Home care nurse work from home jobs - 365 jobs

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position provides general nursing care to patients and families along the health illness continuum in diverse health care settings while collaborating with the health care team. He/She is accountable for the practice of nursing as defined by the Ohio Board of Nursing. Responsibilities And Duties: Assessment/Diagnosis - Performs initial, ongoing, and functional health status assessment as applicable to the population and or individual (30%). Outcomes Identification/Planning - Based on nursing diagnoses and collaborative problems, documents planned nursing interventions to achieve outcomes appropriate to patient needs (30%). Implementation/Evaluation - Evaluates and documents response to nursing interventions and achievement of outcomes at appropriately determined intervals; as part of a multidisciplinary team, revises plan of care based on evaluative data (20%). Leadership - Actively participates in process improvement activities to achieve targeted measures of clinical quality, customer satisfaction, and financial performance (10%). Operations (10%). As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties. The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time. Minimum Qualifications: BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing Additional Job Description: State Driver's License. RN - Registered Nurse BLS - Basic Life Support CPR - Cardiopulmonary Resuscitation Field of Study: Nursing Years of Experience 0 Work Shift: Night Scheduled Weekly Hours : 36 Department Medical Unit 3 Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment

A healthcare provider group is seeking a Clinical Educator NP/PA & Travel Nurse to enhance patient outcomes through education and clinical coverage. This role requires a strong background in Physiatry, a passion for teaching, and the ability to travel nationwide. The competitive compensation includes a salary of $155,000-$185,000, full benefits, and comprehensive travel support. Located remotely with necessary metropolitan area constraints, candidates must be residing in specified locales. #J-18808-Ljbffr

is remote - candidate must reside in the tri-state area (PA, DE, NJ) Must have an active PA license or a Nurse Licensure Compact to include PA. The Care Management Coordinator primary responsibility is to evaluate a member's clinical condition through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient's services based on advanced knowledge and independent analysis of those medical records and application of appropriate medical necessity criteria. If necessary, the Care Management Coordinator directly interact with providers to obtain additional clinical information. The Care Management Coordinator has the authority to commit the company financially by independently authorizing services determined to be medically necessary based on their personal review. For those cases that do not meet established criteria, the Care Management Coordinator provides relevant information regarding members medical condition to the Medical Director for their further review and evaluation. The Care Management Coordinator has the authority to approve but cannot deny the care for patients. The Care Management Coordinator is also responsible for maintaining regulatory compliance with federal, state and accreditation regulations. Additionally, the Care Management Coordinator acts a patient advocate and a resource for members when accessing and navigating the health care system. Key Responsibilities: Utilizes the medical criteria of InterQual and/or Medical Policy to establish the need for inpatient, continued stay and length of stay, procedures and ancillary services. Note: InterQual - It is the policy of the Medical Affairs Utilization Management (UM) Department to use InterQual (IQ) criteria for the case review process when required. IQ criteria are objective clinical statements that assist in determining the medical appropriateness of a proposed intervention which is a combination of evidence-based standards of care, current practices, and consensus from licensed specialists and/or primary care physicians. IQ criteria are used as a screening tool to support a clinical rationale for decision making. Contacts servicing providers regarding treatment plans/plan of care and clarifies medical need for services. Reviews treatment plans/plan of care with provider for requested services/procedures, inpatient admissions or continued stay, clarifying medical information with provider if needed. Identifies and refers cases in which the plan of care/services are not meeting established criteria to the Medical Director for further evaluation determination. Performs early identification of members to evaluate discharge planning needs. Collaborates with case management staff or physician to determine alternative setting at times and provide support to facilitate discharge to the most appropriate setting. Reports potential utilization issues or trends to designated manager and recommendations for improvement. Appropriately refers cases to Case and Disease Management. Ensures request is covered within the member's benefit plan. Ensures utilization decisions are compliant with state, federal and accreditation regulations. Meets or exceeds regulatory turnaround time and departmental productivity goals when processing referral/authorization requests. Ensures that all key functions are documented via Care Management and Coordination Policy. Maintains the integrity of the system information by timely, accurate data entry. Performs additional duties assigned. Education: Active PA Licensed RN BSN Preferred Experience: Minimum of three (3) years of Neonatal Intensive Care clinical experience in a hospital or other health care setting. Prior discharge planning and/or utilization management experience is desirable. Medical management/precertification experience preferred. Knowledge, & Skills: Exceptional communication, problem solving, and interpersonal skills. Action oriented with strong ability to set priorities and obtain results. Team Player - builds team spirit and interdepartmental rapport, using effective problem solving and motivational strategy. Open to change, comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable. Embrace the diversity of our workforce and show respect for our colleagues internally and externally. Excellent organizational planning and prioritizing skills. Ability to effectively utilize time management. Oriented in current trends of medical practice. Proficiency utilizing Microsoft Word, Outlook, Excel, SharePoint, and Adobe programs. Ability to learn new systems as technology advances. Please apply with your interest. You may also reach out to me Thank you, Ashu

