health Registered Nurse FT Weekends! (Job Number: 548843) Description $15K SOB!At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job SummaryProvides planning and delivery of direct and indirect patient care through the nursing process of assessment planning, intervention, and evaluation. Develops nursing care plan in coordination with patient, family, and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with physicians, nursing supervisor/manager, and co-workers as appropriate. Participates in discharge planning process. Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the JD KBHS RN the team Administer medication utilizing the five rights of medication administration reducing the potential for medication errors Assesses and reassess pain. Utilizes appropriate pain management techniques Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan of effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age. Receives physician's orders, ensures transcription is accurate and documents completion. Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments, and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to the level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group. Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to on coming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Performs other duties as requested Knowledge/Skills/Abilities/ExpectationsExcellent oral and written communication and interpersonal skills Knowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications EducationGraduation from an accredited Bachelor of Science in Nursing, Associate Degree in Nursing, or Nursing Diploma program Licenses/CertificationsCurrent state licensure as Registered NurseACLS preferred BCLS certification Crisis prevention training and certification strongly preferred; mandatory completion within 90 days of hire ExperienceMinimum one year in an inpatient psychiatric setting Job: Behavior/Mental HealthPrimary Location: OH-Dayton-Kindred Dayton BHUOrganization: 4020 - Kindred Dayton BHUShift: Weekend
    $50k-67k yearly est. Auto-Apply 10d ago
  • Clinic Registered Nurse (RN) Care Manager

    Primary Health Solutions 4.1company rating

    Hamilton, OH jobs

    Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R - Respect I - Innovation S - Stewardship E - Excellence Registered Nurse (RN) Summary Assists in examination and treatment of patients under a Provider's direction by performing the following duties. A Day in the Life This reflects management's assignment of essential functions. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time. Customer care: · Conducts outreach to patients for Annual Wellness Visits (AWVs), chronic care management, and preventive health screenings. · Educates patients and families on self-management strategies, chronic disease care, and lifestyle modifications to support overall wellness. · Triages patient calls and walk-ins, addresses routine concerns, and escalates clinical issues as appropriate. · Documents all patient interactions and communications in the electronic medical record (EMR) with accuracy and timeliness. · Encourages patients to stay current with preventive services, immunizations, and chronic condition management. Clinical: · Conducts Medicare Annual Wellness Visits and other preventive health assessments, documenting findings and collaborating with Providers to establish or update care plans. · Administers vaccines and injections, including psychotropic medications, per Provider direction and organizational protocols. · Assists Providers with clinical procedures, medication administration, and vital sign collection. · Closes care gaps by ensuring patients receive recommended screenings, labs, immunizations, and follow-up visits. · Reviews and reconciles medications during patient visits; provides education on medication adherence and side effects. · Tracks and follows up on diagnostic tests, referrals, and abnormal results as directed by the Provider. · Assists in the management of patients with complex or chronic conditions, ensuring continuity and coordination of care. · Documents all procedures, education, and communications in the EMR in compliance with quality and regulatory standards. · Participates or directly manages quality initiatives with special populations e.g. 0-2 years receive recommended vaccinations Operations: · Prepares, cleans and sterilizes equipment and exam rooms as established by standard safety and clinical protocols. · Participates in huddles, pre-visit planning, and team meetings to identify patients due for preventive services or follow-up care. · Supports health initiatives, including tracking and reporting of quality metrics (e.g., immunizations, screenings, chronic disease management measures). · Collaborates with care coordinators and Providers to address barriers to care and improve patient outcomes. · Participates in staff education, training, and quality improvement initiatives. · Properly handles the disposal of infectious/hazardous waste, according to OSHA guidelines. · Inventories and requests supplies. · Responsible for performing health and team based care related services within the guidelines of the state of Ohio Board of Nursing. · Support a shared goal model in order to achieve high-quality care that is patient and family centered. · Facilitates coordination of care following hospital, ER utilization or follow up from specialty providers. · May participate in team meetings and quality improvement activities as necessary. · Performs all other duties and tasks as assigned. Requirements Core Competencies · Customer Service: Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met. · Communication: Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills. · Dependability: Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements. · Quality: Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems. · Productivity: Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time well, and handles information flow. Success Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience Graduation from an accredited school of nursing. Bachelor's program preferred. Language Skills Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have the ability to gain knowledge of current practice management system, electronic medical record, Microsoft Word, text paging, Internet, and Intranet. Certificates, Licenses, Registrations RN License. Must hold a current, valid license to practice nursing in the state of Ohio. Other Applicable Requirements Ability to speak Spanish desirable. Knowledge of examination, diagnostic, and treatment room procedures. Knowledge of medical equipment and instruments to administer patient care. Skill in taking vital signs. Skill in maintaining records and recording test results. Skill with geriatric patients and patients in lower socio-economic sectors of the community. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee are occasionally exposed to fumes or airborne particles; toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate. Affirmative Action/EEO Statement It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
    $46k-67k yearly est. 34d ago
  • Clinical Appeals RN - Remote in EST or CST Time Zone

