Hospice Registered Nurse remote jobs - 387 jobs

We are seeking a dedicated and compassionate Wound Care Nurse, Telehealth Coordinator within the skilled nursing environment. The Wound Care Nurse, Telehealth Coordinator is the link between healthcare providers and patients while providing dressing changes to wounds, under direct supervision, utilizing real-time, imaging technologies. If you are passionate about excellent wound care and recognize the role telehealth has for consistent, convenient attention to patients in need, we encourage you to apply for the Telehealth Coordinator position and join our dedicated team. Responsibilities: Act as the in-person, hands on assistant to conduct weekly virtual wound rounds using technology under the guidance of wound care specialists, nurses, or healthcare providers. Photograph wounds using designated telehealth technology and ensure accurate documentation of images for clinical review. Aid patients in navigating telehealth platforms, troubleshoot technical issues, and ensure a seamless virtual connection for appointments. Facilitate patient telehealth scheduling, provide education on virtual visits to patients and staff as needed. Administer all aspects of wound care as per evidence based practice and facility policies, including dressing changes and rounds. Maintain strict adherence to patient confidentiality and privacy regulations, including HIPAA compliance, during all telehealth interactions and documentation processes. Submit orders for wound care products. Qualifications: Graduate of an accredited school of nursing required. Must possess current CPR certifications. Minimum of one (1) year of Wound Care experience required, (2) years preferred. Wound care certification is preferred. Must possess a current, unencumbered, active license to practice as a RN or LPN in state of practice. Excellent communication skills with the ability to convey medical information clearly to physicians, staff, patients and family Empathy, patience, and a genuine desire to provide quality healthcare services to patients at the bedside as well as through telehealth technology. Commitment to maintaining patient confidentiality, privacy, and data security in accordance with healthcare regulations (e.g., HIPAA). Ability to multitask, and adapt to changing telehealth workflows, job requirements, and patient populations. Prior experience in SNF, LTC, or Assisted Living preferred. Travel to assigned facilities using your personal car, valid driver's license, and mileage reimbursement offered. Role starts out Part-Time with the opportunity to be Full-Time.

This is a contract assignment that will start right away and end on April 30th 2024 Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. The review nurse is responsible for reviewing and accurately performing comprehensive review of medical records to abstract relevant clinical data during HEDIS. HEDIS abstractions are completed in accordance with NCQA guidelines and technical specifications. Additional responsibilities include but not limited to folder and file management, annotating medical records and saving completed documents with correct naming conventions on a shared drive as well as data entry into QSHR. ESSENTIAL FUNCTIONS: Abstract medical records Apply product/plan specific abstraction criteria/requirements during medical record review process Maintain defined productivity volumes Sustain accuracy rate of 95% during abstraction and data entry throughout the HEDIS survey Perform quality reviews of abstracted medical records as assigned Ensure open and honest communication with management/designee regarding development or assistance needed throughout project Escalate work related challenges/issues to Senior Director or designee Attend scheduled daily and ad-hoc meetings with HEDIS Project Manager, and /or Quality Management Specialist/ designee to discuss project status, open issues and productivity Comply with HIPAA, PHI, patient confidentiality, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies Other duties as assigned JOB REQUIREMENTS: Registered Nurse (RN)/ Licensed Practical Nurse ( LPN ) with unrestricted license 2 years' HEDIS abstraction/over-reading experience Data entry proficiency Working knowledge PDF, Word and Excel Excellent written and communication skills Database management Preferred Skills: Experience in Pediatrics, Cardiology, Endocrinology and/or Obstetrics QSHR proficiency

As an RN - MICU you will assess, plan, perform, document, and evaluate professional independent nursing practice at Lakeview Hospital; to provide work direction for and oversight of the nursing care provided by unlicensed personnel; to perform and document functions such as carrying out the provider's medical orders; to assist providers with diagnostic and treatment procedures; to provide a safe and therapeutic environment; to coordinate, communicate, interpret, and explain patient care services to the patient ,his/her family, health professionals and important others; to perform related duties as assigned. Work Schedule: 24 hrs weekly; 0.6 FTE; Nights 8 hours shifts (11 pm- 7:30am) every other weekend rotation. Required Qualifications: Associate Degree in Nursing. Licensed as a RN by Minnesota Board of Nursing or has a Wisconsin RN License and Minnesota Boarder State Registry. Registered nurses re-entering the nursing field, who have not completed 520 hours of nursing practice in the past four (4) years must successfully complete a recognized refresher course to qualify for employment. Written information of certification validating successful completion of a refresher course must be provided before employment. Current BLS certification from American Heart Association or American Red Cross (CPR/AED for Professional Rescuer & Health Care Provider) Current ACLS certification. If not present at start, must obtain within 6 months of start date. Stroke Care (NIHSS) required within 6 months of start date. Minimum one year RN critical care (ICU or ED) experience required Preferred Qualifications: Baccalaureate or Master's degree in Nursing Associate Degree prepared nurses enrolled in Baccalaureate in Nursing program Charge nurse experience preferred. Telemetry experience.

