Utilization Review Nurse jobs at Cambia Health Solutions - 515 jobs

RN or LPN Required Are you a compassionate nurse looking for a role that offers work-life balance and the opportunity to make a meaningful impact? Join our vibrant Independent Living community, where your focus will be on wellness and connection, not high-intensity clinical care. This is a unique opportunity for a Nurse Case Manager (RN or LPN) who acts as a specialized coordinator and advocate, managing the health, wellness and care needs of our Independent Living seniors to help them maintain independence. What makes this role unique? Consistent Schedule: Enjoy a predictable Monday-Friday schedule with no weekend shifts. Light Nursing Duties: Minimal hands-on clinical care; your role emphasizes supporting independence and enhancing quality of life. Resident-Centered Support: Assist residents in connecting with services, accompany them to community doctor visits, and provide wellness education to promote healthy living. Collaborative Environment: Work alongside a dedicated team in a warm, welcoming community setting. If you're passionate about building relationships, empowering seniors, and fostering a positive lifestyle, this position is for you! Hours: 7:00am-3:30PM, Monday-Friday The RHS Nurse is primarily responsible for delivering care coordination and case management services for residents and families, as well as providing ongoing education for our Independent Living residents. This is a full-time, hourly position onsite in Wheaton, IL within our Independent Living facility. Here are a few of the daily responsibilities of an RHS Nurse: Evaluates the physical, emotional, and social needs of residents Maintains or improves independence through directing and educating residents, advising on appropriate adaptive equipment use Assess resident's cognitive and physical abilities and recommends adaptation to living environment to reduce barriers of safety and well being Assists in the orientation of new residents' adjustment to community living Maintains appropriate and complete reports, records, physicians orders, care plans, and progress notes for residents. Assures confidentiality of resident information Maintains communication with physicians, families, and appropriate staff regarding resident status Assists residents and families by Offering support in dealing logistically and emotionally with the aging process and illness Provides accurate information and timely updates to residents and families Addresses questions and concerns promptly, or identifies appropriate parties/resources to do so Assist and stimulates residents to participate in social and creative activities Assists in coordinating services for resident being admitted to and discharged from Assisted Living, Health Center, and Hospital Monitors infections and accidents of residents and notifies families and physicians when appropriate Monitors private duty personnel in accordance with community policies and procedure, coordinates care with agency representatives Responds with urgency to emergent health issues of our residents Here are a few of the qualifications we need you to have: Minimum two years clinical or case management experience with elderly population strongly preferred Current Registered Nurse or Licensed Practical Nurse with active license by State of Illinois Current CPR/BLS certificate Comprehensive understanding of the English Language; must be able to read, write, and communicate in English Physical Requirements Able to walk long distances 50% of the work day Must be able to lift and carry up to 30 lbs Must be able to push a wheelchair occupied by a resident weighing up to 200 lbs. independently Must be able to safely respond to emergent situations throughout the entire Independent Living building What we offer: Up to 21 days per year of PTO Insurance: Medical, Dental, Vision Employee Assistance Program Compensation: $32-35 per hour based on experience #Clinical If you're an enthusiastic, compassionate, senior care professional who is passionate about hospitality and senior engagement- please apply, we'd love to get to know you! EEO Employer

