Senior Stars Improvement, Clinical Professional RN
Humana 4.8
Registered nurse prn job at Humana
Become a part of our caring community and help us put health first The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Stars Improvement, Clinical Professional is responsible for a provider assignment of 50+ Medicaid provider groups. This position oversees HEDIS, quality & performance improvement and required quality activities that are related to NCQA health plan performance rating as well as the Agency's Quality Withhold and Liquidated Damages programs for assigned providers. Also supports improvement strategies through engagement with internal and external stakeholders.
The Senior Stars Improvement, Clinical Professional monitors assigned value-based and non-value-based provider/provider groups' performance in key performance indicators related to preventive care, care of chronic conditions and identified medical metrics (ex. HEDIS, APT, readmissions, ED utilization, polypharmacy, etc.). In this role, you will actively engage providers, review of KPIs, improvement strategies and bi-directional feedback related to barriers and opportunities. Educate and assist providers in reducing potential preventable events through the use of data driven methods and resources related to available clinical programs. Support improvement in member experience through education, information and resources related to the annual Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and Humana's Member Experience Medicaid Survey (MEMS).
Responsibilities:
Continue to focus efforts and identify opportunities on performance improvement for assigned providers
Actively engages provider during virtual visit to facilitate education, HEDIS outcomes, care of members and bi-directional feedback.
Attends JOCs with providers and participates in active discussions on HEDIS, member care, and clinical/quality outcomes.
Communicate clinical quality initiatives to assigned providers
Educate and assist providers in reducing potential preventable events
Educate providers and staff about Medicaid Consume Assessment of Healthcare Providers and Systems (CAHPS) survey.
Use your skills to make an impact
Required Qualifications
FL RN License
Must reside in the state of Florida
Must have quality improvement experience in Medicaid or Medicare (Medicaid quality improvement a plus) (i.e. HEDIS, CMS Stars)
Proficient/ intermediate utilization of Excel and PowerPoint.
Prior experience in a fast-paced insurance or health care setting
Experience collaborating with cross-functional teams
Proven analytical skills
Excellent communication skills, both oral and written
Strong relationship building skills
Conducts self in a professional manner with all verbal and written communication when working with associates, peers, and providers
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred
FL BSN License (Bachelor's Degree in Nursing)
Medical Coding Certification
Knowledge of Humana's internal policies, procedures, and systems
Medicaid Health Plan Experience
Additional Information
Workstyle: Remote
Work Location: Must reside in FL
Travel: None
Typical Workdays/Hours: Monday- Friday, 8am- 5pm EST
Work-At-Home Requirements
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first-round interview, you will receive an email correspondence inviting you to participate in a HireVue interview. In this interview, you will receive a set of interview questions over your phone, and you will provide recorded or text message responses to each question.
For best interview experience use a computer over a phone.
You should anticipate this interview to take about 15-20 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Humana Benefits
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Parental and caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
Social Security Task
Humana value's personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
$78.4k-107.8k yearly Auto-Apply 4d ago
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LPN or LVN
Brookdale Senior Living 4.2
Springfield, OH jobs
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity
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. Role is also eligible for team based bonus opportunities. 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.
Assist in maintaining a physical, social and psychological environment in the best interest of residents.
Monitor care of residents according to treatment plans prescribed by a physician as well as documenting responses to care plans.
Nurses also administer medications, ensure cleanliness and security of medicine supply room and adhere to company systems, procedures and processes.
LPN or LVN License Required per state regulations.
Brookdale is an equal opportunity employer and a drug-free workplace.
$41k-52k yearly est. 5d ago
LPN or LVN
Brookdale Senior Living 4.2
Akron, OH jobs
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity
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. Role is also eligible for team based bonus opportunities. 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.
Assist in maintaining a physical, social and psychological environment in the best interest of residents.
Monitor care of residents according to treatment plans prescribed by a physician as well as documenting responses to care plans.
Nurses also administer medications, ensure cleanliness and security of medicine supply room and adhere to company systems, procedures and processes.
LPN or LVN License Required per state regulations.
Brookdale is an equal opportunity employer and a drug-free workplace.
$41k-54k yearly est. 4d ago
LPN or LVN
Brookdale Senior Living 4.2
Cincinnati, OH jobs
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity
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. Role is also eligible for team based bonus opportunities. 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.
Assist in maintaining a physical, social and psychological environment in the best interest of residents.