    Unitedhealth Group Inc. 4.6company rating

    Cypress, CA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST. Primary Responsibilities: * Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid * Identify if additional information is required to process an appeal * Ability to adapt to changes that require cross training on appeal types as they are identified * Ability to work independently * Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases * Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current, valid, and unrestricted RN licensure in your state of residence * 2+ years of clinical experience in an acute care or an outpatient setting * 1+ years of direct experience within one (or more) of the following areas: * Utilization Review * Medicaid and/or Medicare appeals experience * LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC * Proven experience/understanding of billable services and claims in a managed care environment * Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills * Access to high-speed internet * Ability to work 8-5 within EST (Eastern standard time zone) Preferred Qualifications: * 5+ years of Medical Appeal experience working with Medicare and Medicaid * Solid coding experience or Certified Coder (CPC) * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 5d ago
  • Clinical Appeals RN - Remote in EST or CST Time Zone

    Unitedhealth Group 4.6company rating

    Cypress, CA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST. **Primary Responsibilities:** + Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid + Identify if additional information is required to process an appeal + Ability to adapt to changes that require cross training on appeal types as they are identified + Ability to work independently + Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases + Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, valid, and unrestricted RN licensure in your state of residence + 2+ years of clinical experience in an acute care or an outpatient setting + 1+ years of direct experience within one (or more) of the following areas: + Utilization Review + Medicaid and/or Medicare appeals experience + LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC + Proven experience/understanding of billable services and claims in a managed care environment + Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills + Access to high-speed internet + Ability to work 8-5 within EST (Eastern standard time zone) **Preferred Qualifications:** + 5+ years of Medical Appeal experience working with Medicare and Medicaid + Solid coding experience or Certified Coder (CPC) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $28.3-50.5 hourly 5d ago
  • Clinical Appeals RN (M&R) - Remote (M-F 8-5)

    Unitedhealth Group 4.6company rating

    Cypress, CA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims. **Primary Responsibilities:** + Review provider post-service appeals for Medicare and Retirement + Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines + Discuss cases with medical directors when applicable + Ability to communicate and collaborate with other teams in order to gather medical information to process cases + Communicate effectively in both verbal and written documentation + Must meet quality and productivity metrics + Ability to work independently and prioritize + Attend mandatory trainings and scheduled staff meetings + Engage in respectful and courteous team dialog via email, IM and in staff meeting You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Undergraduate degree or equivalent experience + Unrestricted, active RN license + 2+ years of RN experience in acute setting + Proven working knowledge of Clinical Criteria and CMS Guidelines/InterQual + Proven proficiency in basic computer skills + Demonstrated ability to have high speed internet installed in home for Secure Job use only + Proven designated HIPPA compliant home workspace **Preferred Qualifications:** + Undergraduate degree (BSN) + Proven utilization management, prior authorization, case management or prior appeals experience + Proven claims and coding experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $28.3-50.5 hourly 28d ago
  • Clinical Appeals RN (M&R) - Remote (M-F 8-5)