Join our Chronic Care Management (CCM) team within Avance Care, a leading network of 37 practice locations across the Triangle Area (Raleigh-Durham-Chapel Hill), the Charlotte Region, and Wilmington, NC. At Avance Care, we are dedicated to elevating the standard of healthcare. As one of North Carolina's largest networks of independent primary care practices, we provide comprehensive, patient-centered services that support the physical, mental, and emotional well-being of our patients. We are recruiting for a Registered Nurse (RN) to join our Chronic Care Management (CCM) team. This role will support comprehensive, patient-centered care for a designated population while optimizing health outcomes. The CCM RN Coordinator is responsible for establishing, implementing, monitoring, and evaluating high-quality, cost-effective care plans as patients transition across the care continuum. • This is a hybrid role based at our headquarters in Durham, combining in-office and remote work for a balanced schedule. • Supportive Work Environment: We provide a collaborative and encouraging atmosphere where your contributions directly enhance patient health and well-being. You'll also have opportunities for professional growth while making a meaningful impact in the lives of those we serve. • Comprehensive Benefits: Our robust benefits package becomes available starting on the first of the month following 30 days of employment. Selected Responsibilities: • Review patients' medical and social health status using electronic medical records, claims data, and community resources. • Conduct outreach to confirm diagnoses, contributing factors, anticipated treatment plans, and barriers to care. • Facilitate access to necessary care by navigating barriers, advocating for patients, and educating families/caregivers. • Monitor patients enrolled in care management to ensure treatment goals are met and shared across care teams. • Track and support patients post-hospitalization or ER visits to ensure continuity of care and reduce readmission risks. • Assist in primary care provider triage assessment and direct patients to appropriate services. • Provide clinical supervision for LPNs, MAs, and CNAs in case conferencing and approve care plans. • Coordinate patient case assignments based on the clinical abilities of paraprofessional staff. • Maintain accurate documentation in the electronic medical record and communicate updates to care teams. • Identify workflow improvements to enhance cost-effective, high-quality care delivery. • Stay updated on healthcare regulations, trends in ambulatory and cross-continuum care, and accountable care organizations. • Utilize information technology to identify high-risk patients and address care gaps. • Develop and maintain relationships with internal and external stakeholders. Candidates should have a related degree (ADN or BSN), an active Registered Nursing license, and at least 3 years of direct patient care experience. Preferred qualifications include experience in Case Management, home health nursing, health coaching/education, medication administration, or geriatric care. Other Priorities: o Strong verbal and written communication o Ability to maintain confidentiality and integrity o Growth mindset o Flexibility and resilience o Knowledge of common medical terminology and HIPAA regulations. o Ability to work collaboratively in a team-oriented environment. If you're passionate about improving chronic care management and making a meaningful impact on patient health in North Carolina, we encourage you to submit your resume. All offers of employment are contingent upon the successful completion of a background check and drug screen. Avance Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, gender identification, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state or local law.

The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services, length of stay and level of care provided to members. Contributes to overarching strategy to provide quality and cost-effective member care. We are seeking a candidate with a RN licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review experience. Knowledge in coding: DRG, ICD-10, HCPCS codes is highly preferred. Additional experience with 2 years in claims auditing, QA, or recovery auditing ideally in a DRG/Clinical Validation is a plus. Work hours: Monday - Friday 8:00am- 5:00pm Remote position Essential Job Duties • Performs clinical/medical reviews of previously denied cases in which a formal appeals request has been made or upon request by another Molina department to reduce the likelihood of a formal appeal being submitted. • Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge of all relevant and applicable federal and state regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of service provided, length of stay and level of care. • Applies appropriate criteria on PAR and Non-PAR (contracted and non-contracted) cases and with Marketplace EOCs (Evidence of Coverage). • Reviews medically appropriate clinical guidelines and other appropriate criteria with chief medical officer on denial decisions. • Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. • Identifies and reports quality of care issues. • Prepares and presents cases in conjunction with the chief medical officer for administrative law judge pre-hearings, state insurance commission, and meet and confers. • Represents Molina and presents cases effectively to judicial fair hearing officer during fair hearings as may be required. • Serves as a clinical resource for utilization management, chief medical officer, physicians, and member/provider inquiries/appeals. • Provides training, leadership and mentoring for less experienced appeals nurses and administrative team members. Required Qualifications • At least 3 years clinical nursing experience, with at least 1 year of managed care experience in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific program experience as needed (such as specialties in: surgical, ob/gyn, home health, pharmacy, etc.), or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Experience demonstrating knowledge of ICD-9, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). • Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare, CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access and interpret these guidelines. • Critical-thinking skills. • Ability to interact effectively with clinical leaders and peers across the organization. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ) or other health care coding or management certification. 2+ years in claims auditing, QA, or recovery auditing ideally in a DRG/Clinical Validation To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Home Infusion Registered Nurse - Accredo Specialty Pharmacy Candidates for this job must live in the Katy/Fulshear/Brookshire regions. Join Accredo Specialty Pharmacy, part of Evernorth Health Services, and bring your nursing expertise to patients where they feel most comfortable-their homes. As a Home Infusion Registered Nurse, you'll deliver life-changing care while building meaningful relationships and driving positive health outcomes. Responsibilities: Provide safe and effective administration of specialty medications (including IV infusion) in patients' homes. Partner with pharmacists and care teams to ensure holistic patient well-being. Document assessments, treatments, and progress to maintain accurate patient records. Serve as the primary point of contact for patient updates and care coordination. Demonstrate autonomy in clinical decision-making to achieve optimal outcomes. Required Qualifications: Active RN license in the state of practice. Minimum 2 years of RN experience. At least 1 year in critical care, acute care, or home healthcare. Proficiency in IV insertion and infusion techniques. Valid driver's license and ability to travel within a large geographic region. Availability for a 40-hour workweek, including evenings and weekends as needed. Preferred Qualifications: Bachelor of Science in Nursing (BSN). Experience with specialty pharmacy or infusion therapy programs. Benefits: Medical, Dental, Vision, and Life insurance 401k with strong company match Mileage reimbursement and/or company car 26 Paid Days Off (18 days PTO, plus 8 company holidays) Merit and Bonus eligibility 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: ********************* for support. Do not email ********************* 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.