Monitor care of residents according to treatment plans prescribed by a physician as well as documenting responses to care plans.
Nurses also administer medications, ensure cleanliness and security of medicine supply room and adhere to company systems, procedures and processes.
LPN or LVN License Required per state regulations.
Brookdale is an equal opportunity employer and a drug-free workplace.
$41k-52k yearly est. 3d ago
LPN or LVN
Brookdale Senior Living 4.2
Medina, OH jobs
HIRING FULL TIME FIRST SHIFT NURSE: 6:00AM-2:00PM
SECOND SHIFT: 2PM-10PM
PRN-THIRD SHIFT: 10PM-6AM
UNIFORM TOPS PROVIDED
MEALS PROVIDED
EVERY OTHER WEEKEND
ROTATING HOLIDAYS
EXCELLENT BENEFITS
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity
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. Role is also eligible for team based bonus opportunities. 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.
Assist in maintaining a physical, social and psychological environment in the best interest of residents.
Monitor care of residents according to treatment plans prescribed by a physician as well as documenting responses to care plans.
Nurses also administer medications, ensure cleanliness and security of medicine supply room and adhere to company systems, procedures and processes.
LPN or LVN License Required per state regulations.
Brookdale is an equal opportunity employer and a drug-free workplace.
$41k-54k yearly est. 8d ago
TRA RN and Allied specialties Travel and Local Contracts
Tenet Healthcare 4.5
Remote
This is a general application which is applicable across all TRA locations and, all RN and Allied Travel and Local contracts. When you receive your offer letter, it will be customized for the specific position you are hired into.
With TRA, you will receive greater contract security than with outside agencies while accessing exciting travel and local contracts across the nation.
Why Choose TRA?
Guaranteed Hours for Travel Contracts
Preferred Booking Agreement for Local Contracts
Company Matching funds for the 401K
Holiday Pay
TRA is preferred for all contract assignments within Tenet while receiving the same tenure as Tenet staff.
Location: This is a general application link and, you can be hired into any specific position that fits with what location you are looking to be hired into. As mentioned above, your offer letter will be customized and specific for the position you and your Recruiter speak about.
$107k-134k yearly est. Auto-Apply 60d+ ago
Field Nurse Practitioner (Athens, OH)
Molina Healthcare 4.4
Athens, OH jobs
Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and “pop up” clinics. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Provides general medical care and care coordination to various and/or specific patient member populations - adult, women's health, pediatric, and geriatric.
• Performs comprehensive evaluations including history and physical exams for gaps in care and preventive assessments.
• Addresses both chronic and acute primary care complaints, and demonstrates ability to ascertain medical urgency.
• Establishes and documents reasonable medical diagnoses.
• Seeks specialty consultation as appropriate.
• Orders/performs pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptoms; works within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately.
• Understands when a member's needs are beyond their scope of knowledge and when physician oversight is needed.
• Creates and implements a medical plan of care.
• Schedules appointments for visits when appropriate.
• Provides post-discharge coordination to reduce hospital readmission rates and emergency room utilization.
• Performs face-to-face in-person visits in a variety of settings including in-home, skilled nursing facilities, and public locations.
• Performs face-to-face visits via alternative modalities based on business need, leadership direction and state regulations.
• Orders bulk laboratory orders to target specific member populations.
• Performs alternating on-call coverage to triage any urgent lab results and pharmacy inquiries and develops appropriate plans of care.
• Participates in community-based “pop up clinics” to build relationships with communities, and address gaps in health care.
• Drives up to 120 miles a day on a regular basis to a variety of locations within the assigned region. Drives beyond 120 miles as part of extended mileage may be required on special project days. Special projects may include an overnight hotel stay.
• Obtains and maintains cross-state license in other states besides home state based on business need.
• Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and effectively.
• Actively participates in regional meetings.
• May prescribe medications and perform procedures as appropriate.
• Performs timely medical records documentation in electronic medical record (EMR) computer system.
• On occasion, may be required to walk flights of stairs while carrying up to 50 lbs. of equipment.
• Engages in practices constituting the practice of medicine in collaboration with and under the medical direction and supervision of a licensed physician to the degree required by state laws.
• Local travel required (based upon state/contractual requirements).
Required Qualifications
• At least 1 year of experience as a nurse practitioner, or equivalent combination of relevant education and experience.
• Active and unrestricted national certification from one of the following organizations: American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC).