    Unitedhealth Group Inc. 4.6company rating

    Cypress, CA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims. Primary Responsibilities: * Review provider post-service appeals for Medicare and Retirement * Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines * Discuss cases with medical directors when applicable * Ability to communicate and collaborate with other teams in order to gather medical information to process cases * Communicate effectively in both verbal and written documentation * Must meet quality and productivity metrics * Ability to work independently and prioritize * Attend mandatory trainings and scheduled staff meetings * Engage in respectful and courteous team dialog via email, IM and in staff meeting You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Undergraduate degree or equivalent experience * Unrestricted, active RN license * 2+ years of RN experience in acute setting * Proven working knowledge of Clinical Criteria and CMS Guidelines/InterQual * Proven proficiency in basic computer skills * Demonstrated ability to have high speed internet installed in home for Secure Job use only * Proven designated HIPPA compliant home workspace Preferred Qualifications: * Undergraduate degree (BSN) * Proven utilization management, prior authorization, case management or prior appeals experience * Proven claims and coding experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 28d ago
  • Service Care Coordinator RN - Remote in South Austin, TX

    Unitedhealth Group Inc. 4.6company rating

    Austin, TX jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together This is a Field Based role with a Home-Based office. Must be open to traveling up to 50 miles from home office based on business need. If you are located in or within commutable driving distance from South Austin, TX, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: * Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, at least restrictive level of care * Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services * Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members * Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted Registered Nurse license in the state of Texas * 2+ years of experience working within the community health setting or in a healthcare role * Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and ability to use multiple web applications * Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service * Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) * Valid driver's license, access to reliable transportation and the ability to travel in this 'assigned region' to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices * Reside in or within commutable driving distance from South Austin, TX Preferred Qualifications: * 1+ years of experience with long-term care services and support, Medicaid or Medicare * Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations * Proven ability to create, edit, save and send documents, spreadsheets and emails * Reside in South Austin, TX * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 12d ago
  • Call Center Nurse RN, HouseCalls - Remote

