Home Care Nurse jobs at On Lok

On Lok PACE We are a non-profit committed to our participants. Dedicated to The Care of Elders: PACE (Program of All-Inclusive Care for the Elderly) was developed to answer the many problems around caring for frail seniors. The PACE model is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in their community whenever possible. Seniors, their family members, and caregivers face many issues, including transportation to appointments, management of medications, coordination of medical care from different specialists, lack of social interaction, and ability to stay alone at home. On Lok PACE participants receive in home care services and transportation to a On Lok PACE center for primary medical care, social and recreational activities, and other senior care services. We understand the importance of a system that works together. Your expertise, drive and passion can help us carry out our mission to improve lives and advance healthcare. Join our team of leaders to begin a rewarding career! POSITION SUMMARY: Under the clinical direction of the Nurse Manager and supervision of the Program Manager, the Clinic RN Lead is responsible for providing nursing leadership, administrative support, and clinical supervision of clinic operations as well as develop and implement strategies that enhance the quality of care to fulfill On Lok Lifeways mission. DUTIES / RESPONSIBILITIES: Assesses participant's needs and plans appropriate nursing care plans. Implements, directs, supervises, and evaluates nursing care for participants with the ADHC and clinic setting. Participates actively in the interdisciplinary team by offering clinical expertise in team planning, problem solving, and processes. Teaches, supervises, and counsels the participant, geriatric aides, and family members regarding nursing care needs and other related problems of the participant. Serves as the first point of contact within the clinic for incoming calls and/or information concerning participants' status and/or care coordination. Prioritizes and triages care according to medical acuity by utilizing the reviews of daily triage schedules/reports, home care reports and weekend reports to ensure continuity of care is established Oversees staff assignment and appointment scheduling. Provides clinical and administrative support to staff with urgent and emergent visits and physician's orders. Oversees all clinic huddles and clinic meetings to ensure open, accurate, and timely communication within the clinic and among all disciplines/departments. Delegates related tasks to appropriate staff. Partners with medical leadership to ensure efficient and cost effective clinical operations. Oversees clinic office management (ex: equipment, supplies, etc.) and delegates related tasks to appropriate staff. Coordinate, facilitate, and participate in quality assurance and process improvement projects to enhance the quality of participant care. Provide clinical expertise and supervision to RN, LVN, MA, and clinic aide staff to ensure scope, competency and standards of practice. Serve as coordinator/liaison to promote and maintain effective communication within the clinic setting and other departments/disciplines. Provide nursing expertise and leadership to support team, departmental, and organizational goals. Collaborate with Nurse Educators in the training and mentoring of all new and current RN, LVN, MA, and clinic aide staff to ensure competency and promote professional development. Other related duties as assigned. QUALIFICATIONS (knowledge, skills, abilities): Graduate of an accredited college or university with an associate or baccalaureate degree in nursing. Possess a current California RN license. Minimum three years' experience as an RN serving the geriatric or frail population required. Possess a current CPR certificate. Basic knowledge of Microsoft Office. Basic skills in computer literacy. Demonstrated ability to maintain an upbeat, positive approach to coordination, reinforcing positive behaviors and creating a highly effective team. Experience with electronic health record documentation preferred. Experience in leadership roles is desirable. Physical activities require the ability to stoop, reach, stand, push, pull, lift, and grasp. The above statements are intended to describe the general nature of work performed. They are not considered as an exhaustive list of all job tasks performed. On Lok reserves the right to change job descriptions, work hours or work sites as required by the program. On Lok's Employee Benefits include (eligible for any position for 20 hr/wk or more): Medical, Dental, and Vision coverage Retirement Savings Plan 403(b) and Term Life/AD&D Insurance Flexible Spending Account, Commuter Checks, MLA scholarships, Employee Assistance Program (EAP) Pet Insurance and additional discounts Holidays (10 per year), vacation time, sick leave, and long-term disability insurance Your final compensation offer will be determined based on factors such as skills, experience, education, and licenses/certifications. The pay range is expressed as an hourly rate regardless of FLSA status. Exempt positions are paid salaried and are not subject to overtime. Pursuant to the San Francisco Fair Chance Ordinance, and state and federal laws (including federal PACE requirements at 42 CFR 460.64(a); 460.68(a), we will consider for employment qualified applicants with arrest and conviction records. On Lok is an equal opportunity employer committed to a diverse and inclusive workforce. All applicants will receive consideration for employment without regard to sex (including pregnancy), race, religion, color, gender, gender identity, gender expression, sexual orientation, national origin, ancestry, disability, medical condition, genetic information, marital status, age, military or veteran status, or any other legally protected status. If you require reasonable accommodation to participate in the job application or interview process, to perform essential job functions and/or to receive other terms, privileges or benefits of employment please contact Recruitment (*********************).