• Current state-issued license to practice as a Family Nurse Practitioner (FNP). License must be active and unrestricted in state of practice.
• Prescriber Drug Enforcement Agency (DEA) license with authority to prescribe per state qualifications. License must be active and unrestricted in state of practice.
• Current Basic Life Support (BLS) certification.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently with minimal supervision and demonstrate self-motivation.
• Responsive in all forms of communication.
• Ability to remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills; ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency, and electronic medical record (EMR) experience.
Preferred Qualifications
• Experience as a registerednurse or nurse practitioner in a home health, community health or public health setting.
• Experience in home health as a licensed clinician, especially in management of chronic conditions.
• Experience with underserved populations facing socioeconomic barriers to health care.
• Immunization and point of care testing skills.
• Bilingual.
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
#PJNurse
#LI-AC1
Pay Range: $88,453 - $172,484 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the physicians' clinical documentation. Exhibits a sufficient knowledge of clinical documentation requirements, MS-DRG Assignment, and clinical conditions and/or procedures.
Educates members of the patient care team regarding documentation guidelines, including the following: attending physicians, allied health practitioners, nursing, and case management.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
1. Record Review:
* Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population to: (a) evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) record in business partner designated CDI tool and/or host medical record system.
* Conducts follow-up reviews of patients every 24-48 hours or as needed up through discharge to support assigned working MS-DRG assignment upon patient discharge, as necessary.
* Formulate physician queries regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the health record, as necessary.
* Collaborates with providers, case managers, nursing staff and other ancillary staff regarding documentation and to resolve physician queries prior to discharge.
2.CDI
* Communicates/Completes Clinical Documentation Integrity (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up, provider education and DRG Miss-Match reconciliation.
* Assists with Provider education, rounding and communication regarding open queries for resolution.
3. Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD10-CM and PCS coding. Attends CDI Boot camp, CDI/coding trainings annually and quarterly for inpatient coding. Attends monthly education lecture series (MELS) and all CDI/coding assigned learn share modules as well as any additional required CDI education.
4. Assist in training department staff new to CDI
5. Performs other duties as assigned
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* CDI Specialist must display teamwork and commitment while performing daily duties
* Must demonstrate initiative and discipline in time management and medical record review.
* Travel may be required to meet the needs of the facilities.
* Proficient knowledge of disease pathophysiology and drug utilization
* Intermediate knowledge of MS-DRG classification and reimbursement structures
* Critical thinking, problem solving and deductive reasoning skills.
* Effective written and verbal communication skills
* Excellent computer skills including MS Word/Excel
* Knowledge of coding compliance and regulatory standards
* Excellent organizational skills for initiation and maintenance of efficient workflow
* Regular and reliable attendance
* Capacity to work independently in facility on-site setting.
* Capacity to work independently in a virtual office setting if required for specific assignment.
* Exhibit flexibility as needed to meet program needs.
* Understand and communicate documentation strategies.
* Recognize opportunities for documentation improvement.
* Formulate clinically, compliant credible queries.
* Ability to successfully comply to robust auditing and CDI program monitoring
* Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation.
Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
* Preferred: Acute Care nursing and/or Provider relevant experience
* Zero (0) to two (2) years CDI experience
* Two (2) plus years' nursing experience - Medical/Surgical/Intensive Care and/or Case/Utilization Review
* Two (2) plus years' Provider experience - Medical/Surgical/Intensive Care and/or Case/Utilization Review
* Graduate from a Nursing program, BSN, or graduate program; OR
* Graduate from Medical Doctor and/or Foreign Medical Doctor Program
CERTIFICATES, LICENSES, REGISTRATIONS
* Active state RegisteredNurse license; OR
* Graduate MD and/or FMD license
* Preferred: CDIP or CCDS
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Ability to sit for extended periods of time.
* Ability to stand for extended periods of time.
* Must be able to efficiently use computer keyboard and mouse.
* Good visual acuity
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER
* Must be able to travel as needed, not to exceed 10%.
Compensation and Benefit Information
Compensation
* Pay: $72,509- $108,763 annually. Compensation depends on location, qualifications, and experience.
* Management level positions may be eligible for sign-on and relocation bonuses.
Benefits
Conifer offers the following benefits, subject to employment status:
* Medical, dental, vision, disability, life, and business travel insurance
* Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.