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Clinical, Supervisor - RN - Full-time (Remote within Alaska Time Zone Hours) to join our growing team. Job Summary: * The Clinical Supervisor (RN) role will oversee and manage the Utilization Management activities. The primary focus is to maintain high standards in clinical programs and enhance customer relationships to ensure contract requirements are met successfully. Responsibilities: * Manage and oversee Utilization Management (UM) activities. * Ensure overall consistency, thoroughness, and accuracy of clinical programs. * Oversee program to ensure clinical efficiencies, deliverables, and contract functions meet high standards. * Strengthen relationships with customers and meet contract requirements. * Provide day-to-day oversight to manage the utilization review program. * Responsible for utilization reviews as defined by the contract to include prior authorization and retro reviews. * Serve as a Subject Matter Expert (SME) and works with other Service Authorization (SA) nurses to ensure the appropriate, effective, and cost-efficient use of healthcare services for Medicaid beneficiaries. * Evaluates SA requests for medical services to ensure they meet the criteria for medical necessity. * Participate as a team member fostering collaborative decision-making among leadership, committees, teams, or work groups of diverse composition. * Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time. PLEASE NOTE: * This role is contingent upon being awarded a contract. Start dates and final offers are contingent upon the contract award and final contract start dates. * Qualifications Required Qualifications/Experience: * Must be available to work business hours as defined by contract within the Alaska Time Zone. * An active, unrestricted Licensed Registered Nurse (RN) in the State of Alaska. * OR the ability to obtain Alaska RN state licensing within three months of your start date, if selected. * Associate degree or equivalent directly applicable experience in nursing, healthcare administration or a related area. * 5+ years of experience in Utilization Management (UM), Service Authorization (SA), or other clinical review process for Medicaid or another large healthcare payer. Preferred Qualifications/Experience: * Residency within Alaska, Pacific, OR Mountain Time Zone. * Bachelor of Science in Nursing (BSN). * Excellent verbal and written communication skills. * Current working knowledge of utilization management. * Customer-focused, results-oriented, and capable of building and maintaining relationships with internal and external customers. * Organizational skills, ability to plan and prioritize multiple assignments. * Current InterQual and Milliman criteria knowledge. * Experience in using systems that support Utilization Review processing. * Ability to work in team setting and independently. * Computer proficiency in Microsoft Office applications and other software programs essential to perform job functions. * Ability to provide technical guidance and leadership to management team. #LI-SD1 Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at Acentra Health EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Compensation The pay for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range USD $84,080.00 - USD $105,110.00 /Yr.

Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working in a remote UR environment or working as an acute hospital case manager. Preferred Qualifications: + Bachelor's Degree in Nursing. + Master's Degree in Nursing. + Experience working with Interqual guidelines. + Experience in a multi-hospital and/or integrated healthcare system. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 405664 Company: Providence Jobs Job Category: Health Information Management Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Nursing Department: 7000 UTILIZATION MGMT REMOTE Address: CA Mission Hills 15031 Rinaldi St Work Location: Providence Holy Cross Medical Ctr-Mission Hills Workplace Type: On-site Pay Range: $56.44 - $87.63 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Compensation: $80,000-$95,000 + equity This salary range reflects multiple experience levels and locations. Actual compensation within the range will be determined based on factors such as experience, skills, qualifications, and geographic location. Schedule: Full-time, 5 days a week, Tuesday-Saturday Location: Remote Role Type: Full-time | Bilingual Spanish preferred but not required About Bariendo Bariendo is on a mission to cure obesity. Founded by Harvard Medical School professors, we are pioneering quick, non-surgical weight loss procedures that are 7x safer than surgery and more effective and affordable than the best medications. Our digital health platform combines telehealth, distributed clinics, and an expert care team in endoscopic weight loss to deliver lasting, affordable results for the 40% of Americans struggling with obesity. We're growing rapidly-now in 8 cities after just 6 quarters of operations-with a vision to become the one-stop shop for obesity management, offering the most comprehensive set of interventions available online and via our distributed partner clinics. Join us to help patients reclaim their lives. About This Role We are looking for a people-centered, professional, and organized Nurse Patient Concierge to join our team and deliver Bariendo's signature 6-star care. You'll be the first point of contact for patients and a crucial part of making their weight loss journey feel smooth, supported, and stress-free. This is a role for someone who thrives in a fast-paced environment, has a concierge mindset, and finds joy in turning complex coordination into calm execution. In this role, you will: Deliver 6-Star Service: Be the warm, welcoming presence patients first encounter. Whether by phone, text, or email, you'll create a calm, organized, and exceptional experience that reflects Bariendo's high standards of care. Be a Trusted Clinical Guide: Act as a primary point of contact for patients on clinical and care-related questions, escalating appropriately to providers and ensuring clear, timely communication so patients feel confident and supported throughout their treatment. Ensure Clinical & Procedural Readiness: Partner closely with Bariendo's procedure centers to confirm accurate bookings, review patient charts for completeness and readiness, and coordinate outstanding requirements so every patient arrives fully prepared for their procedure. Be a Concierge for Every Concern: Monitor incoming communications, answer phone calls, and anticipate patient needs before they arise. You'll be a responsive, empathetic problem-solver who builds trust with every interaction. Drive Administrative Excellence: Maintain accurate records across our systems, ensure compliance with regulations like HIPAA, and support documentation workflows that enable smooth care delivery. What We're Looking For Clinical, Service-Driven Experience: Active RN license with 3+ years of patient-facing clinical experience, including experience delivering care or care coordination virtually (phone, text, telehealth). Ideally in procedural, ambulatory, or concierge-style settings where high-touch, white-glove support is the norm. Experience in Weight Management or Bariatric Care (preferred): Prior exposure to obesity medicine, bariatric surgery, endoscopy, or medical weight-loss clinics is a strong plus, particularly in patient education, pre-procedure readiness, or longitudinal care coordination. Fluent in Spanish (preferred, not required): Able to communicate clearly and professionally with Spanish-speaking patients across phone, email, and text. Detail-Oriented & Reliable: Comfortable juggling complex logistics with accuracy. You stay organized, catch errors before they happen, and keep things moving smoothly under pressure. Warm, Clear Communicator: You build trust quickly, make patients feel at ease, and bring empathy and professionalism to every interaction. Operationally Sharp & Adaptable: Confident discussing pricing and payment options in a direct-pay model, comfortable navigating EHRs and new software, and energized by fast-paced, ever-evolving environments where proactive problem-solving is key. What Makes This Job Amazing Mission: Join a team of Harvard Medical School professors and healthcare innovators transforming thousands of lives. Watch our patient's stories. Hybrid Environment: Work three days a week from our Market Street office and two days remotely, with some (infrequent) Saturday calls -all patient care is delivered virtually via telehealth. Foundational Role in a Growing Startup: Be part of a fast-growing, mission-oriented team. Collaborate closely with teams like Product to help shape and innovate our virtual care experience. Total Rewards Competitive salary with equity in a high growth, seed-stage startup Comprehensive health benefits (medical, dental, vision) 11 paid holidays, 15 personal vacation days, 10 wellness days Hybrid work, 3 days in-office 2 days remote