To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member's representative in a care plan that assists the member in meeting his/her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes. Responsibilities Provides case management services independently for a caseload ranging in complexity from basic to complex; acuity levels 1-4; performs field-based case management (acuity level 5) with supervision. Initiates and coordinates individualized care plan for assigned members, addressing both clinical and non-clinical components, and ensuring the care plan is available to both the member and primary care provider. Resolves member needs by utilizing multidisciplinary team strategies, including Health Services Integrated Rounds Meetings. Ensures a smooth implementation and continuum of care via effective and frequent communication with providers, members, and identified health care designee. Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and PHC employees. Coordinates referrals and authorizations for services required to improve the member's health status. Maintains accurate and timely documentation, records, and case files in the PHC Case Management System for members in case management. Applies evidence-based interventions based upon member's agreed upon goals/priorities Develops and maintains knowledge of a community based network of alternative modes of care; aids member to connect with community-based organizations to support and enhance wellness. Answers and triages department calls, and distributes department referrals with guidance, in accordance with identified department service levels. Collaborates and coordinates with other internal departments to identify members suitable for case management. Actively participates in essential skills training, unit and departmental assigned learning, and other departmental activities as assigned. Functions collaboratively in a team environment, including acting as a support and resource to other staff. Coordinates and participates in meetings with PHC providers, as assigned. Collaborates with other departments with coordination of care needs through the course of case management services. Demonstrates competence in NCQA documentation standards. Exhibits high professional standards as outlined in the CA Nurse Practice Act and PHC's Code of Conduct. Performs other duties as assigned by the direct supervisor, including the assumption of new duties. Qualifications Education and Experience Associate's degree in Nursing required; Bachelor's degree in Nursing (or higher) preferred. 2 years of experience preferred, to include at least one (1) year of case management experience and one (1) year in an acute care setting; or equivalent combination of education and experience. General knowledge of managed care and/or experience with Medicaid population preferred. Special Skills, Licenses and Certifications Current and unrestricted California Registered Nurse License. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Bilingual skills in Spanish, Russian, or Tagalog preferred. Performance Based Competencies Strong organizational, communication, critical thinking skills and attention to detail required. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Effective telephone and computer data entry skills required. Experience in managed care business practices and ability to access data information using various computer systems. Excellent English written and verbal communication skills required. Work Environment And Physical Demands Able to utilize multiple computer platforms simultaneously. Daily use of telephone and computer for most of the day. Standard cubicle workstation. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $49.54 - $64.41 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change

To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member's representative in a care plan that assists the member in meeting his/her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes. Responsibilities Provides case management services independently for a caseload ranging in complexity from basic to complex; acuity levels 1-4; performs field-based case management (acuity level 5) with supervision. Initiates and coordinates individualized care plan for assigned members, addressing both clinical and non-clinical components, and ensuring the care plan is available to both the member and primary care provider. Resolves member needs by utilizing multidisciplinary team strategies, including Health Services Integrated Rounds Meetings. Ensures a smooth implementation and continuum of care via effective and frequent communication with providers, members, and identified health care designee. Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and employees. Coordinates referrals and authorizations for services required to improve the member's health status. Maintains accurate and timely documentation, records, and case files in the Partnership Case Management System for members in case management. Applies evidence-based interventions based upon member's agreed upon goals/priorities Develops and maintains knowledge of a community based network of alternative modes of care; aids member to connect with community-based organizations to support and enhance wellness. Answers and triages department calls, and distributes department referrals with guidance, in accordance with identified department service levels. Collaborates and coordinates with other internal departments to identify members suitable for case management. Actively participates in essential skills training, unit and departmental assigned learning, and other departmental activities as assigned. Functions collaboratively in a team environment, including acting as a support and resource to other staff. Coordinates and participates in meetings with Partnership providers, as assigned. Collaborates with other departments with coordination of care needs through the course of case management services. Demonstrates competence in NCQA documentation standards. Exhibits high professional standards as outlined in the CA Nurse Practice Act and Partnership's Code of Conduct. Performs other duties as assigned by the direct supervisor, including the assumption of new duties. Qualifications Education and Experience Associate's degree in Nursing required; Bachelor's degree in Nursing (or higher) preferred. 2 years of experience preferred, to include at least one (1) year of case management experience and one (1) year in an acute care setting; or equivalent combination of education and experience. General knowledge of managed care and/or experience with Medicaid population preferred. Special Skills, Licenses and Certifications Current and unrestricted California Registered Nurse License. Valid California driver's license and proof of current automobile insurance compliant with Partnership's policy are required to operate a vehicle and travel for company business. Bilingual skills in Spanish, Russian, or Tagalog preferred. Performance Based Competencies Strong organizational, communication, critical thinking skills and attention to detail required. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Effective telephone and computer data entry skills required. Experience in managed care business practices and ability to access data information using various computer systems. Excellent English written and verbal communication skills required. Work Environment And Physical Demands Able to utilize multiple computer platforms simultaneously. Daily use of telephone and computer for most of the day. Standard cubicle workstation. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $49.54 - $64.41 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change