Job Description Come for the Flexibility, Stay for the Culture A variety of soft skills and experience may be required for the following role Please ensure you check the overview below carefully. BAYADA Home Health Care was founded on the principle that health care gets better when clients get better care at home-the place they most want to be. Delivering care is our highest priority and greatest joy. We care for people of all ages, diagnoses, and acuity levels, giving you the chance to explore and put your skills to work. Many clients require advanced care such as tracheostomy and ventilator management. We offer paid training to prepare you for the unique and rewarding environment you will provide care in, prioritizing your skillset confidence and knowledge. We are looking for nurses to help take care of our infant and pediatric trach and vent clients near Browns Mills, NJ. Training is offered for pediatrics and for pediatric trach and vent. Apply today to develop your skills to high-acuity, hospital-level care, in the home setting. BAYADA Offers Our RNs: One on one care Electronic documentation In-depth paid training and shadowing with award-winning simulation labs Short commute times - we match you with cases near your home 24/7 on call clinical support Available RN Shifts: 8-hour shifts 1st or 3rd shift PRN, Part-Time, or Full-Time RN Field Benefits Include: Weekly pay every Thursday PTO & sick time Medical, Dental, and Vision benefits Company-paid life insurance Employee Assistance Program Public Service Loan Forgiveness Partner 401K Preventive Care Coverage for ALL employees (PRN included) Pay: $34 to $36 per hour Apply now to join our team! NER-SJ-RX As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates. BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here. BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities. xevrcyc Remote working/work at home options are available for this role.

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: uhgbenefits 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.

HealthPartners is looking for a Certified Adult/Geriatric or Family Nurse Practitioner to join our Home-Based Medicine Team. Being a part of our team means you will have an impact on the care that our patients receive every day. As a Home-Based Medicine Nurse Practitioner/Care Coordinator, you will be part of the largest multi-specialty care system in the Twin Cities. This position will provide both telehealth and fieldwork with seeing patients in their homes. Local travel required. This individual will provide the primary health care for patients at home. Provide care coordination to achieve patient centered, high quality and cost-effective care across the continuum Provide nursing leadership in defining and achieving program goals in a changing healthcare environment Utilizes principals of quality of life, maintenance of optimal function and the patient's advanced directives in developing plan of care Supportive, patient-centered practice MN RN and APRN licensure required along with prescriptive authority Home Based Medicine experience (NP or RN) preferred Must be able to provide own transportation for local travel. You will be joining a team that is supportive and respectful of one another and deeply committed to the mission of HealthPartners. Here, you'll become a partner for good, helping to improve the health and well-being of our patients, members and community. Our commitment to excellence, compassion, partnership and integrity is behind everything we do. It's the type of work that makes a difference, the kind of work you can be proud of. We hope you'll join us. WORK SCHEDULE: 8am - 5:00 pm BENEFITS: HealthPartners benefit offerings (for 0.5 FTE or greater) include medical insurance, dental insurance, 401k with company contribution and match, 457(b) with company contribution, life insurance, AD&D insurance, disability insurance, malpractice insurance for work done on behalf of HealthPartners as well as a CME reimbursement account. Our clinician well-being program provides a wealth of information, tools, and resources tailored to meet the unique needs of our health care professionals, including physicians, advanced practice clinicians (APCs) and dentists. HealthPartners is a qualified non-profit employer under the federal Public Service Loan Forgiveness program. TO APPLY: For additional information, please contact Judy Brown, Sr. Physician and APC Recruiter, *********************************. For immediate consideration, please apply online.

OUR PURPOSE We are focused on Good Living for the Greater Good. This means providing a true sense of home and belonging for our Neighbors and Prometheans and giving our time and resources to bring positive change locally and beyond. It also means supporting you in your career goals with the very best working experience, and that starts with us having fun in the work we do together. YOUR ROLE AND IMPACT Some companies call them “Property Administrators”, but at Prometheus our Home Base Coordinators do so much more. Our Senior Home Base Coordinators focus on the administration of multiple properties, and your role is a constant blend of: Financial Administration - Whether it is managing rent collections, reviewing ledgers, processing final account statements, or tracking invoices, you are on top if it all. You make every detail count and count every detail. Leasing Administration - You will provide support to the leasing team in qualifying future Neighbors - verifying applications, performing credit investigations, creating all associated documentation accompanying the rental agreements, and recertifications specifically related to Below Market Rate Housing or similar. Customer Service - You are a problem solver that makes renting easy. When Neighbors have questions about policies or deposit charges, you help them find the answers. When the office gets busy, you are the first one to jump in and answer the phones and provide support to the leasing team in qualifying future Neighbors. JOB QUALIFICATIONS Your Experience - Prometheans come from all walks of life and from all over the globe. We're also very diverse in that we hire talent with experience in other industries and who bring different skill sets and ideas to our company. You should bring a passion for working in a customer service, working knowledge of housing rental laws & ordinances, and enjoy solving problems. Your Cultural Traits - Although we're a highly dispersed organization by the nature of our business, our Prometheans are strongly united by our Purpose, Mission and our Cultural Traits. These are the defining characteristics of a Promethean: Team Oriented, Communicator, Entrepreneurial, Passionate, Self-Starter, Creative, Principled, and Brand Ambassador. Your Education - A Bachelor's degree is preferred and a High school diploma or general education degree (GED) is required. COMPENSATION & BENEFITS We offer a variety of benefits that take compensation well beyond a paycheck. This includes traditional benefits and benefits you might not expect or know about. The provided salary range is based on a number of factors, including location, job-related skills, experience and qualifications. Compensation Pay Range: $33.25 to 40.25 per hour Discretionary Semi-Annual Bonus Plan Benefits & Perks Medical; Vision; Dental:100% Company-paid plans (including eligible dependents) and affordable buy-up options Life insurance; Accidental Death & Dismemberment Insurance; Long Term Disability Behavioral Health Program Accessible 24/7 Tax-Free Flexible Spending Accounts 401(K) Retirement Plan with Employer Matching Recognition & Rewards Program (Torch) Vacation: 10 days per year with accrual increasing over time Anniversary Vacation: 40-hour Vacation Granted at Tenured Milestones Sick Leave: 9 days per year 12 paid holidays, including your birthday! Paid Volunteer Time Tenured-based Housing discounts Educational Assistance, Tuition Reimbursement Learn more about these and other perks of being a Promethean by exploring our full Benefits Guide. Prometheus is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, veteran status, or any other status protected under federal, state or local law. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. If you'd like more information about your EEO rights as an applicant under Federal Employment Laws, please check out these FMLA, EEO, and EPPA pages.