Raleigh General Hospital Registered Nurse (RN), Clinical Instructor Job Type: PRN About our Health System Raleigh General is a 300 bed hospital located in Beckley, WV, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters. Your experience matters At Raleigh General Hospital, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but as a person. As a registered nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve. Job Summary Responsible for planning and presenting education programs as directed and for assisting the in-house patient education programs. Job Requirements Minimum Education Graduate of a Program in Discipline - Required Registered nurse graduated from a school of nursing. BSN and/or MSN preferred. Required SkillsRequires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Certifications: Basic Life Support (BLS) Advanced Cardiovascular Life Support (ACLS) - required if teaching course Pediatric Advanced Life Support (PALS) - required if teaching course - to be obtained within 6 months Evidence of proficient skills in teaching ability, creativity, communication, and in nursing procedure administration. Demonstrated ability to work with persons of diverse backgrounds and training experience. Demonstrated evidence of effective nurse-patient relationships with emphasis on patient teaching. Basic knowledge of Personal Computer. Required Licenses Current licensure by the State Board of Nursing Essential Functions Participates in and conducts orientation and education programs for hospital staff and community. Assists with planning, developing and implementing educational programs for hospital staff. Provides patient instruction and education. Assists in coordinating educational activities (conferences, seminars) within the hospital. Coordinating and/or teaching scheduled Childbirth classes. Delivers direct patient care appropriate to the age of patient served. Serves as primary contact between The Training Center and the hospital

Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity Why Join Us? ✅ Leadership opportunity with autonomy and support ✅ Competitive salary & comprehensive benefits package ✅ 10 days on/4 days off schedule - maximize your work-life balance ✅ Hands-on engagement with multiple teams Are You the Right Fit? ✔️ Active RN License ✔️ 5+ years previous experience as a Director of Nursing in a skilled nursing facility or experience as a District/Regional Nurse Consultant (Nursing home/long term care) ✔️ Strong background in building teams & cultivating a positive workplace culture ✔️ Certifications in Infection Prevention/Control and MDS (preferred) If you're a passionate nursing leader ready to make a significant impact, we'd love to hear from you! Apply today and take the next step in your career. Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility Medical, Dental, Vision insurance 401(k) Associate assistance program Employee discounts Referral program Early access to earned wages for hourly associates (outside of CA) Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility Paid Time Off Paid holidays Company provided life insurance Adoption benefit Disability (short and long term) Flexible Spending Accounts Health Savings Account Optional life and dependent life insurance Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Full-time associates in role are also eligible for an annual bonus incentive. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. Education and Experience Education as required to obtain state nursing license (RN). Five years of skilled nursing experience as a Director of Nursing (DON) or District/Regional Nurse Consultant required. Certification in Infection Prevention/Control and RAI process preferred. Basic typing skills, along with a working knowledge of personal computing and word processing software, are required, preferably in a Microsoft Windows environment. Certifications, Licenses, and Other Special Requirements RN license. Management/Decision Making Applies existing guidelines and procedures to make varied decisions within a department. Uses sound judgment and experience to solve moderately complex problems based on precedent, example, reasonableness, or a combination of these. Knowledge and Skills Possesses extensive knowledge of a distinct skill or function and a thorough understanding of the organization and work environment. Has a working knowledge of a functional discipline. Physical Demands and Working Conditions Standing Requires interaction with co-workers, residents or vendors Walking Sitting Occasional weekend, evening or night work if needed to ensure shift coverage. Use hands and fingers to handle or feel On-Call on an as needed basis Reach with hands and arms Possible exposure to communicable diseases and infections Climb or balance Potential injury from transferring, repositioning, or lifting residents Talk or hear Exposure to latex Taste or smell Ability to lift: Up to 50 pounds Possible exposure to blood-borne pathogens Possible exposure to various drugs, chemical, infectious, or biological hazards Subject to injury from falls, burns, odors, or cuts from equipment Requires Travel: Occasionally Vision Manages the day-to-day healthcare operations of the community to ensure resident's healthcare needs are met. Ensures residents are treated with respect and dignity and ensures quality care as residents' healthcare needs change. Supervises licensed nurses and other direct care staff within the community. Plans, organizes, develops, and directs the overall operations of the Clinical Services Department in accordance with federal, state and local standards. Responsible and accountable for maintaining the highest degree of quality care at all times. Travels 100% within the division as assigned to support management vacancies, start-ups, vacations, etc. Oversees the assessment of comprehensive nursing needs of each resident using acceptable long term care assessment tools and according to state and federal time frames. Coordinates the care plans for each resident. Participates in community surveys completed by authorized government agencies. Monitors the community Quality Indicators and survey reports. Assists with the development of success plans for identified areas of opportunity. Develops and implements a Clinical Services organizational structure. Determines staffing needs; recruits, selects, hires, and orients nursing staff/direct care personnel. Directly supervises community-based licensed nursing staff (LPN/LVN, RN), CNAs, and Med Techs/CMAs (if allowed/required by State Regulations). Also responsible to supervise nursing administrative associates. Assigns and directs work of subordinates, appraises performance, rewards and disciplines associates, and addresses complaints and resolves problems. Provides training, supervision, and monitoring of associates in the administration of medications as described/allowed in Nurse Practice Act, including auditing of medication administration records. Trains and educates resident care associates on an ongoing basis with classroom in- services, situation-specific training, and resident-specific training. Supervises the maintenance of resident charts and reviews documentation performed by caregiving staff. Assesses the health, functional and psycho-social status of residents, initiates individualized service plans, proactively manages care and services for each resident, evaluates effectiveness, and maximizes the resident's opportunity to remain in their environment. Manages the health care of residents, including the dissemination of information to families and associates. Ensures that family members are aware of residents' need for scheduled appointments. Participates in pre-admission screening of prospective new residents. Ensures that required documentation is completed prior to or upon resident admission, including nursing assessments, service plans, and other assigned forms. Updates assessments as required by policy and as described/allowed in Nurse Practice Act. Performs on-site evaluations of residents admitted to alternate care environments for treatment and maintains contact with resident families with the intent of returning the resident to Brookdale. Evaluates residents; documents changes in condition, and notifies executive director, physician, and resident's legally responsible party/family of resident's condition and reactions. Prepares the Physician Visit Form and reviews and updates the resident chart. Facilitates continuity of care for residents receiving home health care, hospice services, and other third party healthcare-related services. Ensures in-house ancillary medical services such as podiatrist visits, doctor visits, and dental visits, psych visits, lab tests, X-ray, ambulance, etc., are scheduled and followed through. Participates in, or leads, meetings relevant to resident care issues, such as Care Plan, Change of Condition, Clinical Stand-Up, and Collaborative Care meetings involving appropriate parties as needed. Participates in department quality improvement activities. Assists in keeping the environment safe for associates to reduce the occurrence of Workers' Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated. Shares on-call and manager-on-duty responsibilities/shifts as required. Supports other requirements within the division as assigned. This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.

Are you a skilled, compassionate nurse looking for flexible work in clinical research? As a Clinical Research Nurse - Home Visits (PRN), you'll provide high-quality nursing care directly in patients' homes while supporting important research studies. This role is ideal for nurses who value flexibility, independence, enjoy local travel, and want to supplement their income with meaningful work. Key Points to Know: • You'll use your own vehicle to visit patients in their homes, typically within 1-2 hours of your location. • Shifts are PRN / per diem, meaning you'll work only when projects are available in your area; project frequency may vary. • Orientation, training, and project-specific instructions are provided before each assignment. • You will be compensated for all time spent on training, travel, and patient visits, including documentation. We are posting this role now and will be reviewing applications on a rolling basis between now and Christmas. Interviews will begin in the New Year , so you may experience a brief delay in hearing back from us during the holiday period. Thank you in advance for your patience - we look forward to connecting in January. Position: Clinical Research Nurse - Home Visits (PRN) Job Type: Contract, PRN, Per Diem Hourly Rate: $60/hr onsite and $50/hr travel time Work Location: Chicago, Illinois; Drive up to 1-2 hours to patient homes in your area (travel time compensated!) Job Description: As a Clinical Research Nurse - Home Visits (PRN), you will play a crucial role in ensuring the successful execution of research studies in patient homes. You will be responsible for administering investigational medications/products, conducting patient assessments, collecting vital information, and adhering to study protocols with utmost accuracy and ethics. Your expertise and caring nature will help us maintain compliance with each study's protocol and safeguard the well-being of study patients. Principal Duties and Responsibilities: Deliver competent, high-quality nursing care to study patients in their homes. Accountable for the competent and confident delivery of high-quality clinical care to patients/participants. Ensure compliance with each study's protocol by providing thorough review and documentation at each subject study visit. Administer investigational medications/products as needed; Perform patient assessments to determine presence of side effects; notify Principal Investigator of findings/issues. Perform medical tests as outlined in protocol, including, but not limited to: vital signs, specimen collection, electrocardiograms; Process specimens and ship specimens per protocol. Provide patient education and medical information to study patients to ensure understanding of proper medication dosage, administration, and disease treatment. Responsible for adherence to clinical research policies to ensure ethical conduct and protect vulnerable populations. Communicate effectively, promoting open and trusting relationships. Qualifications: Relevant Nurse Licensure CH-GCP Certificate Graduate from an accredited BSN or Associate Degree in Nursing or Nursing Diploma program Minimum 2 years' post qualification acute care experience Clinical Research experience preferred BLS certification required Experience and knowledge of working in clinical research trials with ICH-GCP (Good Clinical Practice) Certification - (training can be provided) Good basic IT skills, utilizing mobile devices and Microsoft systems Trained in Handling and Transport of Hazardous Substances (training can be provided) A flexible schedule is essential Unencumbered driver's license, reliable car Benefits: Competitive hourly pay rate, including compensation for travel time. Flexible schedule to maintain work-life balance. Mileage reimbursement for travel expenses. Ongoing training and support to growth your clinical research skills Opportunity to make a meaning impact on patients' lives while contributing to cutting-edge medical research. Join our team and contribute to groundbreaking medical advancements through clinical research!