RN or LPN Required Are you a compassionate nurse looking for a role that offers work-life balance and the opportunity to make a meaningful impact? Join our vibrant Independent Living community, where your focus will be on wellness and connection, not high-intensity clinical care. This is a unique opportunity for a Nurse Case Manager (RN or LPN) who acts as a specialized coordinator and advocate, managing the health, wellness and care needs of our Independent Living seniors to help them maintain independence. What makes this role unique? Consistent Schedule: Enjoy a predictable Monday-Friday schedule with no weekend shifts. Light Nursing Duties: Minimal hands-on clinical care; your role emphasizes supporting independence and enhancing quality of life. Resident-Centered Support: Assist residents in connecting with services, accompany them to community doctor visits, and provide wellness education to promote healthy living. Collaborative Environment: Work alongside a dedicated team in a warm, welcoming community setting. If you're passionate about building relationships, empowering seniors, and fostering a positive lifestyle, this position is for you! Hours: 7:00am-3:30PM, Monday-Friday The RHS Nurse is primarily responsible for delivering care coordination and case management services for residents and families, as well as providing ongoing education for our Independent Living residents. This is a full-time, hourly position onsite in Wheaton, IL within our Independent Living facility. Here are a few of the daily responsibilities of an RHS Nurse: Evaluates the physical, emotional, and social needs of residents Maintains or improves independence through directing and educating residents, advising on appropriate adaptive equipment use Assess resident's cognitive and physical abilities and recommends adaptation to living environment to reduce barriers of safety and well being Assists in the orientation of new residents' adjustment to community living Maintains appropriate and complete reports, records, physicians orders, care plans, and progress notes for residents. Assures confidentiality of resident information Maintains communication with physicians, families, and appropriate staff regarding resident status Assists residents and families by Offering support in dealing logistically and emotionally with the aging process and illness Provides accurate information and timely updates to residents and families Addresses questions and concerns promptly, or identifies appropriate parties/resources to do so Assist and stimulates residents to participate in social and creative activities Assists in coordinating services for resident being admitted to and discharged from Assisted Living, Health Center, and Hospital Monitors infections and accidents of residents and notifies families and physicians when appropriate Monitors private duty personnel in accordance with community policies and procedure, coordinates care with agency representatives Responds with urgency to emergent health issues of our residents Here are a few of the qualifications we need you to have: Minimum two years clinical or case management experience with elderly population strongly preferred Current Registered Nurse or Licensed Practical Nurse with active license by State of Illinois Current CPR/BLS certificate Comprehensive understanding of the English Language; must be able to read, write, and communicate in English Physical Requirements Able to walk long distances 50% of the work day Must be able to lift and carry up to 30 lbs Must be able to push a wheelchair occupied by a resident weighing up to 200 lbs. independently Must be able to safely respond to emergent situations throughout the entire Independent Living building What we offer: Up to 21 days per year of PTO Insurance: Medical, Dental, Vision Employee Assistance Program Compensation: $32-35 per hour based on experience #Clinical If you're an enthusiastic, compassionate, senior care professional who is passionate about hospitality and senior engagement- please apply, we'd love to get to know you! EEO Employer

RN or LPN Required Are you a compassionate nurse looking for a role that offers work-life balance and the opportunity to make a meaningful impact? Join our vibrant Independent Living community, where your focus will be on wellness and connection, not high-intensity clinical care. This is a unique opportunity for a Nurse Case Manager (RN or LPN) who acts as a specialized coordinator and advocate, managing the health, wellness and care needs of our Independent Living seniors to help them maintain independence. What makes this role unique? Consistent Schedule: Enjoy a predictable Monday-Friday schedule with no weekend shifts. Light Nursing Duties: Minimal hands-on clinical care; your role emphasizes supporting independence and enhancing quality of life. Resident-Centered Support: Assist residents in connecting with services, accompany them to community doctor visits, and provide wellness education to promote healthy living. Collaborative Environment: Work alongside a dedicated team in a warm, welcoming community setting. If you're passionate about building relationships, empowering seniors, and fostering a positive lifestyle, this position is for you! Hours: 7:00am-3:30PM, Monday-Friday The RHS Nurse is primarily responsible for delivering care coordination and case management services for residents and families, as well as providing ongoing education for our Independent Living residents. This is a full-time, hourly position onsite in Wheaton, IL within our Independent Living facility. Here are a few of the daily responsibilities of an RHS Nurse: Evaluates the physical, emotional, and social needs of residents Maintains or improves independence through directing and educating residents, advising on appropriate adaptive equipment use Assess resident's cognitive and physical abilities and recommends adaptation to living environment to reduce barriers of safety and well being Assists in the orientation of new residents' adjustment to community living Maintains appropriate and complete reports, records, physicians orders, care plans, and progress notes for residents. Assures confidentiality of resident information Maintains communication with physicians, families, and appropriate staff regarding resident status Assists residents and families by Offering support in dealing logistically and emotionally with the aging process and illness Provides accurate information and timely updates to residents and families Addresses questions and concerns promptly, or identifies appropriate parties/resources to do so Assist and stimulates residents to participate in social and creative activities Assists in coordinating services for resident being admitted to and discharged from Assisted Living, Health Center, and Hospital Monitors infections and accidents of residents and notifies families and physicians when appropriate Monitors private duty personnel in accordance with community policies and procedure, coordinates care with agency representatives Responds with urgency to emergent health issues of our residents Here are a few of the qualifications we need you to have: Minimum two years clinical or case management experience with elderly population strongly preferred Current Registered Nurse or Licensed Practical Nurse with active license by State of Illinois Current CPR/BLS certificate Comprehensive understanding of the English Language; must be able to read, write, and communicate in English Physical Requirements Able to walk long distances 50% of the work day Must be able to lift and carry up to 30 lbs Must be able to push a wheelchair occupied by a resident weighing up to 200 lbs. independently Must be able to safely respond to emergent situations throughout the entire Independent Living building What we offer: Up to 21 days per year of PTO Insurance: Medical, Dental, Vision Employee Assistance Program Compensation: $32-35 per hour based on experience #Clinical If you're an enthusiastic, compassionate, senior care professional who is passionate about hospitality and senior engagement- please apply, we'd love to get to know you! EEO Employer

Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB SUMMARY: As a member of the Utilization Management Team, the UR Coordinator helps establish and maintain efficient methods of ensuring the medical necessity and appropriateness of hospital admissions and extended stays. The Utilization Management Team directs the program in accordance with Mountain View Hospital's mission and strategic goals. The Utilization Management Team directs those activities within the facility which monitor adherence to the hospital's utilization review plan. The goal of Utilization Management is to continuously improve effective use of hospital services through monitoring patient admissions and stays. About Mountain View: Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley - all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice. Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply. BENEFITS: Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include: Medical, Dental and Vision Insurance Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off Retirement Plans (401K with up to 6% match) Earned Quarterly Bonus Program Education Reimbursement Program Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital Please note benefits are based on eligibility according to full-time, part-time or PRN status classification. Qualifications Education/Certification: High School Diploma or equivalent. Coding certificate completion is required within 1 year of employment Experience: Background in medical terminology is helpful. Medical coding and/or insurance experience preferred, however coding certification will be required with in one calendar year of employment

* Currently licensed in Idaho as a Registered Nurse (RN) * Ability to analyze and use health information to make informed decisions and recommendations * At least two years of nursing experience related to case management, long-term care, or care of older adults or people who are living with significant physical and developmental disabilities * Computer proficiency and solid writing skills Knowledge of IDAPA regulations and criteria for Intense Support Services is helpful. Liberty Healthcare is an equal opportunity employer committed to diversity, equity, and inclusion. Our organization is composed of, and proudly serves, people of diverse backgrounds and abilities. Click "Apply" and submit your resume for immediate consideration.

The Review Services Coordinator is a critical role in adjudicating pre-authorization coverage requests for all types of services - medical and DME. The work environment is fast paced and at many times complex. Knowledge of health plan functions is required and include reading and interpreting contracts and coverage and understanding claims payment. This role includes handling a high volume of incoming calls from members and providers, managing multiple requests simultaneously and accurately and easily identifying requests that require a higher level of clinical review. This position must have a strong knowledge of medical terminology, CPT, HCPC and ICD coding as well as strong computer skills. This position requires that all CMS, State and Federal compliance and regulatory requirements be met. Essential Responsibilities: Adjudicate pre-authorization requests for all services - medical & DME. Determine urgency of request based on information provided. Enter & process selected patient medical information into the Referral Management System (RMS) to produce the authorization. Receive and process incoming phone calls from members, providers and internal KFHPW departments. Perfom and research complex issues related to authorization denials, delays and claims related issues. Ability to get to the root cause of an issue and provide a accurate, concise explanation to the member, provider and/or internal KFHPW department. Other duties as assigned (eWatson, training, JIVA, Ring of Defense) Click here for Important Additional Job Requirements. Share this job with a friend You may also share this job description with a friend by email or social media. All the relevant details will be included in the message. Click the button labeled that is next to Submit. Basic Qualifications: Experience Minimum two (2) years of health care experience with emphasis in health insurance including pre-authorizations, benefits/eligibility, and billing. Minimum two (2) years of experience with online computer systems and Microsoft Office. Minimum one (1) year of phone customer service experience. Education High School Diploma or General Education Development (GED) required. License, Certification, Registration N/A Additional Requirements: Medicare and strong communication skills. Computer skills in Windows environment, including MS Word and Excel. Kaiser Foundation Health Plan of Washington applications. Communication and interpersonal skills. Working knowledge of Health Plan benefits and policies. Basic understanding of Medicare regulations, particularly those pertaining to the provision of Part B services. Working with the public with emphasis on problem solving and conflict resolution. Preferred Qualifications: Kaiser Foundation Health Plan of Washington (KFHPW) work experience. Experience with health plan contracts & coverage. Health plan claims experience. Medical coding experience with ICD-9/10, CPT and HCPCS. Some college courses preferred.