Job Title: Work From Home-Online Hotel Coordinator-Entry Level About Destination Knot:Destination Knot is a travel planning company dedicated to creating unforgettable experiences for every type of traveler. From romantic getaways and family vacations to group trips and business stays, we provide personalized hotel and resort booking services with care and attention to detail. Position Overview: We're looking for a motivated and detail-oriented Online Hotel Coordinator to join our remote team. This is an entry-level role ideal for someone eager to begin a career in the travel industry. You'll help match clients with the perfect hotel accommodations, manage bookings, and provide outstanding customer support throughout the planning process. Key Responsibilities:Assist clients in researching and booking hotel and resort accommodations Respond to inquiries via email, phone, or chat in a timely, professional manner Review client preferences to recommend suitable lodging options based on budget, location, and travel dates Manage reservation details and updates using booking tools and systems Maintain accurate client records and documentation Support post-booking needs such as changes, special requests, or follow-up questions Stay informed on current travel trends, hotel promotions, and destination offerings Qualifications:No prior travel industry experience required-training provided Strong communication and customer service skills Organized, dependable, and detail-oriented Comfortable working remotely and managing tasks independently Tech-savvy with basic knowledge of online platforms (booking systems a plus) Must be 18 years or older with reliable internet access and a computer Passion for travel and helping others plan great experiences What We Offer:Remote, flexible work environment Entry-level onboarding and continuous training Supportive team and professional development opportunities Access to industry tools and hotel booking platforms Travel perks and performance-based incentives Work Environment: This is a remote position with flexible hours. It's perfect for individuals who are self-motivated, enthusiastic, and ready to start a fulfilling path in the travel and hospitality industry.$40,000 - $60,000 a year We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Home Infusion Registered Nurse - Accredo Take your nursing skills to the next level by helping to improve lives with Accredo, the specialty pharmacy division of Evernorth Health Services. We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes. As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications. However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care. You'll work independently, making decisions that lead to the best outcomes for your patients. You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team. For more than 30 years, Accredo by Evernorth has delivered dedicated, first-class care and services for patients. We partner closely with prescribers, payers, and specialty manufacturers. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on the lives of others. How you'll make a difference and improve lives: Empower Patients: Focus on the overall well-being of your patients. Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health. Administer Medications: Take full responsibility for administering IV infusion medications in patients' homes. Provide follow-up care and manage responses to ensure their well-being. Stay Connected: Be the main point of contact for updates on patient status. Document all interactions, including assessments, treatments, and progress, to keep track of their journey. Requirements: Active RN license in the state where you'll be working and living 2+ years of RN experience 1+ year of experience in critical care, acute care, or home healthcare Strong skills in IV insertion Valid driver's license Willingness to travel to patients' homes within a large geographic region Ability to work 32 hours a week (can include days, evenings, and weekends, per business need) Flexibility to work different shifts on short notice and be available for on-call visits as needed If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ...@cigna.com for support. Do not email ...@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Part-time Description We're pleased to announce an opportunity for the position of Health Home Care Coordinator within the Community Based Teams Department. The Health Home Care Coordinator provides comprehensive care coordination services to eligible individuals and their families. This role involves assessing member needs, developing and monitoring individualized service plans, making appropriate referrals, and advocating on behalf of members with other service providers. Care Coordinators maintain a dedicated caseload and ensure consistent monthly engagement with assigned members across various settings. Health Home Care Coordinator's support members in identifying and accessing resources, delivering health education, and applying motivational interviewing techniques to foster goal achievement, resilience, and healthy lifestyle choices. The Care Coordinator promotes wellness through coaching and awareness of chronic health conditions, aiming to reduce emergency service usage and prevent hospital readmissions. *Prefer that the candidate resides in Whitman County, WA (or nearby) to provide in-person support as needed. Position is primarily remote but includes local travel (Whitman County) for member meetings. Benefits Information Medical and Dental insurance options for employees and families Vision and Life insurance as well as other auxiliary insurance options 403(b) retirement plan with up to 6% matching contribution Health Savings Account and Flexible Spending Account options Paid vacation earned on a pro-rated basis according to worked/paid leave hours Paid Sick leave earned on a pro-rated basis according to actual hours worked Eleven paid holidays per year on a pro-rated basis according to hours worked *Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Salary Description Offered At: $21.65 - $23.42 per/hr.