To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member's representative in a care plan that assists the member in meeting his/her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes. Responsibilities Provides case management services independently for a caseload ranging in complexity from basic to complex; acuity levels 1-4; performs field-based case management (acuity level 5) with supervision. Initiates and coordinates individualized care plan for assigned members, addressing both clinical and non-clinical components, and ensuring the care plan is available to both the member and primary care provider. Resolves member needs by utilizing multidisciplinary team strategies, including Health Services Integrated Rounds Meetings. Ensures a smooth implementation and continuum of care via effective and frequent communication with providers, members, and identified health care designee. Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and PHC employees. Coordinates referrals and authorizations for services required to improve the member's health status. Maintains accurate and timely documentation, records, and case files in the PHC Case Management System for members in case management. Applies evidence-based interventions based upon member's agreed upon goals/priorities Develops and maintains knowledge of a community based network of alternative modes of care; aids member to connect with community-based organizations to support and enhance wellness. Answers and triages department calls, and distributes department referrals with guidance, in accordance with identified department service levels. Collaborates and coordinates with other internal departments to identify members suitable for case management. Actively participates in essential skills training, unit and departmental assigned learning, and other departmental activities as assigned. Functions collaboratively in a team environment, including acting as a support and resource to other staff. Coordinates and participates in meetings with PHC providers, as assigned. Collaborates with other departments with coordination of care needs through the course of case management services. Demonstrates competence in NCQA documentation standards. Exhibits high professional standards as outlined in the CA Nurse Practice Act and PHC's Code of Conduct. Performs other duties as assigned by the direct supervisor, including the assumption of new duties. Qualifications Education and Experience Associate's degree in Nursing required; Bachelor's degree in Nursing (or higher) preferred. 2 years of experience preferred, to include at least one (1) year of case management experience and one (1) year in an acute care setting; or equivalent combination of education and experience. General knowledge of managed care and/or experience with Medicaid population preferred. Special Skills, Licenses and Certifications Current and unrestricted California Registered Nurse License. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Bilingual skills in Spanish, Russian, or Tagalog preferred. Performance Based Competencies Strong organizational, communication, critical thinking skills and attention to detail required. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Effective telephone and computer data entry skills required. Experience in managed care business practices and ability to access data information using various computer systems. Excellent English written and verbal communication skills required. Work Environment And Physical Demands Able to utilize multiple computer platforms simultaneously. Daily use of telephone and computer for most of the day. Standard cubicle workstation. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $49.54 - $64.41 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change

Job Details Lemoore 224 - Lemoore, CA Full Time $22.00 - $22.50 Hourly Negligible Day Health CareCare Coordinator - Temporary ACHC is a Federally Qualified Health Center and licensed primary care clinic. We provide medical and dental care, with additional specialists in Chiropractic, Internal Medicine, Neurology, Pediatrics, Psychology, Podiatry and Optometry. ACHC Clinics are located across Fresno, Kings and Tulare counties. SUMMARY The Care Coordinator works in partnership with patients and providers to promote timely access to needed care, comprehension and continuity of care, and the enhancement of patient well-being. The Care Coordinator addresses gaps in care and promotes timely access to appropriate care, increasing the utilization of preventative care and healthy behaviors to improve the health of the population at risk. RESPONSIBILITIES Monitors Gap in Care reports to assist in getting patients the appropriate appointments and/or interventions. Consult and communicate with patients and family members to discuss their health problems. Consult and collaborate with other health care providers and specialists to set up patient appointments and treatment plans. Care management coordination of non-clinical services such as transportation. Attend ongoing training to keep abreast of new developments in health care. Treat patients with empathy and respect and conduct oneself in a professional manner. Comply with organizational guidelines and health care laws and regulations. Document Client services in medical record. Initiate outreach as necessary. Make outbound calls to patients for wellness checks and scheduling appointments. Log information into the system and document all calls to provider offices. Gather charts and information. Plan and execute health events Coordinate and manage patient hospital discharge process in a timely manner Qualifications SKILLS Interact in a courteous helpful manner with patients, clients, and staff. Exudes patience and compassion. Advanced organization skills. Time management skills. Exceptional documentation skills Excellent customer service. Works effectively with a diverse population and positively in a teamwork environment. Excellent verbal, written communication and interpersonal skills to enhance interactions with staff, patients, patient's families, physicians, and other health care organizations. Ability to work with clinical staff and handle workload for more than one provider. Knowledge of medical terminology (CPT & ICD-10 codes). Commitment to the concepts of preventative health care programs and team approach to health care delivery. Ability to learn about patients and their health care needs and be sensitive to patient circumstances. Computer skills and proficiency in Microsoft Word, Excel, and Outlook. Strong analytical thinking and the ability to handle multiple tasks concurrently. A general understanding of insurances: Commercial & Medicaid Experience with Motivational Interviewing or willingness to learn concept and incorporate competency into work. Strong knowledge of patient navigation. Ability to build relationships with different types of people, including clients, organization members, and members of the health care team. EDUCATION/EXPERIENCE Associate degree preferred At least 1 year minimum of case management experience Computer literacy required Strong understanding of cultural competency with the target population. PHYSICAL/COGNITIVE REQUIREMENTS The physical and cognitive demands listed below represent essential functions of this position and are required with or without reasonable accommodation: Hearing: Sufficient to engage with patients and staff in person and by telephone. Speaking: Clear verbal communication to convey medical and operational information. Vision: Visual acuity adequate for reading printed materials and viewing electronic screens. Cognitive Abilities: Aptitude to complete tasks, including abilities such as learning, remembering, focusing, categorizing, and integrating information for decision-making, problem-solving, and comprehending. Motor Function & Mobility: Ability to move within the work environment to complete tasks and interact with others. Occasional lifting and carrying of items up to 10 pounds without assistance. Frequent standing, sitting, bending, reaching, and other movements typical of a standard workday. Regular use of hands and fingers for typing, writing, operating tools or equipment, and handling materials. Some pushing and pulling required during daily tasks. Aria Community Health Center participates in E-Verify. Aria Community Health Center is an equal opportunity employer and does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.