JOB TITLE: UTILIZATION REVIEW/CASE MANAGEMENT - Nurse DEPARTMENT: CASE MANAGEMENT (QUALITY) The Utilization Review/Case Management Nurse is directly responsible for review of patient admissions for severity of illness and intensity of service to ensure appropriate level of stay and effective discharge planning is provided. Working closely with the Medical Staff and Nursing units in this effort, effective and efficient utilization is accomplished. Additionally, working with multi-disciplinary teams ensures safe transitions of care. GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENT To provide personalized, professional healthcare services to the residents of the Communities we serve. PRINCIPLE DUTIES AND RESPONSIBILITIES 1. Coordinate and facilitate patient progression throughout the continuum to achieve desired outcomes and organizational goals while promoting continuity of care, collaborative practice and appropriate utilization of resources. 2. Monitors review on all patient admissions to determine the appropriateness of hospitalization. 3. Collects and records necessary information of admission for review. 4. Meet with identified patients/families to assess needs and develop an individualized discharge plan, collaborating and communicating with the interdisciplinary team in all phases of the discharge planning process. 5. Conduct appropriate reviews and discusses payer criteria and issues on a case-by-case basis with clinical staff. 6. Demonstrates working knowledge of contractual arrangements and fiscal accountability as it relates to appropriate application of Utilization Management program. 7. Provides concurrent reviews of all admissions to determine change of diagnosis, symptoms, problems, patient condition, treatment scheduled, admission status, barriers to care, and facilitates safe transition to home or extended care facility. 8. Communicates with variety agencies both governmental and private to facilitate safe transitions of care, provide justification of admission, and provide continued length of stay based on Severity of Illness/Intensity of Service criteria, IntraQual &/or MCG Criteria. 9. Initiate and facilitate referral for home health, hospice, durable medical equipment & supplies, nursing home placement, and Swing Bed placement & provides accurate documentation. 10. Maintains knowledge of current trends and developments by reading literature and attending appropriate seminars, inservices, or conferences. 11. Facilitates discharge planning and interdisciplinary healthcare conferences to communicate potential discharge needs. 12. Assists and is involved in the Gibson Area Hospital's continuous quality improvement efforts designed to enhance patient outcomes, increase patient satisfaction, and improve the utilization to the Gibson Area Hospital's human capital and physical resources. 13. Maintains confidentiality of patient information and patient privacy. 14. Other duties as assigned. Qualifications PHYSICAL REQUIREMENTS 1. Physical strength to perform the following lifting tasks: • Floor to waist - 40 pounds • 14” to waist - 50 pounds • Waist to shoulder - 20 pounds • Shoulder to overhead - 10 pounds • Carry 40 pounds for 30 feet • Push 40 pounds/force for 30 feet • Pull 40 pounds/force for 10 feet 2. Work requires the ability to lift and carry files on a daily basis. 3. Work requires the ability to stand up to one hour at a time. 4. Work requires communication abilities necessary to assess patient's condition and interact with physicians and exchange information with care providers and others on a daily basis, including ability to use telephone. 5. Work requires proofreading and checking documents for accuracy on a daily basis. 6. Work requires ability to use a keyboard to enter and transform words or data on a daily basis. Ability to communicate in writing. 7. Visual acuity necessary to observe patient, obtain information, and use documentation. 8. Auditory acuity necessary to hear patient/family/staff for the purpose of communication. REPORTING RELATIONSHIP Director of Quality and Case Management. EDUCATION, KNOWLEDGE AND ABILITIES REQUIRED 1. Knowledge and skills necessary to provide utilization and case management of patient care units appropriate to the age of the patient served including infant, pediatric, adult, and geriatric. 2. Knowledge of utilization review interventions and overall understanding of compliance with Severity of Illness and Intensity of Service criteria & IntralQual/MCG Criteria. 3. Knowledge of utilization policies, procedures, area of resources, and state and federal regulation. 4. Advanced communication skills are required to interact with patients/families, healthcare providers, and outside agencies. 5. Registered Nurse with at least two years clinical experience preferred. 6. Emotional stability to deal with high stress level associated with working with acutely ill patients and maintaining effective working relationships with peers and physicians. 7. Keen mental functions to perform assessment and decision making skills in the management of utilization of the units in the hospital. 8. BLS certification required. INFECTION EXPOSURE RISK LEVEL Category 2- Low Risk Position contains tasks that involve no exposure to blood, body fluids, or tissue, but employment may require performing unplanned tasks that do involve exposure. WORKING CONDITIONS 1. Works in a normal office or patient care environments where there are relatively few discomforts due to dust, dirt, noise, and the like. 2. Works with patients and may be exposed to contagious diseases of infectious material, but potential for person harm and injury is limited when proper safety and health precautions and equipment are used.