is Remote (US/Canada) No agencies please Maximus (****************************** is a mission-driven consumer performance medicine telehealth company that provides men and women with content, community, and clinical support to optimize their health, wellness, and hormones. Maximus has achieved profitability, 8-figure ARR, and is doubling year over year - with a strong cash position. We have raised $15M from top Silicon Valley VCs such as Founders Fund and 8VC as well as leading angel investors/operators from companies like Bulletproof, Tinder, Coinbase, Daily Stoic, & Shopify. Position Summary In this role as a Care Coordinator supporting Maximus patients, you will be instrumental in delivering a seamless care experience. Your primary responsibilities include managing provider video conferencing schedules, coordinating with lab and pharmacy partners, and overseeing patient messaging queues. You will also serve as a key contributor to our patient concierge experience. The ideal candidate is driven by a passion for lifestyle, wellness, and fitness, constantly seeks innovative approaches to their work, and is eager to shape the overall patient journey. Key Responsibilities Video Conferencing & Scheduling Coordinate and maintain provider schedules for video consultations, ensuring efficient appointment booking and minimizing scheduling conflicts. Monitor upcoming telehealth appointments, confirm patient/provider availability, and troubleshoot any technical issues that may arise. Lab & Pharmacy Coordination Liaise with laboratory partners to manage test orders, track results, and ensure timely communication of lab outcomes to providers and patients. Collaborate with pharmacy partners to facilitate prescription orders, refills, and medication-related inquiries. Messaging Queue Management Oversee and triage patient messages in digital platforms, ensuring inquiries are addressed promptly and directed to the appropriate clinical team member. Escalate urgent or complex issues to the appropriate care team members, keeping patients informed of next steps. Patient Communication & Support Provide friendly and empathetic support to patients, answering questions related to appointments, lab tests, prescriptions, and follow-ups. Educate patients on the use of telehealth platforms, including troubleshooting basic technical issues and sharing best practices for virtual visits. Digital Healthcare Administration Maintain accurate and up-to-date electronic health records (EHR), ensuring data integrity and confidentiality. Identify opportunities to streamline workflows and enhance patient experiences, bringing recommendations to leadership. Quality Assurance & Compliance Ensure compliance with all relevant healthcare regulations and company policies, including HIPAA and data privacy laws. Participate in team meetings to review patient feedback, address operational challenges, and discuss quality improvement initiatives. Qualifications Experience: 1-3 years of experience in a care coordinator, healthcare administration, or telehealth support role. Education: Associate's or Bachelor's degree in Healthcare Administration, Public Health, or a related field preferred. Technical Skills: Familiarity with EHR systems, telehealth platforms, scheduling software, and basic troubleshooting of common technical issues. Communication Skills: Excellent verbal and written communication skills to effectively coordinate with patients, providers, and partners. Organizational Skills: Strong attention to detail and ability to manage multiple tasks efficiently in a fast-paced, digital environment. Interpersonal Skills: Empathetic, patient-focused approach with a commitment to delivering high-quality care and exceptional patient experiences. Compliance Knowledge: Understanding of healthcare regulations, especially HIPAA and data privacy guidelines. What We Offer (Benefits): Full Suite: Medical, Dental, Vision, Life Insurance Flexible vacation/time-off policies Fully remote work environment Maximus is an equal opportunity employer, which not only includes standard protected categories, but the additional freedom from discrimination against your free speech and beliefs, as long as they are aligned with company values. We celebrate intellectual diversity. Note: We utilize AI note-taking technology during our interview sessions to ensure we capture all answers and details accurately. Candidates are also encouraged to use AI note-takers for their own records if they wish.

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. The Care Coordinator will coordinate the with the Care Team Lead and Care Team Member Services Manager to ensure the team has the resources required to satisfy member enrollment and maintenance in the IPC Copay Assistance Program. The Care Coordinator will respond accordingly to incoming and make external calls to client members to ensure appropriate processing of copay assistance. Essential Duties and Functions: Provide client support where needed Coordinate member implementation calls with Care Team Lead Provide adhoc claims review as required Identify utilizing patients, review history, determine next coverage date Assist patient with enrollment in the manufacturer's program Maintain patient database for follow-up, tracking and reporting Receive notification of new patient's prior authorization/or review daily rejected and paid claims This position will include job duties that require risk designations for access to Electronic Protected Health Information (PHI) in the course of their job responsibilities Other duties may be assigned Competencies: Planning/organizing-the individual prioritizes and plans work activities and uses time efficiently. Makes good and timely decisions that propels our company forward Interpersonal skills-the individual maintains confidentiality, remains open to others' ideas and exhibits willingness to try new things. Creates an environment where teammates feel connected and energized. Written and Oral communication-Communicate a concise message that resonates every time. The individual speaks clearly and persuasively in positive or negative situations and demonstrates group presentation skills. Problem solving-Create innovative ways for our customers and our company to be successful. The individual identifies and resolves problems in a timely manner, gathers and analyzes information skillfully and maintains confidentiality. Quality control-the individual demonstrates accuracy and thoroughness and monitors own work to ensure quality. Adaptability-the individual adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected vents. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Required Certified Pharmacy Technician (CPhT.) License or 2-5 years of experience in a retail pharmacy or pharmacy benefit management environment Excellent communication skills Proficient with MS Office Suite Professional telephone demeanor Ability to maintain a high level of confidentiality Pay Range 18.00 - 20.00 Hourly The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