Excel is seeking highly skilled healthcare professionals for travel assignments across the United States. As a Travel Healthcare Professional, you will have the opportunity to work in diverse healthcare settings, providing essential medical care while exploring new locations and cultures. Key Responsibilities: Provide direct patient care in accordance with healthcare facility policies and procedures. Collaborate with interdisciplinary teams to ensure comprehensive patient care. Maintain accurate patient medical records and documentation. Adhere to infection control standards and other regulatory requirements. Educate patients and their families on healthcare plans and treatments. Qualifications: Active state licensure in [specify relevant states] (e.g., RN, LPN, PT, OT). Minimum [number] years of experience in [specialty]. BLS/CPR certification (ACLS, PALS, or others as required by specialty). Excellent communication and interpersonal skills. Ability to adapt to different environments and work independently. Why Choose Excel Medical Staffing: Trusted partner with a proven track record in healthcare staffing. Competitive compensation package including hourly wages and stipends. Access to a wide range of healthcare facilities and specialties. Personalized support throughout your assignment. Opportunity to enhance your skills and build a diverse professional portfolio.

Home Infusion Registered Nurse - Accredo Specialty Pharmacy Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services. We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes. As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications. However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care. You'll work independently, making decisions that lead to the best outcomes for your patients. You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team. For more than 30 years, Accredo has delivered dedicated, first-class care and services for patients. We partner closely with prescribers, payers, and specialty manufacturers. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on the lives of others. How you'll make a difference and improve lives: * Empower Patients: Focus on the overall well-being of your patients. Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health. * Administer Medications: Take full responsibility for administering IV infusion medications in patients' homes. * Provide follow-up care and manage responses to ensure their well-being. * Stay Connected: Be the main point of contact for updates on patient status. Document all interactions, including assessments, treatments, and progress, to keep track of their journey. Requirements: * Active RN license in the state where you'll be working and living * 2+ years of RN experience * 1+ year of experience in critical care, acute care, or home healthcare * Strong skills in IV insertion * Valid driver's license * Willingness to travel to patients' homes within a large geographic region * Ability to work 40 hours a week (can include days, evenings, and weekends, per business need) * Flexibility to work different shifts on short notice and be available for on-call visits as needed If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 40 - 67 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Home Infusion Registered Nurse - Accredo Specialty Pharmacy Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services. We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes. As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications. However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care. You'll work independently, making decisions that lead to the best outcomes for your patients. You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team. For more than 30 years, Accredo has delivered dedicated, first-class care and services for patients. We partner closely with prescribers, payers, and specialty manufacturers. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on the lives of others. How you'll make a difference and improve lives: Empower Patients: Focus on the overall well-being of your patients. Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health. Administer Medications: Take full responsibility for administering IV infusion medications in patients' homes. Provide follow-up care and manage responses to ensure their well-being. Stay Connected: Be the main point of contact for updates on patient status. Document all interactions, including assessments, treatments, and progress, to keep track of their journey. Requirements: Active RN license in the state where you'll be working and living 2+ years of RN experience 1+ year of experience in critical care, acute care, or home healthcare Strong skills in IV insertion Valid driver's license Willingness to travel to patients' homes within a large geographic region Ability to work 32 hours a week (can include days, evenings, and weekends, per business need) Flexibility to work different shifts on short notice and be available for on-call visits as needed If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 40 - 67 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

is intended to start January 2026. The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in. Work Culture: GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work - Together. GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer). GCHP's focuses on 5 Core Values in the workplace: • Integrity • Accountability • Collaboration • Trust • Respect Disclaimers: • Flexible work schedule is based on job duties, department, organization, or business need. • Gold Coast Health Plan will not sponsor applicants for work visas. POSITION SUMMARY The RN, Quality Improvement (QI) will support the Quality Improvement and Health Services Programs, assisting the health plan to successfully achieve organizational objectives for clinical quality and patient safety. This position will be responsible for core clinical and regulatory compliance functions within the QI and Health Services arena, including Facility Site Review (FSR) Medical Record Review (MRR), Potential Quality Issue (PQI) investigation and reporting, and liaison with the team in designing and implementing clinical quality improvement strategies and interventions to support quality metrics and regulatory requirements. The RN, Quality Improvement I will work closely with the Health Services leadership