Shift: 12pm - 12am Performs clinical review of patient records to evaluate the utilization of acute care services. Communicates to third party payors to support the medical necessity of the hospital admission for services reimbursement. Ensures the patient care team is aware of general length of stay requirements for all patients. Facilitates physician documentation through concurrent interaction with physicians to support reimbursement and clinical severity is captured for the service rendered to patients receiving hospital care. Provides clinical knowledge and data collection for quality improvement initiatives. Optimizes reimbursement for acute care services. This is NOT a remote position. Qualifications Education: Associates Degree in Nursing. Bachelor's Degree in Nursing preferred. Evidence of continuing professional development Licensure/Certification/Registry: Current RN licensure in the State of Illinois required Experience: Minimum of 3- 5 years of recent acute care and/or home health nursing or case management experience required. Previous utilization review experience strongly preferred. Other Knowledge/Skills/Abilities: Understanding of healthcare reimbursement mechanisms preferred. Strong oral and written communication skills. Demonstrated adaptability to changes in health care environment with proactive problem solving attitudes Understanding of the principles of performance improvement, team collaboration, and conflict resolution Not ready to apply? Connect with us for general consideration.

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experience skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. Must have DON or Regional Nurse experience in Skilled Nursing $140,000 - $160,000 Full-time are eligible for: * 401K * Medical, Dental & Vision * FSA & Dependent Care FSA * Life Insurance * AD&D, Long Term Disability, Short Term Disability * Critical Illness, Accident, Hospital Indemnity * Legal Benefits, Identity Theft Protection * Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. * Resident Assessment/Care Plan Development * Delivery of Resident Care * Facility Support * Supervision * Customer Service * Residents' Rights * Resident Comfort and Safety * Pharmacy Knowledge * Lab Values * Infection Control * Continuing Education Qualifications * Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. * Understanding of CMS regulations and experience with the survey process. * A current, active license to practice as a Registered Nurse (RN) * Ability to travel to assignments. * Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. * Demonstrate working knowledge of infection control principles and practices. * Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. * Proven ability to communicate effectively and positively with staff, residents and family members. * Basic understanding of computer technology. * Proven written and oral communication skills. * Proven decision-making and analytical skills. * Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to **************************.

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experience skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. **Must have DON or Regional Nurse experience in Skilled Nursing** $140,000 - $160,000 Full-time are eligible for: 401K Medical, Dental & Vision FSA & Dependent Care FSA Life Insurance AD&D, Long Term Disability, Short Term Disability Critical Illness, Accident, Hospital Indemnity Legal Benefits, Identity Theft Protection Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. Resident Assessment/Care Plan Development Delivery of Resident Care Facility Support Supervision Customer Service Residents' Rights Resident Comfort and Safety Pharmacy Knowledge Lab Values Infection Control Continuing Education Qualifications Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. Understanding of CMS regulations and experience with the survey process. A current, active license to practice as a Registered Nurse (RN) Ability to travel to assignments. Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. Demonstrate working knowledge of infection control principles and practices. Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. Proven ability to communicate effectively and positively with staff, residents and family members. Basic understanding of computer technology. Proven written and oral communication skills. Proven decision-making and analytical skills. Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to ************************** .