Telephonic Case Manager - Rare Opportunity! EK Health is now hiring for a Telephonic Nurse Case Manager (RN) for our Case Management Team! This role includes assessing, planning, implementing, coordinating, and evaluation of service options. The goal of the Case Manager is to assist the injured worker in receiving appropriate, cost-effective medical care for their injury in a timely manner, and to expedite their return to work. Position Logistics: Monday - Friday, 8:30am -5:30pm local time, Full-time Remote. NOTE: Requires a Compact RN license in good standing. Workers Compensation experience is preferred but not required. Wage is based on experience, education, certifications and location (may be either hourly or salary based on individual state requirements). Benefits & Perks: Base pay $35-42/hr ($72,800 - $87,360 annually). Wage is based on experience, education, certifications and location (may be either hourly or salary based on individual state requirements). Medical, Dental and Vision Insurance 401K Paid Time Off Paid holidays Equipment is provided Monthly internet stipend Here's a snapshot of what you'll be doing (not all-inclusive): Communicate with medical providers, employers and with injured workers Perform a complete nursing evaluation to determine needs of patient Review and evaluate all medical correspondence, provider reports, & treatment plan history Evaluate clinical status of claimant and research for alternative options to treatment as warranted Communicate with the claims examiners regarding directives, and provide updates on file status Arranging transportation services when necessary and authorized Evaluating therapy facilities and their progress on specific cases Prepare comprehensive notes following any discussions had with injured worker, medical providers, claims examiners, and employers in the case file Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation Upon authorization, implement this plan of care with patient, physician and health care providers Arrange for care/services as needed (home care, procedures, medication, equipment or supplies) Monitor the plan of care with modifications or changes suggested to the patient and physician as the need arises Coordinate information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any is involved) Requirements Graduate of an accredited school of nursing 3-5 years clinical experience as an RN outside of school Valid Compact RN license in good standing with no restrictions Valid state-appropriate RN license in good standing with no restrictions Possesses and can demonstrate the professional and technical skills of a Registered Nurse Experience in Case Management, Workers' Compensation experience preferred, but not required Experience in Home Health Care, Occupational Health considered a plus Excellent Written and Oral Communication Skills Excellent Interpersonal & Organizational Skills High comfort level with computers and computer programs (MS Word, MS Excel, Email)

Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is good for people and good for Berkley's insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology to deliver the best outcome for injured workers and Berkley's operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers' compensation cases. To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley's operating units with reliable results, and reduced time and expenses associated with case management. Responsibilities As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers. Coordinate and implement medical case management to facilitate case closure Timely and comprehensive communication with with employers, adjusters and the injured workers. Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction Acquire and maintain nursing licensure for all jurisdictions as business needs require Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services Document activities and case progress using appropriate methods and tools following best practices for quality improvement Reviewing job analysis/job description with all providers to coordinate and implement disability case management. This includes coordinating job analysis with employer to facilitate return to work. Engage and participate in special projects as assigned by case management leadership team Occasionally attend on site meetings and professional programs Foster a teamwork environment Maintaining and updating evidence based medical guidelines (such as Official Disability Guidelines, MD Guidelines and all required state regulated guidelines) in reference to the injured worker treatment plan and work status. Obtain and maintain applicable state certifications and/or licensures in the state where job duties are performed. Obtain case management professional certification (CCM) within 2 years of hire Qualifications Minimum 2 years of experience in workers compensation insurance and medical case management preferred Minimum of 4 years medical/surgical clinical experience required Ability to work standard business hours in the either Central Standard Time, Mountain Standard Time or Pacific Time Zone (Monday through Friday, 8:00 AM to 5:00 PM CST/MST/PST). Exhibit strong communication skills, professionalism, flexibility and adaptability Possess working knowledge of medical and vocational resources available to the Workers' Compensation industry Demonstrate evidence of self-motivation and the ability to perform case management duties independently Demonstrate evidence of computer and technology skills Oral and written fluency in both Spanish and English a plus Education Graduate of an accredited school of nursing and possess a current RN license. A Compact Nursing License is strongly preferred. A California license is ideal but not mandatory. Candidates must be willing and able to obtain a California license within 90 days of their start date. Additional Company Details ****************** The Company is an equal employment opportunity employer We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees • Base Salary Range: $80,000 - $88,000 • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Additional Requirements • Domestic U.S. travel required (up to 10% of time) Sponsorship Details Sponsorship not Offered for this Role