team and the Chief Medical Officer to assess the Program's outcomes, identify areas of needed improvement, and institute actions to promote the delivery of high-quality care. This employee must be able to interpret the requirements of the Plan's regulatory bodies, and state and federal regulations, NCQA accreditation standards, and institute processes/programs to ensure compliance. Amount of Travel Required: 30-50% Reasonable Accommodations Statement To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions. ESSENTIAL FUNCTIONS Job Function & Responsibilities • Work closely with other departments of the Health Plan, Health Services and Ql team, and Chief Medical Officer to achieve the goals of the Quality Improvement and Health Equity Transformation (QIHET) Program by identifying issues and implementing corrective actions to ensure compliance with DHCS regulatory requirements and optimize GCHP quality performance. • Lead the timely investigation, processing, and reporting of identified potential quality issues (PQI following the Plan's procedures and timelines). • Track and trend PQI outcomes for the purpose of reporting and prioritization of improvement actions/interventions. • Annually review and edit relevant policies and procedures per APL updates, regulatory requirements, NCQA standards and/or required process changes. • Conduct facility site reviews (FSR), Medical Record Reviews (MRR), and/or Physical Accessibility Review Surveys (PARS) according to DHCS site survey requirements and maintain the FSR database for ongoing tracking of contracted sites and reporting purposes. • Ensure timely follow up on all FSR/MRR activities, including provider communication and corrective action plan documentation. • Lead and/or participate in quality improvement activities and audits, including but not limited to, focused medical record review (MRR), monitoring of Initial Health Appointment (IHA), blood lead screening in children, and other performance improvement projects. • Participate and/or provide clinical support to regulatory compliance activities, including but not limited to, DHCS Medical Audits, HEDIS compliance audits, and internal/external audits. • Support, as needed, the annual HEDIS project, including medical record abstraction and over-reads to determine compliance with HEDIS measures and optimize performance outcomes. • Utilize clinical expertise to create and/or revise policies and procedures per new APL requirements, regulatory requirements, and/or NCQA standards, establish QIHET work plan metrics and key performance indicators, implement provider training programs, and develop member and provider newsletter and website content. • Lead, facilitate and/or participate in relevant committees and work groups; prepare reports, data, or other materials for committee presentation. • Complete project-related communications, including job aides, member/physician communications, website content, work plans/action plans, graphical analyses, and agendas/minutes, as applicable. • Research best practices, and industry standards to help promulgate quality outcomes for the Plan. • Demonstrate strong critical thinking, collaboration, and work ethic, with the ability to foster teamwork and work effectively with providers and multi-disciplinary teams, and adapt quickly to changing priorities • Perform all other duties as assigned. MINIMUM QUALIFICATIONS Education & Experience: Required Education and Experience • Current CA Registered Nursing License - Unencumbered • Associate or bachelor's degree (two or four-year college or technical school) Required, Field of Study: Nursing • 1-2 years of clinical experience in Quality Improvement, Risk Management, Compliance, and/or Accreditation demonstrating increasing responsibility in clinical quality improvement. KNOWLEDGE, SKILLS & ABILITIES • Analytical and problem-solving acumen. • Critical thinking skills • Excellent verbal and written communication skills and ability to interact in a positive manner within the medical/clinic community. • Team player who builds effective working relationships within and across teams. • Ability to work independently. • Strong organizational skills • Ability to analyze, interpret, apply, and communicate policies, procedures and regulations. • Understanding and ability to perform data analysis, basic statistical skills including intermediate knowledge of Excel. • Proven experience with performance improvement methodologies required. PREFERRED QUALIFICATIONS • Public Health and/or ambulatory care/clinic setting background • Medicaid Health Plan experience • Certified Facility Site Reviewer or FSR experience • Knowledge of quality improvement processes and risk mitigation strategies in a managed care environment. • Knowledge of DHCS requirements, NCQA Accreditation standards, and HEDIS. Technology & Software Skills: • Highly competent in the MS Office products including proficiency in Word, Excel, PowerPoint, and databases. • Working knowledge with electronic health record systems including Cerner, NextGen, and Meditech. Certifications & Licenses: A valid and current Driver's License, Auto Insurance, and Current CA Registered Nurse licensure(s) Competency Statements • Business Acumen - Ability to grasp and understand business concepts and issues. • Decision Making - Ability to make critical decisions while following company procedures. • Goal Oriented - Ability to focus on a goal and obtain a pre-determined result. • Interpersonal - Ability to get along well with a variety of personalities and individuals. • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type. • Time Management - Ability to utilize the available time to organize and complete work within given deadlines. • Consensus Building - Ability to bring about group solidarity to achieve a goal. • Relationship Building - Ability to effectively build relationships with customers and co-workers. • Presentation Skills - Ability to effectively present information publicly. • Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards. • Judgment - The ability to formulate a sound decision using the available information. • Communication, Oral - Ability to communicate effectively with others using the spoken word. • Communication, Written - Ability to communicate in writing clearly and concisely. • Problem Solving - Ability to find a solution for or to deal proactively with work-related problems.