    Unitedhealth Group Inc. 4.6company rating

    Columbia, MD jobs

    Optum is seeking a Call Center Nurse RN to join our HouseCalls team. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum. As a member of the broader Home and Community Care team, you'll provide annual clinical assessments to patients in the comfort of their homes. This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being. At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. The HouseCalls Clinical Support Team (HCCST) supports Advanced Practice Clinicians in the HouseCalls program by providing telephonic consultation to plan members post HouseCalls visit. This position is completely telephonic in a call center environment. Goals of the program include providing a one-time outreach to members for follow up post HouseCalls visit to provide education and clarification on any concerns raised during their HouseCalls visit. The main objective of this program is to ensure successful transition of care from the HouseCalls Advanced Practice Clinician back to the members Primary Care Provider. This team includes nurse care managers and social workers. The Nurse Care Manager (NCM) will report directly to the Manager/or Director of Clinical Operations of HCCST. The NCM interacts via telephonic consult with members and providers to assist with education and clarification on any concerns raised during the HouseCalls visit and ensure the member has/or assist in obtaining an appointment with the provider to transition care. They work to ensure members receive quality customer service by answering questions, addressing concerns, providing education, providing resource information, and entering referrals. The schedule is Monday through Friday from 9AM to 5:30PM Eastern or 9AM to 5:30PM Central respectively. Primary Responsibilities: * Perform telephonic outreach to members identified by the Advance Practice Clinician for specific referral related issues * Ensure member has scheduled appointment with Primary Care Provider (PCP)/specialty provider; help scheduling appointment, if needed * Refer members to internal departments such as Social Work, or Clinical Help Desk when appropriate * Gather clinical information telephonically from patient/family * Assist patients/members with urgent needs requiring acute intervention that arise during the call * Identify triggers for hospitalization and barriers to meeting healthcare goals as they arise during the call * Complete required documentation in compliance with auditing standards and policies * Provide patient/family education on disease process and trigger management that arise during the call or are directly related to referral reasons * Assist with connections to appropriate community resources if needed * Understand and maintain confidentiality of legal and ethical issues * Maintain compliance with all HIPAA (Health Insurance Portability and Accountability Act) regulations * Enhance the experience of both internal and external customers by providing excellent customer service while maintaining production metrics * Serve as a clinical resource and consultant for other clinicians * Attend and participate in team huddles and staff meetings * Work with Supervisor to identify system improvements that could be made to drive operational advancements and efficiencies * Provide cross-coverage support across the team and assist with special projects, as needed * Assume other duties as assigned and directed by the Supervisor or Manager of Clinical Call Center Operations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current, unrestricted Compact RN (Registered Nurse) license in the state of residence * Willing and able to obtain additional licensure in assigned states within 6 months of hire * 3+ years of clinical experience in a hospital, acute care, home health / hospice, direct care, or case management position * Computer/typing proficiency to enter and retrieve data in electronic clinical records * Proficient with Microsoft Word, Outlook, and Excel * Proven ability to communicate complex or technical information in a manner that others can understand and the ability to understand and interpret complex information from others * Proven ability to perform positively and efficiently in production driven environment * Dedicated, distraction-free space in home and access to company approved high-speed internet (Broadband Cable, DSL, Fiber) Preferred Qualifications: * Telephonic case management experience * Home care / field based case management * Medicaid, Medicare, or managed care experience * Experience working remotely from home * Experience working in a call center environment * Experience working in a metrics-driven environment * Demonstrated excellent customer service skills * Reside in the Central or Eastern time zone * Proven solid problem-solving skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $58.8k-105k yearly 1d ago
  • RN Project Director of Quality - Addictions

    Acadia Healthcare 4.0company rating

    Registered nurse med/surg job at Acadia Healthcare

    RN Director of Quality - Addictions Champion Quality. Strengthen Safety. Advance Excellence Across Behavioral Health. Acadia Healthcare's Specialty Division is seeking a Project Director of Quality (PDQ) - a mission-driven, highly skilled healthcare leader dedicated to advancing patient safety and regulatory excellence across our national network of specialty treatment centers. This vital role supports Acadia's facilities focused on substance use disorder, eating disorder, and complex mental health treatment, ensuring that each site operates with an unwavering commitment to quality, compliance, and clinical integrity. The PDQ will serve as a trusted partner to facility and division leadership, often providing on-site interim Quality leadership during vacancies, transitions, or periods of heightened regulatory activity. A Rewarding Leadership Opportunity: Acadia offers a highly competitive compensation package, including base salary, annual performance bonus, and equity eligibility, along with a comprehensive benefits suite and travel support. This is an ideal opportunity for an accomplished clinical quality professional seeking both career growth and national impact within one of the country's leading behavioral healthcare organizations. Why This Role Matters: At Acadia Healthcare, we are united by one purpose - to deliver hope and healing through exceptional care. The Project Director of Quality plays a central role in realizing that mission across the Specialty Division, ensuring that each facility consistently meets and exceeds standards of regulatory compliance, accreditation, and performance improvement. You'll be the driving force behind continuous readiness, leading initiatives that safeguard patient safety, elevate outcomes, and reinforce fidelity to Acadia's evidence-based treatment programs. Responsibilities Key Responsibilities: Serve as the on-site Director of Quality for Specialty Division facilities as needed, overseeing all aspects of regulatory readiness, accreditation, and patient safety. Lead and strengthen Quality Assurance and Performance Improvement (QAPI) programs, using data to drive measurable improvements in outcomes and care consistency. Partner with facility and division leadership to ensure compliance with Joint Commission, CARF, CMS, and state regulatory requirements. Conduct proactive audits, rounding, and assessments to identify risk and support zero-deficiency survey outcomes. Provide education, coaching, and mentoring to facility leadership and staff to build sustainable internal quality systems. Support regulatory engagement and the development and submission of Plans of Correction as required. Lead and facilitate Root Cause Analyses, safety rounding, and implementation of corrective actions. Collaborate across Acadia's Specialty Division to share best practices and promote a culture of accountability and excellence. Travel extensively (up to 80%) to provide direct, hands-on support at facilities across the U.S. Qualifications You are a seasoned healthcare quality leader who thrives in behavioral health settings - particularly those focused on substance use, eating disorders, and mental health care. You bring both the technical expertise and emotional intelligence required to lead through influence, not just authority. Registered Nurse (RN) with a Bachelor of Science in Nursing (BSN) required Master's degree (MSN, MHA, MPH, or related field) strongly preferred Proven leadership in regulatory readiness, quality improvement, and accreditation management within behavioral healthcare Deep knowledge of Joint Commission and/or CARF standards, CMS Conditions of Participation, and state licensing regulations Demonstrated success developing and executing Quality programs that improve safety, outcomes, and compliance Exceptional communication, analytical, and leadership skills Ability and willingness to travel up to 80% to facilities nationwide Join Us This is more than a traveling leadership role - it's a chance to shape the culture of quality across Acadia's Specialty Division, influencing care that is safe, effective, and transformative. Be the standard-bearer for quality. Be the difference for those we serve. Join Acadia Healthcare and help define the next standard of excellence in behavioral health. AHCORP #LI-JR1 #Remote Not ready to apply? Connect with us for general consideration.
    $22k-73k yearly est. Auto-Apply 12d ago
  • RN Clinical Director - Caretenders