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experienced skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. Must have DON or Regional Nurse experience in Skilled Nursing This position is in Washington State $140,000 - $160,000 Full-time are eligible for: * 401K * Medical, Dental & Vision * FSA & Dependent Care FSA * Life Insurance * AD&D, Long Term Disability, Short Term Disability * Critical Illness, Accident, Hospital Indemnity * Legal Benefits, Identity Theft Protection * Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. * Resident Assessment/Care Plan Development * Delivery of Resident Care * Facility Support * Supervision * Customer Service * Residents' Rights * Resident Comfort and Safety * Pharmacy Knowledge * Lab Values * Infection Control * Continuing Education Qualifications * Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. * Understanding of CMS regulations and experience with the survey process. * A current, active license to practice as a Registered Nurse (RN) * Ability to travel to assignments. * Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. * Demonstrate working knowledge of infection control principles and practices. * Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. * Proven ability to communicate effectively and positively with staff, residents and family members. * Basic understanding of computer technology. * Proven written and oral communication skills. * Proven decision-making and analytical skills. * Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to **************************.

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experience skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. Must have Previous DON or Regional Nurse experience in the Skilled Nursing industry $130,000 - $160,000 Full-time are eligible for: * 401K * Medical, Dental & Vision * FSA & Dependent Care FSA * Life Insurance * AD&D, Long Term Disability, Short Term Disability * Critical Illness, Accident, Hospital Indemnity * Legal Benefits, Identity Theft Protection * Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. * Resident Assessment/Care Plan Development * Delivery of Resident Care * Facility Support * Supervision * Customer Service * Residents' Rights * Resident Comfort and Safety * Pharmacy Knowledge * Lab Values * Infection Control * Continuing Education Qualifications * Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. * Understanding of CMS regulations and experience with the survey process. * A current, active license to practice as a Registered Nurse (RN) * Ability to travel to assignments. * Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. * Demonstrate working knowledge of infection control principles and practices. * Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. * Proven ability to communicate effectively and positively with staff, residents and family members. * Basic understanding of computer technology. * Proven written and oral communication skills. * Proven decision-making and analytical skills. * Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to **************************.

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experience skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. Must have Previous DON or Regional Nurse experience in the Skilled Nursing industry $130,000 - $160,000 Full-time are eligible for: 401K Medical, Dental & Vision FSA & Dependent Care FSA Life Insurance AD&D, Long Term Disability, Short Term Disability Critical Illness, Accident, Hospital Indemnity Legal Benefits, Identity Theft Protection Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. Resident Assessment/Care Plan Development Delivery of Resident Care Facility Support Supervision Customer Service Residents' Rights Resident Comfort and Safety Pharmacy Knowledge Lab Values Infection Control Continuing Education Qualifications Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. Understanding of CMS regulations and experience with the survey process. A current, active license to practice as a Registered Nurse (RN) Ability to travel to assignments. Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. Demonstrate working knowledge of infection control principles and practices. Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. Proven ability to communicate effectively and positively with staff, residents and family members. Basic understanding of computer technology. Proven written and oral communication skills. Proven decision-making and analytical skills. Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to ************************** .

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experienced skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. **Must have DON or Regional Nurse experience in Skilled Nursing** This position is in Washington State $140,000 - $160,000 Full-time are eligible for: 401K Medical, Dental & Vision FSA & Dependent Care FSA Life Insurance AD&D, Long Term Disability, Short Term Disability Critical Illness, Accident, Hospital Indemnity Legal Benefits, Identity Theft Protection Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. Resident Assessment/Care Plan Development Delivery of Resident Care Facility Support Supervision Customer Service Residents' Rights Resident Comfort and Safety Pharmacy Knowledge Lab Values Infection Control Continuing Education Qualifications Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. Understanding of CMS regulations and experience with the survey process. A current, active license to practice as a Registered Nurse (RN) Ability to travel to assignments. Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. Demonstrate working knowledge of infection control principles and practices. Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. Proven ability to communicate effectively and positively with staff, residents and family members. Basic understanding of computer technology. Proven written and oral communication skills. Proven decision-making and analytical skills. Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to ************************** .

Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experience skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. **Must have DON or Regional Nurse experience in Skilled Nursing** Starting at $130,000 /yr Full-time are eligible for: 401K Medical, Dental & Vision FSA & Dependent Care FSA Life Insurance AD&D, Long Term Disability, Short Term Disability Critical Illness, Accident, Hospital Indemnity Legal Benefits, Identity Theft Protection Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. Resident Assessment/Care Plan Development Delivery of Resident Care Facility Support Supervision Customer Service Residents' Rights Resident Comfort and Safety Pharmacy Knowledge Lab Values Infection Control Continuing Education Qualifications Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. Understanding of CMS regulations and experience with the survey process. A current, active license to practice as a Registered Nurse (RN) Ability to travel to assignments. Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. Demonstrate working knowledge of infection control principles and practices. Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. Proven ability to communicate effectively and positively with staff, residents and family members. Basic understanding of computer technology. Proven written and oral communication skills. Proven decision-making and analytical skills. Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to ************************** .

We are seeking a highly motivated, qualified Illinois registered nurse to join our team as a Regional Nurse Consultant. The responsibilities of this position are to guide our Skilled Nursing Facilities to achieve optimal regulatory and quality outcomes. The Regional Nurse Consultant will be assigned to support communities in Illinois. Benefits: Competitive compensation DailyPay Paid time off Paid holidays Health insurance for full-time employees Dental insurance for full-time employees Vision insurance for full-time employees Employer-paid life insurance for full-time employees Employee assistance program Voluntary benefit plans offered to full- and part-time employees Retirement plan Wellness program Free continuing education through Relias Great team to work alongside * Further benefit details listed on total rewards guide Qualifications: Current and valid RN license for the state of Illinois Must have at least two years of nursing experience, preferably in long-term, assisted and/or supportive living care with leadership and management experience Previous multi-community oversight preferred Travel is required and may be 60 miles or greater Must be charismatic, energetic, and people-oriented Excellent communication and customer service skills Good working knowledge of computers

Full-time Description Join us at the Nexus of care and compassion. Regional Nurse Consultant Benefits: Employee rewards program BCBS healthcare coverage 401k PTO package and paid holidays Team-oriented work environment Regional Nurse Consultant Responsibilities: As a Regional Nurse Consultant, you will responsible for regulatory requirements, programs, processes, and outcomes in your facilities. You will develop and implement nursing policies, standards, and practices. You will responsible for nursing strategic planning. You will oversee proper nursing department budgeting across facilities. You will review facility level master schedules. You will oversee survey management. Requirements Regional Nurse Consultant Qualifications: Registered Nurse in the State of Illinois in good standing Master's degree in nursing, preferred 5 years of nursing leadership experience at the corporate level Minimum of 10 years as a Registered Nurse Experience overseeing large nursing teams At least 5 years in LTC and knowledge of LTC regulations keywords: chief of nursing services, skilled nursing finance, registered nurse, rn Salary Description $140000 - $150000 / per year