* 401k with up to 6% employer match
* 10 paid holidays per year
* Health savings accounts, healthcare & dependent flexible spending accounts
* Employee Assistance program, Employee discount program
* Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
* For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.
E-Verify: *****************************
The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.
**********
$72.5k-108.8k yearly 16d ago
Registered Nurse - Field Assessor- Remote (Per Diem)
Unitedhealth Group Inc. 4.6
Alamosa, CO jobs
Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
* Provide high-quality clinical services within scope of practice and infection control standards
* Coordinate care with other members of the patient/client's care team from admission to discharge
* Complete clinical nursing assessments per federal/state program requirements and payer needs
* Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
* Develop and revise individualized plans of care/service plans with other community providers
* Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current and unrestricted RN licensure in the state of practice
* Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
* Current CPR certification
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
State Specific Requirements:
* LA:
* 1+ years of clinical experience as a RegisteredNurse
* 1+ years of clinical experience as a RegisteredNurse
* 1+ years of clinical experience as a RegisteredNurse may be waived for a RegisteredNurse with recent clinical experience as an LPN
* RN licensure must have no restrictions
Preferred Qualifications:
* 1+ years of RN experience
* Able to work independently
* Good communication, writing, and organizational skills
* 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28.3-50.5 hourly 24d ago
Registered Nurse - Field Assessor- Remote (Per Diem)
Unitedhealth Group 4.6
Alamosa, CO jobs
**Explore opportunities with [agency name],** a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Provide high-quality clinical services within scope of practice and infection control standards
+ Coordinate care with other members of the patient/client's care team from admission to discharge
+ Complete clinical nursing assessments per federal/state program requirements and payer needs
+ Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
+ Develop and revise individualized plans of care/service plans with other community providers
+ Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current and unrestricted RN licensure in the state of practice
+ Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
+ Current CPR certification
+ Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **State Specific Requirements:**
+ LA:
+ 1+ years of clinical experience as a RegisteredNurse
+ 1+ years of clinical experience as a RegisteredNurse
+ 1+ years of clinical experience as a RegisteredNurse may be waived for a RegisteredNurse with recent clinical experience as an LPN
+ RN licensure must have no restrictions **Preferred Qualifications:**
+ 1+ years of RN experience
+ Able to work independently
+ Good communication, writing, and organizational skills
*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.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$28.3-50.5 hourly 24d ago
Senior Stars Improvement, Clinical Professional RN
Humana 4.8
Registered nurse prn job at Humana
Become a part of our caring community and help us put health first The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Stars Improvement Clinical Professional focused on maternal health is responsible for a provider assignment of 50+ Medicaid provider groups. This position oversees HEDIS, quality & performance improvement and required quality activities that are related to NCQA health plan performance rating as well as the Agency's Quality Withhold and Liquidated Damages programs for assigned providers. Also supports improvement strategies through engagement with internal and external stakeholders.
The Senior Stars Improvement, Clinical Professional monitors assigned value-based and non-value-based provider/provider groups' performance in key performance indicators which may include preventive care, maternal health, and identified medical metrics (ex. HEDIS, admissions, readmissions, ED utilization, polypharmacy, pre-term delivery rate, cesarean section rate, etc.). In this role, you will actively engage providers, review KPIs, improvement strategies and bi-directional feedback related to barriers and opportunities. Educate and assist providers in reducing potential preventable events through the use of data driven methods and resources related to available clinical programs. Support improvement in member experience through education, information and resources related to the annual Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and Humana's Member Experience Medicaid Survey (MEMS).
The Senior Stars Improvement, Clinical Professional will collaborate with internal stakeholders and leaders to analyze and inform strategies for improvement in maternal health outcomes for our members and the communities we serve.
Responsibilities:
Continue to focus efforts and identify opportunities on performance improvement for assigned providers
Actively engages provider during routine virtual visits to facilitate education, HEDIS and medical metric outcomes, care of members and bi-directional feedback.
Attends joint operating committee meetings (JOCs) with providers and participates in active discussions on HEDIS, member care, and clinical/quality outcomes.
Communicate clinical quality initiatives to assigned providers
Educate and assist providers in developing strategies to reduce potential preventable events
Educate providers and staff about Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
Actively engage with internal stakeholders, leaders and teams to analyze and inform improvement strategies to address maternal health outcomes. Engagement may include formal and informal discussions, in individual or group settings.