    Unitedhealth Group 4.6company rating

    Columbus, OH jobs

    **$5000 Sign On Bonus for External Candidates** Explore opportunities with Caretenders, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Clinical Director, you will oversee and direct the patient care operations of the home care facility. This includes: coordinating and completing assigned projects to effectively support the immediate and long range objectives of the company; oversight of the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care; implementing and maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered. This position also acts as a liaison with management staff and other departments throughout the company. **Primary Responsibilities:** + Coordinates and completes assigned projects to effectively support the immediate and long-range objectives of the company + Oversees the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care + Implements and maintains administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations. + Enhances the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered + All CMS and state regulations must be followed regarding supervision of nursing services + If Clinical Director is not an RN, Executive Director/Administrator or Patient Care Manager must be designated as supervising RN for nursing services unless state regulations dictate otherwise You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current and unrestricted RN licensure in the state of practice or PT/OT/SLP, must have current applicable license in the state + Current CPR certification + Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation **Preferred Qualifications:** + 1+ years of supervisory and/or management experience in home health setting or related healthcare setting + Ability to manage multiple tasks simultaneously + Able to work independently + Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $46k-53k yearly est. 5d ago
  • RN Clinical Director - Caretenders

    Unitedhealth Group Inc. 4.6company rating

    Columbus, OH jobs

    $5000 Sign On Bonus for External Candidates Explore opportunities with Caretenders, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Clinical Director, you will oversee and direct the patient care operations of the home care facility. This includes: coordinating and completing assigned projects to effectively support the immediate and long range objectives of the company; oversight of the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care; implementing and maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered. This position also acts as a liaison with management staff and other departments throughout the company. Primary Responsibilities: * Coordinates and completes assigned projects to effectively support the immediate and long-range objectives of the company * Oversees the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care * Implements and maintains administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations. * Enhances the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered * All CMS and state regulations must be followed regarding supervision of nursing services * If Clinical Director is not an RN, Executive Director/Administrator or Patient Care Manager must be designated as supervising RN for nursing services unless state regulations dictate otherwise You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted RN licensure in the state of practice or PT/OT/SLP, must have current applicable license in the state * Current CPR certification * Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation Preferred Qualifications: * 1+ years of supervisory and/or management experience in home health setting or related healthcare setting * Ability to manage multiple tasks simultaneously * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $46k-53k yearly est. 5d ago

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