Case Manager / Admissions Nurse (RN or LPN) Location: Martha & Mary Status: Exempt | Full-Time Pay Range: $85,000 - $95,000 annually depending on applicable experience About Martha & Mary At Martha & Mary, we are called to bridge generations and enrich lives. Our team is committed to providing compassionate, coordinated, and high-quality care to those we serve. If you are a skilled nurse with a passion for care coordination, advocacy, and collaboration, we invite you to join our mission-driven organization. Position Summary The Case Manager / Admissions Nurse oversees, manages, and coordinates the care experience for residents and patients from admission through discharge. Serving as the primary point of contact for care coordination, this role ensures seamless communication across interdisciplinary teams, external providers, residents, and families. The Case Manager plays a critical role in utilization management, discharge planning, quality outcomes, and patient advocacy while also providing leadership and oversight to licensed nursing staff and NACs. This position functions as an exempt role and requires flexibility to meet the needs of residents and patients. Key Responsibilities Care Coordination & Clinical Oversight Coordinate and integrate case management and social service functions into individualized plans of care and discharge planning. Conduct medical record reviews, utilization reviews, and quality assessments from admission through discharge. Oversee direct provision of care and ensure evidence-based practices are delivered. Conduct Care Conferences, Warm Handovers, interdisciplinary rounds, and family conferences. Assist with admission assessments, orders, and paperwork per DNS direction. Coordinate admissions, discharges, transfers, and bed management with nursing leadership and admissions teams. Communicate with primary care providers, hospital partners, and external specialists throughout the resident stay. Initiate and present NOMNOC (denial) letters as appropriate. Collaboration & Communication Work closely with internal partners including Nursing Leadership, Social Work, Rehab Services, MDS, HIM, A/R, Therapists, and Operations. Collaborate with external stakeholders such as family members, hospitals, discharge planners, HMOs, physicians, home health agencies, and other providers. Serve as a resident and patient advocate, ensuring informed decision-making and family education. Utilization, Compliance & Quality Monitor RUG utilization, PDPM outcomes, and appropriate service use. Conduct reviews related to falls, wounds, medication errors, readmissions, pharmacy discrepancies, and other quality indicators. Ensure appropriate testing, timely results, and adherence to regulatory and payer requirements. Participate in weekly Case Management meetings and continuous quality improvement initiatives. Leadership & Supervision Provide day-to-day leadership, guidance, and supervision to Licensed Nurses and NACs. Participate in hiring, performance management, coaching, and employee development in alignment with organizational values. Troubleshoot care concerns, complaints, and conflicts, escalating to DNS or Operations leadership as needed. Additional Duties Perform medication destruction and disposal oversight. Assist nursing staff with care activities as needed. Perform all regular RN or LPN duties per licensure and job description. General Expectations Support and uphold Martha & Mary's mission, vision, and values. Maintain confidentiality and professionalism at all times. Demonstrate reliability, flexibility, and strong teamwork. Manage multiple priorities in a fast-paced, changing environment. Approach challenges with initiative, diplomacy, and a sense of humor. Exhibit a genuine interest in caring for the elderly and long-term care residents. Required Qualifications Education Associate Degree required Bachelor's Degree preferred Licensure Current RN or LPN license in the State of Washington (required) Experience Sub-acute care or Skilled Nursing experience preferred Knowledge, Skills & Abilities Strong knowledge of Medicare, HMO contracts, MDS, PDPM utilization, and evidence-based practices Exceptional communication and customer service skills Highly organized with strong documentation abilities Ability to collaborate effectively with interdisciplinary teams Proficiency with MS Office Suite and healthcare systems including Answers on Demand, ADP, DocSTAR, FaxCORE, and mobile technology Ability to safely use medical devices and equipment Why Join Martha & Mary? Mission-driven, values-based culture Collaborative interdisciplinary team environment Opportunity to make a meaningful impact on resident and family experiences Competitive compensation and comprehensive benefits Benefits: Martha & Mary offers fair wages, competitive benefits and supportive work environments, where we become friends and family. We invite you to apply and become a part of one of Kitsap County's largest not-for profit employers. The following benefits/compensation are offered at Martha & Mary. Paid Time Off (PTO) is accrued at varying rates depending on length of employment. Accrual rates begin at 5.32 hours per month based on a 40-hour workweek. These accruals include the required sick leave per Washington State's Paid Sick Leave Law 40% discount on child care services while working Comprehensive benefit package after 60 days to include medical, dental, vision and life insurance options for full time employees. Career advancement opportunities across multiple sites and departments 403(b) Retirement Savings Plan is available immediately upon hire 6 Paid Holidays Employee Assistance and Counseling for life's challenges outside of the workplace Cell phone, Health Club and Auto service discounts And much more Martha & Mary employee benefits and wages offered are reviewed annually and are intended to be fair, beneficial and competitive in today's market whether just entering our workforce or nearing retirement. Benefit offerings are based on employment status. Salary ranges, benefits and other compensation are subject to change. Martha & Mary is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job DescriptionDescription: Join us at the Nexus of care and compassion. Regional Nurse Consultant Benefits: Employee rewards program BCBS healthcare coverage 401k PTO package and paid holidays Team-oriented work environment Regional Nurse Consultant Responsibilities: As a Regional Nurse Consultant, you will responsible for regulatory requirements, programs, processes, and outcomes in your facilities. You will develop and implement nursing policies, standards, and practices. You will responsible for nursing strategic planning. You will oversee proper nursing department budgeting across facilities. You will review facility level master schedules. You will oversee survey management. Requirements: Regional Nurse Consultant Qualifications: Registered Nurse in the State of Illinois in good standing Master's degree in nursing, preferred 5 years of nursing leadership experience at the corporate level Minimum of 10 years as a Registered Nurse Experience overseeing large nursing teams At least 5 years in LTC and knowledge of LTC regulations keywords: chief of nursing services, skilled nursing finance, registered nurse, rn