Job Description is intended to start January 2026. The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in. Work Culture: GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work - Together. GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer). GCHP's focuses on 5 Core Values in the workplace: • Integrity • Accountability • Collaboration • Trust • Respect Disclaimers: • Flexible work schedule is based on job duties, department, organization, or business need. • Gold Coast Health Plan will not sponsor applicants for work visas. POSITION SUMMARY The RN, Quality Improvement (QI) will support the Quality Improvement and Health Services Programs, assisting the health plan to successfully achieve organizational objectives for clinical quality and patient safety. This position will be responsible for core clinical and regulatory compliance functions within the QI and Health Services arena, including Facility Site Review (FSR) Medical Record Review (MRR), Potential Quality Issue (PQI) investigation and reporting, and liaison with the team in designing and implementing clinical quality improvement strategies and interventions to support quality metrics and regulatory requirements. The RN, Quality Improvement I will work closely with the Health Services leadership team and the Chief Medical Officer to assess the Program's outcomes, identify areas of needed improvement, and institute actions to promote the delivery of high-quality care. This employee must be able to interpret the requirements of the Plan's regulatory bodies, and state and federal regulations, NCQA accreditation standards, and institute processes/programs to ensure compliance. Amount of Travel Required: 30-50% Reasonable Accommodations Statement To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions. ESSENTIAL FUNCTIONS Job Function & Responsibilities • Work closely with other departments of the Health Plan, Health Services and Ql team, and Chief Medical Officer to achieve the goals of the Quality Improvement and Health Equity Transformation (QIHET) Program by identifying issues and implementing corrective actions to ensure compliance with DHCS regulatory requirements and optimize GCHP quality performance. • Lead the timely investigation, processing, and reporting of identified potential quality issues (PQI following the Plan's procedures and timelines). • Track and trend PQI outcomes for the purpose of reporting and prioritization of improvement actions/interventions. • Annually review and edit relevant policies and procedures per APL updates, regulatory requirements, NCQA standards and/or required process changes. • Conduct facility site reviews (FSR), Medical Record Reviews (MRR), and/or Physical Accessibility Review Surveys (PARS) according to DHCS site survey requirements and maintain the FSR database for ongoing tracking of contracted sites and reporting purposes. • Ensure timely follow up on all FSR/MRR activities, including provider communication and corrective action plan documentation. • Lead and/or participate in quality improvement activities and audits, including but not limited to, focused medical record review (MRR), monitoring of Initial Health Appointment (IHA), blood lead screening in children, and other performance improvement projects. • Participate and/or provide clinical support to regulatory compliance activities, including but not limited to, DHCS Medical Audits, HEDIS compliance audits, and internal/external audits. • Support, as needed, the annual HEDIS project, including medical record abstraction and over-reads to determine compliance with HEDIS measures and optimize performance outcomes. • Utilize clinical expertise to create and/or revise policies and procedures per new APL requirements, regulatory requirements, and/or NCQA standards, establish QIHET work plan metrics and key performance indicators, implement provider training programs, and develop member and provider newsletter and website content. • Lead, facilitate and/or participate in relevant committees and work groups; prepare reports, data, or other materials for committee presentation. • Complete project-related communications, including job aides, member/physician communications, website content, work plans/action plans, graphical analyses, and agendas/minutes, as applicable. • Research best practices, and industry standards to help promulgate quality outcomes for the Plan. • Demonstrate strong critical thinking, collaboration, and work ethic, with the ability to foster teamwork and work effectively with providers and multi-disciplinary teams, and adapt quickly to changing priorities • Perform all other duties as assigned. MINIMUM QUALIFICATIONS Education & Experience: Required Education and Experience • Current CA Registered Nursing License - Unencumbered • Associate or bachelor's degree (two or four-year college or technical school) Required, Field of Study: Nursing • 1-2 years of clinical experience in Quality Improvement, Risk Management, Compliance, and/or Accreditation demonstrating increasing responsibility in clinical quality improvement. KNOWLEDGE, SKILLS & ABILITIES • Analytical and problem-solving acumen. • Critical thinking skills • Excellent verbal and written communication skills and ability to interact in a positive manner within the medical/clinic community. • Team player who builds effective working relationships within and across teams. • Ability to work independently. • Strong organizational skills • Ability to analyze, interpret, apply, and communicate policies, procedures and regulations. • Understanding and ability to perform data analysis, basic statistical skills including intermediate knowledge of Excel. • Proven experience with performance improvement methodologies required. PREFERRED QUALIFICATIONS • Public Health and/or ambulatory care/clinic setting background • Medicaid Health Plan experience • Certified Facility Site Reviewer or FSR experience • Knowledge of quality improvement processes and risk mitigation strategies in a managed care environment. • Knowledge of DHCS requirements, NCQA Accreditation standards, and HEDIS. Technology & Software Skills: • Highly competent in the MS Office products including proficiency in Word, Excel, PowerPoint, and databases. • Working knowledge with electronic health record systems including Cerner, NextGen, and Meditech. Certifications & Licenses: A valid and current Driver's License, Auto Insurance, and Current CA Registered Nurse licensure(s) Competency Statements • Business Acumen - Ability to grasp and understand business concepts and issues. • Decision Making - Ability to make critical decisions while following company procedures. • Goal Oriented - Ability to focus on a goal and obtain a pre-determined result. • Interpersonal - Ability to get along well with a variety of personalities and individuals. • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type. • Time Management - Ability to utilize the available time to organize and complete work within given deadlines. • Consensus Building - Ability to bring about group solidarity to achieve a goal. • Relationship Building - Ability to effectively build relationships with customers and co-workers. • Presentation Skills - Ability to effectively present information publicly. • Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards. • Judgment - The ability to formulate a sound decision using the available information. • Communication, Oral - Ability to communicate effectively with others using the spoken word. • Communication, Written - Ability to communicate in writing clearly and concisely. • Problem Solving - Ability to find a solution for or to deal proactively with work-related problems.