Pine Park Health is a value-based primary care practice revolutionizing healthcare for residents of senior living communities across Arizona, California, and Nevada. We empower seniors to get healthy, stay healthy, and lead lives they love through a care model designed with everyone in mind - patients, families, community staff, providers, and payers. Our innovative approach brings healthcare directly to seniors' homes, offering prevention, screening, chronic condition management, lab work, and diagnostic testing in the comfort of their apartments. With weekly community visits, our teams provide consistent care while collaborating closely with facility staff to address comprehensive health needs. We've eliminated unnecessary barriers to urgent care through same-day and next-day appointments, helping seniors avoid emergency rooms and hospitalizations. Today, over 185+ communities trust Pine Park Health, and we're rapidly expanding our reach and impact. If you're mission-driven and passionate about transforming senior healthcare, this is your opportunity to make a meaningful difference! The Opportunity: We're clinicians, operators, product designers, and technologists that are passionate about redesigning the way people receive care. We provide care for residents of senior living communities and are looking for driven, compassionate, clinicians like you to join us. Our focus is on giving our patients evidence-based, person-centered care that aligns with their values and what matters to them. Over the last three years, we've experienced tremendous growth and are looking for a Registered Nurse excited to help lead us into the future. As an RN in our new team, you will be the hub of our care team structure and model of care. You will collaborate with our PCPs, Medical Directors, Technology Team, partners, and of course our patients as we work to build a company that delivers the best quality geriatric care available. In addition to providing great care, and working in a dynamic team environment, you'll have the chance to influence the development of healthcare technologies that enable our unique model. What You'll Do: Collaborate with a dedicated team of Primary Care Providers (PCPs), Medical Directors, and Medical Assistants supporting a patient panel. Triage inbound communications, including calls, faxes, emails and instant messages from teammates, patients, and partners. You will aim for "one touch" call resolution, escalate to the PCPs when necessary, and route sub-clinical tasks to our Medical Assistants. Act as a support system and escalation point for LVNs/LPNs/MAs within the team, enhancing our team's efficiency and effectiveness. Engage in comprehensive chart preparation before patient appointments. Oversee post-appointment processes, including diagnostic orders, referrals, medication orders, and provide crucial patient education on care plan adjustments when needed. Participate in daily team huddles, offering guidance and fostering efficient teamwork in support of patients & partners. Conduct virtual patient assessments, developing personalized care plans and monitoring health outcomes. Promote patient health through education on preventive care and self-management strategies consistent with the patient's care plan and wishes. Participate in crisis intervention and palliative care discussions, focusing on patient comfort and quality of life. Engage in ongoing quality improvement initiatives and contribute to research efforts aimed at enhancing geriatric care. What We're Looking For: A current unrestricted RN license in CA (preferably AZ and NV as well) with at least 2 years of clinical experience, preferably in geriatrics or related fields. Strong experience in remote roles, showcasing proficiency with technology and digital communication platforms. A track record of high accountability, exceptional communication, and the ability to thrive in a fast-paced environment. Experience with geriatric patients, particularly in settings like senior living communities or skilled nursing facilities. Familiarity with chronic care management and a solid understanding of geriatric-related diseases and treatments. A collaborative mindset, valuing the contributions of a multidisciplinary team and committed to improving patient outcomes. Why You'll Love Us: We're a smart, heart-centered, low-ego group motivated to make waves in the lives of seniors and the healthcare industry. We're solving complex, vital problems that affect real people and need bright, focused, driven minds like yours to help us achieve our goals. We empower team members to act like owners and have designed a learning-focused environment where you get ongoing support and regular feedback to help you grow. You'll get to invest in integrating technology with geriatric care, offering a unique opportunity to influence healthcare innovation. This is a dynamic and high-impact position at the core of our care delivery model. We work to create a supportive and collaborative environment where your contributions are valued and encouraged. Pine Park Health is an opportunity to be part of a fast-paced, mission-driven, startup organization focused on enhancing the health and well-being of geriatric patients. At Pine Park Health, we're passionate about transforming geriatric care and empowering our team to make a lasting impact. If you're dedicated to advancing healthcare through innovation and compassionate care, we'd love to hear from you. Pine Park Health is an equal opportunity employer - we aim to recruit, hire, develop, compensate, and promote regardless of race, religion, country of origin, gender, sexual orientation, age, marital status, veteran status, or disability.