Mission 💪 Our mission is to ensure that no one in the world has to suffer from a treatable skin disease because of an access issue ever again. 👋 Honeydew is building a platform for hundreds of millions of people globally to access expertise and science-backed skin treatments, from prescription to retail. Our tech-forward dermatology experience helps people with chronic skin conditions access licensed specialists, FDA-approved treatment, and ongoing support in record time (24 hours vs an industry average of 6 months). Honeydew is the future of skin health - digitally native, scientifically rooted, integrated end-to-end (evaluation + treatments + lab tests), and powered by AI. About the Role Start Being The Reason Someone Finally Feels Seen. As a Care Coordinator at Honeydew, you'll be the thoughtful voice during someone's treatment - the person who crafts messages that make patients feel heard, supported, and confident in their skincare journey. This isn't just customer service, it's healthcare. You know that feeling when someone actually listens to your healthcare concerns? When you're not just another ticket number or appointment slot? That's what you'll create every single day at Honeydew - one message at a time. If you join us, you'll be central to our mission as a trusted guide helping people navigate one of the most frustrating parts of modern life: getting healthcare that works. Your Day-to-Day You'll be the empathetic problem-solver behind the screen: Master the art of written communication - crafting clear, warm, professional messages via app chat that make patients feel supported (this is 99% of your patient interaction) Turn healthcare chaos into clarity through thoughtful, detailed written responses that anticipate questions before they're asked Coordinate directly with pharmacies and labs via phone to troubleshoot prescription issues, insurance hiccups, and delivery problems Connect with dermatology providers as needed to ensure care plans stay on track Keep meticulous records because details matter when it's someone's health on the line Bridge the gap between patients, providers, and insurance companies through strategic communication across channels Partner with medical teams to communicate care plans that actually fit into people's real lives Monitor patient progress through ongoing messaging, troubleshoot obstacles, and celebrate wins along their journey Important to Keep in Mind about the Schedule Honeydew is open, serving patients between 9am and 10pm Eastern every day, and Care Coordinators can choose the structure of their workday on their own. However, Care Coordinators have a responsibility to respond to patients within 4 hours on weekdays and within 6 hours on weekends. Abiding by these response times is crucial to success. As part of the initial onboarding and training process, Care Coordinators are expected to be available 7 days a week in order to ramp up to a full-time (35+ hours/week) schedule. You Might Be Our Person If… You genuinely like people, even when they're frustrated and it's coming through in ALL CAPS You're comfortable with async communication You can read tone and emotion in written messages and respond appropriately You find satisfaction in solving problems that don't have obvious solutions You like to be proactive in offering advice, rather than just following a template You believe healthcare should be accessible to everyone, not just the privileged few You find joy in doing work that matters What We're Looking For... The Non-Negotiables: High school diploma or equivalent You're an exceptional writer and speaker - clear, warm, professional across every channel You type at least 40 WPM You're comfortable with Gmail and Chrome (or similar) Rock-solid internet and a private workspace - HIPAA compliance isn't optional, and dropped connections aren't an option You have a customer service mentality but understand healthcare isn't retail - empathy and professionalism are your baseline, not your ceiling You thrive working independently - no one's looking over your shoulder, and you don't need them to You're coachable and collaborative - you take feedback as fuel, not criticism, and communicate openly with the team We're Looking For At Least Two Of These: Customer service experience - you've turned "difficult customers" into your happiest ones Healthcare or clinical support background - you speak the language and understand the stakes Remote work experience - you've already figured out how to stay focused when Netflix is two clicks away The Nice-to-Haves (But Honestly, You'll Pick These Up Fast): Comfortable with Slack and Zoom - if you're not, no stress, you'll be fluent in a week What You Get Full remote flexibility Direct impact you can measure Ability to grow within the company $100 monthly tech stipend Free Honeydew membership Direct access to new dermatology treatments 20% off Honeydew products Bi-monthly get togethers Peer-to-peer recognition through Motivosity Full-time employees also get: Health insurance & HSA match 401(k) retirement savings with employer match Unlimited time off Hourly pay: $15/hour (or the applicable state or local minimum wage, if higher) Our Process Application Skills assessment (async) - max 30 minutes Screening interview - 20-30 minutes Team Lead interview - 30 minutes CEO interview - 30 minutes Offer Candidates must be authorized to work for any employer in the US. This role is not eligible for visa sponsorship. Candidates residing in the following states will be considered for this role: AL, AZ, DC, FL, GA, ID, MD, MI, MO, NJ, NY, NC, OH, PA, TX, UT, VA, WA, WI

If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you. Under general technical direction, responsible for medically managing assigned caseload and by applying clinical expertise ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. Also act as a clinical resource for field claim partners. This is a remote position, however, you will be required to report into the office twice a month per business requirements if you reside within 50 miles of the following offices: Lake Oswego, OR, Chandler, AZ, Hoffman Estates, IL, Suwanee, GA, Indianapolis, IN, Plano, TX, Boston, MA, Westborough, MA, Las Vegas, NV, and Weatogue, CT . Please note this policy is subject to change. Responsibilities: Follows Liberty Mutual's established standards and protocols to effectively manage assigned caseload of medical/disability cases and by applying clinical expertise assist to achieve optimal outcome and to facilitate claim resolution and disposition. Effectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return to work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome. Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements. Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation to achieve best possible case outcome. Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries. Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy. Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner. Accurately and appropriately documents time tracking for work performed. Achieves annual time tracking goal. Handles special projects as assigned. Qualifications Ability to analyze and make sound nursing judgments and to accurately document activities. Strong communication skills in order to build relationships with injured employees, medical professionals, employers, field claims staff and others. Good negotiation skills to effectively establish target return to work dates and coordinate medical care. Knowledge of state, local and federal laws related to health care delivery preferred. Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel and Outlook). Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing). Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience. Previous medical case management experience a plus. Must also have current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law. Must have additional professional certifications, such as CCM, COHN, CRRN, etc., where required by WC law. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