Prime Home Health is a leading provider of skilled in-home nursing and care for patients. We are currently looking for a passionate, empathetic, motivated and COMMITTED individual to fill our Certified Home Health Aide (CHHA) position! We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care. Job Description We are seeking a Home Health Aide (HHA) to become a part of our team! You will provide routine healthcare to patients at the patient's home or in a care facility. Responsibilities: Provide routine individualized care to the elderly, convalescents, or persons with disabilities Monitor and report changes in patient health status Provide personal care, such as bathing and dressing patients Provide specialized healthcare such as administering medication and changing bandages Teach family members ways to care for patient Qualifications Qualifications: Experience in hospice, home health, or other related fields Positive and patient demeanor Ability to build rapport with patients Ability to handle physical workload Excellent written and verbal communication skills Additional Information Job Types: Part-time, Full-time Salary: $18.00 per hour Benefits: Health insurance Medical specialties: Home Health Standard shift: Day shift Weekly schedule: Monday to Friday Work setting: In-person Long-term care Ability to commute: Gardena: Reliably commute or planning to relocate before starting work (Required) Willingness to travel: 25% (Preferred) Work Location: In person Prime Providers is an amazing place to work!

FLSA Status: Non-Exempt Department: Health Services Reports To: Health Services Management The Utilization Management and Discharge Planning Nurse performs clinical review in accordance with applicable regulatory and professional standards for Organization Determination Requests using clinical experience and skills in a collaborative process to assess, plan, implement, coordinate and evaluate options to ensure appropriate utilization of member healthcare services and benefits for all lines-of-business in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below. * Conduct clinical review to ensure effective and appropriate utilization of benefits and services for prospective, concurrent and retrospective/claims review organization determination authorization requests within regulatory turnaround requirements for all SCFHP lines of business. * Complete authorization reviews by applying the appropriate clinical criteria/guidelines, policy, procedures and clinical judgment to render coverage determinations. * Document pre-admission status, including living arrangements, physical and mental function, social support, durable medical equipment (DME), and other services received. * Draft appropriate notification letters such as approval, denial, delay and modify notifications to providers and members and language threshold following regulatory requirements. * Perform onsite concurrent review activities, as needed in the home, facility or community setting. For Long Term Care UR RN: Conduct regularly scheduled on-site visits to contracted skilled nursing facilities to follow up on re-admissions, confirm member census, conduct member assessments and provide on-site utilization and concurrent review. * Review and monitor hospital or nursing facility census and internal reports to track, reconcile and update discrepancies in member case files. For Long Term UR RN: Monitor and oversee re-admission and transfer prevention strategy. * Facilitate and coordinate communication related to post discharge with member interdisciplinary care team (ICT) including physicians, specialists, public services, community agencies and vendors to ensure care plan development and coordination of benefits and services. * Apply the use of clinical judgment to identify and coordinate referrals to appropriate departments or programs for member identified continuity of care needs, such as Case Management, Behavioral Health, Managed Long Term Services and Supports (MLTSS), community resources, Pharmacy and Quality. * Proactively and collaboratively interface with external case management staff including delegates to facilitate discharge planning and care transitions. * Maintain adherence with Model of Care of CMC, LTSS and DHCS regulatory requirements. * Facilitate appropriate processing of Letters of Agreement with non-contracted Providers for approved medically necessary services. * Participate in new and ongoing clinical Quality Improvement initiatives. * Perform other duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. * Active California Board of Nursing License (RN) without restriction. (R) * Minimum one year of licensed related health care experience. (R) * Knowledge of managed care principles and practices with emphasis in Utilization Management and/or Case Management. (R) * Knowledge of MediCal and/or Medicare guidelines and regulations. (D) * One year of experience with a Managed Care Health Plan. (D) * Knowledge of Milliman/MCG guidelines or other nationally accredited utilization review criteria or standards. (D) * Ability to make determinations based on Nursing knowledge when no criteria are available or applicable. (R) * Ability to consistently meet accuracy and timeline requirements to maintain regulatory compliance. (R) * Clinical knowledge and critical thinking skills with the ability to assess individualized whole-person care needs necessary to develop an effective care plan. (R) * Experience working with designated member population (e.g. behavioral health, seniors and persons with disabilities, children). (D) * Ability to work within an interdisciplinary team structure. (R) * Ability to conduct home, facility and other community-based visits. (R) * Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R) * Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the operations as dictated by business needs. (R) * Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific case management programs. (R ) * Ability to use a keyboard with moderate speed and a high level of accuracy. (R) * Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing as mandated by nursing scope of practice. (R) * Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) * Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) * Ability to maintain confidentiality. (R) * Ability to comply with all SCFHP policies and procedures. (R) * Ability to perform the job safely and with respect to others, to property and to individual safety. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: * Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) * Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) * Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) * Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) * Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) * Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels.