Use your skills to make an impact
Required Qualifications
FL RN License
Must reside in the state of Florida
Must have quality improvement experience in Medicaid or Medicare (Medicaid quality improvement a plus) (i.e. HEDIS, CMS Stars)
Proficient/ intermediate utilization of Excel and PowerPoint.
Prior experience in a fast-paced insurance or health care setting
Experience collaborating with cross-functional teams
Proven analytical skills
Excellent communication skills, both oral and written
Strong relationship building skills
Demonstrated ability to work independently, proactively initiate tasks, conduct thorough research, and acquire new knowledge to support ongoing development.
Conducts self in a professional manner with all verbal and written communication when working with associates, peers, and providers
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Bachelor's degree in nursing or related field
Medical Coding Certification
Certified Professional in Healthcare Quality (CPHQ)
Knowledge of Humana's internal policies, procedures, and systems
Medicaid Health Plan Experience
Additional Information
Workstyle: Remote
Work Location: Must reside in FL
Travel: None
Typical Workdays/Hours: Monday- Friday, 8am- 5pm EST
Work-At-Home Requirements:
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format:
As part of our hiring process for this opportunity, we will be using exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first-round interview, you will receive an email correspondence inviting you to participate in a HireVue interview. In this interview, you will receive a set of interview questions you may answer via by phone or computer, and you will provide recorded or text message responses to each question. Some of the questions may require longer responses and using a computer vs phone to type responses may work best. You should anticipate this interview to take about 15-20 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Why Humana?
At Humana, we know your well-being is important to you, and it's important to us too. That's why we're committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few:
Work-Life Balance
Generous PTO package
Health benefits effective day 1
Annual Incentive Plan
401K - with company match
Well-being program
Paid Volunteer Time Off
Student Loan Refinancing
If you share our passion for helping people, we likely have the right place for you at Humana.
Social Security Task:
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an offer will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Explore opportunities with a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
Primary Responsibilities:
* Provide high-quality clinical services within scope of practice and infection control standards
* Coordinate care with other members of the patient/client's care team from admission to discharge
* Complete clinical nursing assessments per federal/state program requirements and payer needs
* Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
* Develop and revise individualized plans of care/service plans with other community providers
* Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current and unrestricted RN licensure in the state of practice
* Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
State Specific Requirement:
* CA: 1+ years of experience in professional nursing
Preferred Qualifications:
* Able to work independently
* Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The 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.
**Explore opportunities** with a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
**Primary Responsibilities:**
+ Provide high-quality clinical services within scope of practice and infection control standards
+ Coordinate care with other members of the patient/client's care team from admission to discharge
+ Complete clinical nursing assessments per federal/state program requirements and payer needs
+ Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
+ Develop and revise individualized plans of care/service plans with other community providers
+ Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current and unrestricted RN licensure in the state of practice
+ Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
+ Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **State Specific Requirement:**
+ CA: 1+ years of experience in professional nursing **Preferred Qualifications:**
+ Able to work independently
+ Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$28.3-50.5 hourly 24d ago
Behavioral Health Senior Clinical Admin RN - Remote
Unitedhealth Group 4.6
Phoenix, AZ jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**
The Senior Clinical Admin Nurse will be responsible for providing individualized attention to UMR membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Candidate must be willing to work Monday - Friday 8:00 am - 5:00 pm.**
**Primary Responsibilities:**
+ Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently
+ Educate and guide members regarding BHSUD
+ Assist members with adverse determinations, including the appeal process
+ Teach members how to navigate UMR internet-based wellness tools and resources
+ Outreach to membership providing pre-admission counseling to membership
+ Outreach to membership providing discharge planning to membership and caretakers
+ Track all activities and provide complete documentation to generate customer reporting
+ Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed
+ Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases
+ Contribute to treatment plan discussions
+ Other duties as assigned
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current and unrestricted RN compact license
+ 2+ years of acute nursing experience
+ 2+ years of behavioral health nursing experience
+ 2+ years of case management experience
+ Demonstrated basic computer proficiency (i.e. MS Word, Outlook)
+ Proven ability to function independently and responsibly with minimal supervision
**Preferred Qualifications:**
+ Bachelor's degree in nursing
+ CCM
+ 2+ years of managed care experience
+ Critical care, pediatric, med-surg and/or telemetry experience
+ Utilization management experience
+ Adverse determination experience
+ Telecommute experience
**Soft Skills:**
+ Demonstrated excellent verbal and written communication skills
+ Excellent customer service orientation
+ Proven team player and team building skills
+ Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
*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 salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_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._
$60.2k-107.4k yearly 8d ago
RN Home Care Visits PRN- Parma
Unitedhealth Group Inc. 4.6
Parma, OH jobs