LOCATION: Remote - the is a home-based, virtual position that operates Monday - Friday from 8:30am-5:00pm (EST). The person in this position must live in North Carolina or within 40 miles of the NC border. GENERAL STATEMENT OF JOB The Care Coordinator is responsible for providing proactive intervention and telephonic coordination of care to eligible members to ensure that they receive appropriate screening, assessment, services, and care transitions. Responsibilities include administering screenings and assessments, developing care plans to achieve a member's health goals, and managing discharges/transitions between care settings. Care coordinators possess customer service and active listening skills needed to guide individuals of varying backgrounds towards their goals for whole person health. Care Coordinators perform telephonic outreach and engagement activities for members who are eligible for Tailored Care Management and also provide care coordination for members who qualify for supportive Social Determinants of Health services. Note: This position requires access to, and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health. ESSENTIAL JOB FUNCTIONS Outreach and Engagement: Telephonic outreach and engagement for members eligible for plan-based Tailored Care Management (TCM). Referring members who opt in to TCM for assignment to a care manager. Provide telephonic outreach and administration of Care Needs Screenings to all Vaya Medicaid plan members. Provide telephonic outreach and engagement to members eligible for care coordination. Conducting the above activities according to applicable rules, regulations, and contract requirements as outlined in Vaya policy and procedure Documenting above activities in designated software platforms according to Vaya policy and procedure Care Coordination and Transition of Care Management : Provide telephonic assessment and person-centered care planning for members who opt in to Care Coordination. Link members to appropriate care to meet their care plan goals, coordinate member care including locating appropriate providers and services, assisting with appointment reminders, and providing education about relevant health topics and recommended screenings and immunizations Manage transitions of care between settings ensuring that members receive appropriate discharge planning and follow up with discharge appointments Assessing eligibility for the NC Healthy Opportunities Pilot and linking eligible members to these services using the NCCARE360 software platform Conducting above activities in the designated software platform according to Vaya policy and procedure. Other duties as assigned. KNOWLEDGE, SKILLS, & ABILITIES A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance. Exceptional interpersonal skills, effective oral and written communication skills, and the ability to make prompt independent decisions based upon relevant facts Problem solving, negotiation, and conflict resolution skills are essential to balance the needs of both internal and external customers. The employee must be detail oriented, able to organize multiple tasks and priorities, and to effectively manage projects from start to finish. Work activities quickly change according to mandated changes and changing priorities. The employee must be able to shift focus to meet changing priorities. Knowledge of Behavioral Health/I/DD Tailored Plan (Tailored Plan) eligibility and services Working understanding of the concepts of whole-person health and health-related resource needs (formerly known as social determinants of health) Community integration (Independent living skills; transition and diversion, supportive housing, employment, etc.) Health promotion (Common physical comorbidities, self-management, use of IT, care planning, ongoing coordination) Person-centered needs assessment and care planning, etc. Serving pregnant and postpartum women with SUD or with SUD history Thorough knowledge of standard office practices, procedures, equipment, and techniques and have intermediate to advanced proficiency in Microsoft Office products (Word, Excel, Power Point, Outlook, Teams, etc.) EDUCATION & EXPERIENCE REQUIREMENTS Bachelor's Degree in Human Services and at least two (2) years of progressive experience providing similar services to the population served. OR Bachelor's Degree in a field other than Human Services and at least four (4) years of progressive experience providing similar services to the population served. To meet federal requirements for Care Coordination, the incumbent must be qualified as a Qualified Professional according to 10A NCAC 27G .0104. Preferred work experience: Call Center (inbound/outbound) experience Tailored Care Management experience Care Coordination experience SDoH experience Medical Administration or Assessment Customer Success At least four (4) years of post-degree experience in customer success management, communications, and/or administrative care) PHYSICAL REQUIREMENTS Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading. Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time. Mental concentration is required in all aspects of work. RESIDENCY REQUIREMENT: The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border. SALARY: Depending on qualifications & experience of candidate. This position is non-exempt and is eligible for overtime compensation. DEADLINE FOR APPLICATION: Open Until Filled APPLY: Vaya Health accepts online applications in our Career Center, please visit ****************************************** Vaya Health is an equal opportunity employer.

Job DescriptionCLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic and well-respected organization offering tremendous career growth potential. At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply. 100% REMOTE! Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering). SUMMARY STATEMENT The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in meeting national and local policies as well as accepted medical standards of care. The incumbent applies clinical knowledge to assess the medical necessity, level of services and appropriateness of care which may include cases requiring prior authorization, complex pre-payment medical review or post-payment medical review. ESSENTIAL DUTIES & RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary. 90% of time will be spent on one or more of the following activities depending on assignments: Review and analyze pre and post pay complex health care claims from a medical perspective, inclusive of prior authorization: Perform clinical review work as assigned; may provide guidance to other team members and accurately interpret and apply broad CMS guidelines to specific and highly variable situations. Conduct review of claim data and medical records to make clinical decisions on the coverage, medical necessity, utilization and appropriateness of care per national and local policies, as well as accepted medical standards of care. Review provider practices and identify issues of concern, overpayment and need for corrective action as necessary; includes surfacing potential fraud and abuse or practice concerns. May develop recommendations for further corrective action based on medical review findings. May refer for review, or implement, corrective action related to medical review activities. May process claims and complete project work in the appropriate computer system(s). The remaining 10% of time will be spent on the following activities depending on assignments: Identify providers needing education and individually educate providers who are subject to medical review processes: Initiate or participate in provider teaching activities, creating written teaching material, providing one on one education or education to a group as a result of a medical review (e.g., probe, progressive corrective action, consent, etc.) or appeal. This may involve discussion with CMS leaders and leaders in the provider community. Participate in special projects as assigned. REQUIRED QUALIFICATIONS * Valid nursing degree * 2 years' clinical experience * Excellent written and oral communication skills * Demonstrated experience with evaluating medical and health care delivery issues (e.g., Inpatient Rehab Facility) * Strong computer skills to include Microsoft Office proficiency * Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Inpatient Rehabilitation Facility Experience * Bachelor of Science in Nursing (BSN) * Insurance industry experience * Certified Coder ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed. At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is offered with no fee to candidate.