How you'll change lives As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of a cross-functional team, working under the supervision of a Charge Nurse and assisting and supervising Patient Care Technicians (PCTs) to care for patients living with kidney disease. What you'll be doing Patient care. You'll work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include completing and documenting physical assessments before and after treatments and monitoring patients during treatment. You'll ensure quality renal care by completing monthly reviews of patient medication profiles and administering medications according to physician orders. Teamwork. You'll be a critical member of an interdisciplinary team to provide all required patient assessment and care planning activities. You'll also make sure center staffing requirements are met at all times under the direction of the Administrator and according to state regulations for staffing ratios. Safety & Quality. Working under the supervision of a Charge Nurse, you'll adhere to all company policies and procedures and state and federal laws and regulations. You'll participate in all required staff meetings and continuing education offerings.

Inova Health is looking for a dedicated Registered Nurse (RN) Clinical Documentation Denials Auditor to join the team. This role will be fully-time remote, Monday-Friday, regular business hours 8:00 AM - 4:30 PM (flexible). Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities. Registered Nurse (RN) Clinical Documentation Denials Auditor Job Responsibilities: Evaluates specificity and completeness of physician documentation to ensure optimal coding (e.g. mortality outcomes using APR-DRG, SOI and ROM, appropriate reduction of complications based on PSI and HAC, revenue assurance outcomes based on reimbursement DRG (MS-DRG), documentation of significant chronic conditions affecting resource utilization based on HCC). Summarizes audit findings for individual records along with specific documentation guidelines to improve expected clinical outcomes for an individual physician, physician practice, or specialty. Conducts follow-up audits (i.e. concurrent or post-discharge) with routine feedback until documentation practice comes into line with expected clinical outcomes. Works with Clinical Documentation Improvement (CDI) Director and Lead Auditor on other work related to physician audits and education programs. Demonstrates proficiency with Cobius to access external audit work, record summary results and upload appeal letters. Demonstrates proficiency with Encompass 360 and HDM audit functions to review electronic medical records with advanced functions (i.e. ex, auto-suggest and search) and record detail coding audit results. Showcases proficiency in reviewing records in Epic electronic medical records - which may be the only option for audits of older records. Demonstrates proficiency in writing effective appeal letters that include appropriate coding guidelines and medical references. Identifies trends in external audit findings related to coding quality and physician documentation. Prepares educational communications related to these findings. Evaluates physicians' documentation, diagnostic reports, and clinical findings for validation of diagnoses. Processes the requests for second opinion reviews when clinical validity is not supported or in question. May perform additional duties as assigned. Minimum Qualifications: Certification: Certified Coding Specialist / Certified Clinical Documentation Specialist; ACDIS/AHIMA certification, CCDS or CDIP Licensure: Current RN license and eligible to practice in VA Experience: Seven years of recent CDI, DRG validation or coding audit experience in an acute hospital setting with clinician training as RN, BSN, NP, PA or MD; Coding certification CCS and CDI certification CCDS or CDIP Education: Associate Degree in Nursing or Medicine. Preferred Qualifications: Experience: Recent coding experience. Clinical background and coding + denials knowledge. Experience writing denials & appeals. Outpatient and/or inpatient experience. Knowledge to identify clinical indicators (example: sepsis). EPIC experience. Certifications: CCDS Skills: presenting Remote Eligibility: This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV

Our Virtual Urgent Care team is looking for an experienced Physician Assistant or Nurse Practitioner to join their team. In this role, you will be providing virtual medical care to patients of varying type and acuity. This is a full-time night shift position. As we care for patients of all ages, we cannot consider Adult/Gerontology trained Nurse Practitioners. Qualifications Physician Assistant * Required Master's Degree Graduate of an accredited Physician Assistant educational program * LIC-Physician Assistant - STATE_MI State of Michigan Upon Hire required * CRT-Physician Asst Certified (PA-C) - NCCPA National Commission on Certification of Physician Assistants Upon Hire required * CRT-Basic Life Support (BLS) - AHA American Heart Association 90 Days required Or * CRT-Basic Life Support (BLS) - ARC American Red Cross 90 Days required * CRT-Pediatric Adv Life Support (PALS) - AHA American Heart Association 120 Days required * CRT-Adv Cardiovascular Life Support (ACLS) - AHA American Heart Association 120 Days required Nurse Practitioner * Required Master's Degree Nurse Practitioners who obtained their education and certification after 2000 must show evidence of completion of a master's, post-master's or doctorate from a Nurse Practitioner program that is accredited by the Commission on the Collegiate of Nursing Education or the National League for Nursing Accrediting Commission * 3 years of relevant experience current, relevant clinical experience * Previous experience functioning in a collaborative role as a Nurse Practitioner * LIC-Nurse Practitioner (NP) - State of Michigan * CRT-Basic Life Support (BLS) * CRT-Neonatal Resuscitation Program (NRP) * CRT-Pediatric Adv Life Support (PALS) Corewell Health West Medical Group The Corewell Health West Medical Group is part of a not-for-profit health system serving 13 counties in West Michigan. Corewell Health West is a region of Corewell Health, formerly the BHSH System (Beaumont Health and Spectrum Health) that provides care and coverage with an exceptional team of 60,000+ dedicated people-including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving over 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. Corewell Health People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy, and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 65,000+ dedicated people-including more than 12,000 physicians and advanced practice providers and more than 15,500 nurses providing care and services in 21 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving more than 1.3 million members Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. For more information, visit corewellhealth.org. How Corewell Health cares for you * Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here. * On-demand pay program powered by Payactiv * Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! * Optional identity theft protection, home and auto insurance, pet insurance * Traditional and Roth retirement options with service contribution and match savings * Eligibility for benefits is determined by employment type and status Primary Location SITE - 515 Michigan St NE - Grand Rapids Department Name Virtual Urgent Care - CHMG West Employment Type Full time Shift Variable (United States of America) Weekly Scheduled Hours 40 Hours of Work Variable Days Worked Variable Weekend Frequency Every third weekend CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling ************.