Explore opportunities with Almost Family - Middleburg Heights PC, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
Primary Responsibilities:
* Provide high-quality clinical services within scope of practice and infection control standards
* Coordinate care with other members of the patient/client's care team from admission to discharge
* Complete clinical nursing assessments per federal/state program requirements and payer needs
* Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
* Develop and revise individualized plans of care/service plans with other community providers
* Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current and unrestricted RN licensure in the state of practice
* Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
* Current CPR certification
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
Preferred Qualifications:
* 1+ years of RN experience
* Able to work independently
* Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28.3-50.5 hourly 37d ago
Registered Nurse - Field Assessor - LTS - Remote
Unitedhealth Group Inc. 4.6
Lake Katrine, NY jobs
Explore opportunities with the LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
Primary Responsibilities:
* Provide high-quality clinical services within scope of practice and infection control standards
* Coordinate care with other members of the patient/client's care team from admission to discharge
* Complete clinical nursing assessments per federal/state program requirements and payer needs
* Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
* Develop and revise individualized plans of care/service plans with other community providers
* Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current and unrestricted RN licensure in the state of practice
* Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
Preferred Qualifications:
* 1+ years of RN experience
* Current CPR certification
* Able to work independently
* Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28.3-50.5 hourly 24d ago
Registered Nurse - Field Assessor - LTS - Remote
Unitedhealth Group 4.6
Lake Katrine, NY jobs
**Explore opportunities with the LHC** **Group** , a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
**Primary Responsibilities:**
+ Provide high-quality clinical services within scope of practice and infection control standards
+ Coordinate care with other members of the patient/client's care team from admission to discharge
+ Complete clinical nursing assessments per federal/state program requirements and payer needs
+ Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
+ Develop and revise individualized plans of care/service plans with other community providers
+ Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current and unrestricted RN licensure in the state of practice
+ Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
+ Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **Preferred Qualifications:**
+ 1+ years of RN experience
+ Current CPR certification
+ Able to work independently
+ Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$28.3-50.5 hourly 24d ago
RN Home Care Visits PRN- Lorain
Unitedhealth Group Inc. 4.6
Lorain, OH jobs
Explore opportunities with Almost Family - Middleburg Heights PC, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
Primary Responsibilities:
* Provide high-quality clinical services within scope of practice and infection control standards
* Coordinate care with other members of the patient/client's care team from admission to discharge
* Complete clinical nursing assessments per federal/state program requirements and payer needs
* Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
* Develop and revise individualized plans of care/service plans with other community providers
* Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current and unrestricted RN licensure in the state of practice
* Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
* Current CPR certification
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
Preferred Qualifications:
* 1+ years of RN experience
* Able to work independently
* Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The 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.
#LHCJobs
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28.3-50.5 hourly 37d ago
RN Home Visits PRN- New Philadelphia
Unitedhealth Group Inc. 4.6
New Philadelphia, OH jobs
Explore opportunities with Steubenville CHHC PC, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
Primary Responsibilities:
* Provide high-quality clinical services within scope of practice and infection control standards
* Coordinate care with other members of the patient/client's care team from admission to discharge
* Complete clinical nursing assessments per federal/state program requirements and payer needs
* Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
* Develop and revise individualized plans of care/service plans with other community providers
* Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current and unrestricted RN licensure in the state of practice
* Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
* Current CPR certification
* Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
Preferred Qualifications:
* 1+ years of RN experience
* Able to work independently
* Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The 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.
#LHCJobs
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28.3-50.5 hourly 37d ago
RN Home Visits PRN- New Philadelphia
Unitedhealth Group 4.6
New Philadelphia, OH jobs
Explore opportunities with Steubenville CHHC PC, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the RegisteredNurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
**Primary Responsibilities:**
+ Provide high-quality clinical services within scope of practice and infection control standards
+ Coordinate care with other members of the patient/client's care team from admission to discharge
+ Complete clinical nursing assessments per federal/state program requirements and payer needs
+ Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
+ Develop and revise individualized plans of care/service plans with other community providers
+ Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current and unrestricted RN licensure in the state of practice
+ Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation
+ Current CPR certification
+ Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **Preferred Qualifications:**
+ 1+ years of RN experience
+ Able to work independently
+ Good communication, writing, and organizational skills
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The 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.
**\#LHCJobs**
_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._