Part time Shift: Variable Less than 12 hour shift (United States of America) Hours per week: 0 Job Information Exemption Status: Non-Exempt This experienced student team member is in their last semester of an accredited nursing program. Nurse Interns are team members typically work exclusively with their preceptors to bridge the gap from learner to perform as they end their practicum prior to begining their career as a Registered Nurse at Stormont Vail Health. They are a part of the care delivery team under the direction of and be assistive to, a Registered Nurse to provide delegated, direct patient care intervention, including the performance of non-sterile procedures. Responsible to provide a safe environment for their assigned patients; to complete the assigned work; to monitor the patient for changes in condition and to report those changes to the RN/LPN. Education Qualifications A current nursing student in good standing and would start in this role no more than 4 weeks prior to starting their last semester. Required Experience Qualifications Intent to continue nursing career after graduation at Stormont Vail Health and has accepted an offer for a RN position. Required Experience in an office or clinic setting. Preferred Skills and Abilities Knowledgeable of and follows proper technique for patient care. (Required proficiency) Communicates pertinent patient information to appropriate staff in a timely manner. (Required proficiency) Functions with an awareness and application of safety issues as identified within the institution. (Required proficiency) Participates actively in educational activities for department. (Required proficiency) Demonstrates competency in selected psychomotor skills. (Required proficiency) Licenses and Certifications First Responder - RQI Required within 90 days. What you will do Knowledgeable of and follows correct techniques in the collection and labeling of specimens; assists in appropriate procedures under the guidance of a preceptor. Will spend the majority of time directly with the RN Preceptor observing direct patient care duties. Student Nurse Interns will perform expanded skills under the direct supervision of their nurse preceptor (see RN Student Nurse Intern - Learn While you Work Document). Implements identified plan through coordination of care with interdisciplinary care team to employ strategies to promote health and wellness. Collaborative with interdisciplinary care team encompassing strategies to achieve expected outcomes. Assumes responsibility for patient safety by utilizing appropriate channels to communicate patient safety and patient care issues to appropriate bodies. Communicate pertinent data and information relative to the patient, situation, or setting in a timely manner. Applies proper techniques with hand washing, care and cleaning of exam rooms and equipment and determination of when and how to use personal protective clothing/equipment. Maintains cleanliness of equipment, examination and patient rooms. Promote infection prevention through use of standard precautions, proper procedure in dressing changes, wound care, hand hygiene and cleanliness of the patient rooms/department Provide assistance with activities of daily living (ADL'S), accurate measurement and recording of weight, height, vital signs and report any changes to assigned nurse. Obtains vital signs, medication list, allergies, and patient questionnaires, screenings and history information accurately. Applies appropriate technique while performing EKG, and vital signs. Performs other related nursing tasks and duties under the supervision of a preceptor at all times. Delivers care guided by Jean Watson's Theory of Human Caring illustrated by creating caring relationships, taking time to have uninterrupted moments with patients and displaying unconditional acceptance and respect. Promotes a mutually respectful environment that encourages the exchange of ideas and supports the effectiveness of professional relationships and integrates ethics in all aspects of practice. Demonstrates advocacy in all roles and settings. Practices Diversity, Equity and Inclusion principles in their daily work by respecting others' uniqueness, perspectives, backgrounds or beliefs. Communicates effectively in all areas of professional practice. Supports students to enhance their knowledge, skills, and abilities. Commits to lifelong learning through critical thinking, self-reflection, and inquiry for personal growth and development. Demonstrates willingness to participate in process of evolution the scope of the Stormont Vail Health professional practice model Responsible for understanding and showing respect for patients' rights including confidentiality of patient information. Utilizes appropriate resources to provide, and sustain evidence-based nursing services that are safe, effective, and financially responsible, and used judiciously. Required for All Jobs Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health Performs other duties as assigned Patient Facing Options Position is Patient Facing Remote Work Guidelines Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards. Stable access to electricity and a minimum of 25mb upload and internet speed. Dedicate full attention to the job duties and communication with others during working hours. Adhere to break and attendance schedules agreed upon with supervisor. Abide by Stormont Vail's Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually. Remote Work Capability On-Site; No Remote Scope No Supervisory Responsibility No Budget Responsibility No Budget Responsibility Physical Demands Balancing: Occasionally 1-3 Hours Carrying: Occasionally 1-3 Hours Climbing (Ladders): Rarely less than 1 hour Climbing (Stairs): Occasionally 1-3 Hours Crawling: Rarely less than 1 hour Crouching: Occasionally 1-3 Hours Driving (Automatic): Rarely less than 1 hour Driving (Standard): Rarely less than 1 hour Eye/Hand/Foot Coordination: Frequently 3-5 Hours Feeling: Frequently 3-5 Hours Grasping (Fine Motor): Frequently 3-5 Hours Grasping (Gross Hand): Frequently 3-5 Hours Handling: Frequently 3-5 Hours Hearing: Occasionally 1-3 Hours Kneeling: Rarely less than 1 hour Lifting: Occasionally 1-3 Hours up to 50 lbs Operate Foot Controls: Rarely less than 1 hour Pulling: Frequently 3-5 Hours up to 50 lbs Pushing: Frequently 3-5 Hours up to 50 lbs Reaching (Forward): Occasionally 1-3 Hours up to 25 lbs Reaching (Overhead): Occasionally 1-3 Hours up to 25 lbs Repetitive Motions: Occasionally 1-3 Hours Sitting: Occasionally 1-3 Hours Standing: Frequently 3-5 Hours Stooping: Occasionally 1-3 Hours Talking: Frequently 3-5 Hours Walking: Frequently 3-5 Hours Working Conditions Burn: Rarely less than 1 hour Chemical: Rarely less than 1 hour Combative Patients: Occasionally 1-3 Hours Dusts: Rarely less than 1 hour Electrical: Rarely less than 1 hour Infectious Diseases: Frequently 3-5 Hours Mechanical: Rarely less than 1 hour Needle Stick: Occasionally 1-3 Hours Noise/Sounds: Occasionally 1-3 Hours Poor Ventilation, Fumes and/or Gases: Rarely less than 1 hour Radiant Energy: Rarely less than 1 hour Risk of Exposure to Blood and Body Fluids: Rarely less than 1 hour Risk of Exposure to Hazardous Drugs: Rarely less than 1 hour Hazards (other): Rarely less than 1 hour Vibration: Rarely less than 1 hour Wet and/or Humid: Rarely less than 1 hour Stormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment. Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.