Full time Shift: 12 Hour Day Shift (United States of America) Hours per week: 36 Job Information Exemption Status: Non-Exempt Medical/Surgical virtual nursing is a specialty within the nursing profession that encompasses the care of individuals across the life span who present with physical, emotional, or psychological alterations of health. Medical/Surgical virtual nursing is care of acute and chronic illnesses in nature and occurs in a variety of care settings. Medical/Surgical nursing encompasses care that ranges from cardiac, oncology, stroke, joint, spine, post-surgical, palliative, psychiatric and end-of-life issues. It includes the care of patients greater than age 12 and all health conditions. Medical/Surgical nurses have adapted nursing process to include components of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation of human responses when caring for patients. Education Qualifications Bachelors of Science: Nursing (BSN) Preferred Skills and Abilities Demonstrates awareness and sensitivity to rights of patient/significant other, as identified within the institution. (Required proficiency) Demonstrates awareness and application of safety issues as identified within the institution. (Required proficiency) Demonstrates awareness of legal issues in all aspects of patient care and departmental functioning. Strives to manage situations in a manner, which minimizes risk to the patient and the institution. (Required proficiency) Demonstrates competency in selected psychomotor skills. (Required proficiency) Ability to communicate effectively using verbal, non-verbal and written methods. (Required proficiency) Ability to perform mathematical calculations related to medication administration and equipment calibration. Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. (Required proficiency) Licenses and Certifications Registered Nurse - KSBN A multistate license with the ability to practice within the State of Kansas is also accepted. Required RQI, CPR or ACLS certifications may be required in lieu of or in addition to BLS depending on department. What you will do Collects pertinent data and information relative to the patient, situation, or setting. Analyzes assessment data to determine actual or potential problems, and issues. Identifies expected outcomes for a plan individualized to the patient or situation. Develops a collaborative plan encompassing strategies to achieve expected outcomes. Collaborates virtually with physicians, nurses and other health care team members implementing identified plan through coordination of care and employs strategies to promote health and wellness. Virtually evaluates progress toward attainment of goals and outcomes through coordination with patient and review of medical record. Virtually monitors and preemptively gets ahead of subtle signs and symptoms of clinical deterioration or status changes in coordination with multidisciplinary care team. Delivers professional nursing 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. Mentors nurses new to their role for the purpose of ensuring successful enculturation, orientation, competence, and emotional support. 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 and lead nursing practice in process evolution the scope of the Stormont Vail Health professional practice model Utilizes appropriate resources to plan, 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 Not 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 Full-Time Scope No Supervisory 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 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: Occasionally 1-3 Hours Lifting: Occasionally 1-3 Hours up to 50 lbs Operate Foot Controls: Rarely less than 1 hour Pulling: Occasionally 1-3 Hours up to 50 lbs Pushing: Occasionally 1-3 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 Explosive: Rarely less than 1 hour Extreme Temperatures: Rarely less than 1 hour Infectious Diseases: Occasionally 1-3 Hours Mechanical: Rarely less than 1 hour Needle Stick: Frequently 3-5 Hours Noise/Sounds: Frequently 3-5 Hours Other Atmospheric Conditions: Rarely less than 1 hour 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: Occasionally 1-3 Hours Risk of Exposure to Hazardous Drugs: Occasionally 1-3 Hours 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.

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.

As an advocate for the patient, the RN care manager will assess, plan, implement, coordinate, monitor, and evaluate the options and services required to meet an individual's health needs, using clinical and community resources to promote quality, cost effective outcomes. Integrates evidenced based clinical guidelines, preventive guidelines, and protocols, in the development of individualized care plans that are patient centric. Provides targeted interventions to avoid hospitalization and emergency room visits. Essential Functions and Responsibilities: 1. Provides telephonic and face-to-face comprehensive assessment and care management services to patients as part of an interdisciplinary team. 2. Uses multi-dimensional assessment skills, risk assessment and screening tools to target high risk and vulnerable populations. 3. Assesses over time the health care, educational, and psychosocial needs of the patient/caregiver. Uses standardized assessment tools such as depression screening, functionality, and health risk assessment. 4. Provides follow up with patient/family when patient transitions from one setting to another. Completes timely post-hospital follow up: Medication reconciliation, PCP or specialist follow-up appointment, assess symptoms, teach warning signs, review discharge instructions, coordination of care, and problem solve barriers. 5. Uses clinical judgment to determine level of care and collaborates with the PCP, patient and interdisciplinary team, including continuum of care settings and community. Required: * RN with a valid unrestricted Michigan license. * Three (3) years clinical nursing experience serving chronically ill patients and extensive knowledge of issues associated with chronic care and geriatrics. Preferred: * RN, BSN. * Three (3) years experience in a health plan or Physician Organization environment with care coordination, care management, and/or population health. * Telephonic care management experience. * Home care and/or hospice experience. * Complex Care Management course completion or CCM. Additional Information * Schedule: Full-time * Requisition ID: 25007188 * Daily Work Times: 8am-5pm * Hours Per Pay Period: 80 * On Call: No * Weekends: No