FLSA Status: Non-Exempt Department: Health Services Reports To: Health Services Management Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521 Under the guidance and direction of the UM department RN Manager or Director, the Utilization Management Review Nurse (LVN) performs prospective and retrospective clinical review for inpatient and outpatient authorization requests in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and applicable business requirements. Following regulatory or evidence-based guidelines, assesses for medical necessity of services and/or benefit coverage which result in approved determination for services or the need to collaborate with Medical Directors for potential denial considerations. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below. * Conduct clinical review to ensure effective and appropriate utilization of benefits and services for prospective, concurrent and retrospective/claims review organization determination authorization requests within regulatory turnaround requirements for all SCFHP lines of business. * Process authorization reviews by applying the appropriate clinical criteria/guidelines, policies and procedures. * Draft and process timely notification of action (NOA) letters for authorization determinations to providers and to members, in member specific language preferences as identified within member demographic information. * Coordinate referrals to appropriate departments or programs for member identified continuity of care needs, such as Case Management, Behavioral Health, Managed Long Term Services and Supports (MLTSS), community resources, Pharmacy and Quality. * Maintain adherence with CMS (Medicare) and DHCS (Medi-Cal) regulatory requirements. * Facilitate appropriate processing of Letters of Agreement with non-contracted Providers for approved medically necessary services. * Perform other duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. * Active California Board of Nursing Licensed Vocational Nurse License (LVN) without restriction. (R) * Minimum one year of licensed related health care experience. (R) * One year of experience within a Managed Care Health Plan. (D) * Knowledge of managed care principles and practices with emphasis in Utilization Management and/or Case Management. (R) * Knowledge of MediCal and/or Medicare guidelines and regulations. (D) * Knowledge of Milliman/MCG guidelines or other nationally accredited utilization review criteria or standards. (D) * Ability to consistently meet accuracy and timeline requirements to maintain regulatory compliance. (R) * Ability to pass random quarterly case file reviews in accordance with departmental monitoring standards. * Ability to successfully pass departmental bi-annual inter-rater reliability testing. (R) * Ability to work within an interdisciplinary team structure. (R) * Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the operations as dictated by business needs. (R) Working knowledge of and the ability to efficiently operate all applicable computer software including applications such as Outlook, Word, Excel, and specific case management programs. (R) * Ability to use a keyboard with moderate speed and accuracy. (R) * Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing as mandated by nursing scope of practice. (R) * Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) * Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) * Ability to maintain confidentiality. (R) * Ability to comply with all SCFHP policies and procedures. (R) * Ability to perform the job safely and with respect to others, to property and to individual safety. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: * Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) * Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) * Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) * Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) * Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) * Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels.

Job DescriptionBenefits: Company parties Competitive salary Flexible schedule Training & development Wellness resources The Nurse Care Manager is a health and human services specialist who acts as a guide and advocate for families who are caring for older relatives or disabled adults. The Nurse Care Manager is educated and experienced in fields related to aging life care / care management, including a specialized focus on issues related to aging and elder care. The Nurse Care Manager will provide professional insight to clients in their homes. This involves coordinating client status through comprehensive care planning on a weekly basis. Nurse Care Manager collaborates with and ensures that doctors orders are followed, supports family decision-making, monitors medications, surveys physical activity and safety in the home, along with psychological behavior. Nurse Care Manager supports clients through a holistic, client-centered approach. Nurse Care Manager will support families through guidance leading families to the actions and decisions that ensure quality care and an optimal life for client through assessment and monitoring; planning and problem-solving; education and advocacy; and family caregiver coaching. Reporting Relationship: Reports to Director of Care Management Responsibilities/Activities: In-home Nurse visits with client Development of comprehensive plan of care following thorough assessment of physical, functional, and psycho-social status Provide hospital/facility visits when as needed Facilitating conference calls between the client and family as needed to clarify treatment plans Attend physician appointments and facilitate communication between doctor, client, and family Interact with the health care system effectively and frequently Reconciling prescribed medication Assessing clients environment, functional, psycho-social status and financial well-being Identifying and developing action plans to empower clients to remain and thrive at home Help families adjust, cope and problem-solve around long-distance and in-home caregiving Connecting clients and their families with medical, legal, housing, insurance and financial issues Coaching clients to manage their health and well-being Completing required paperwork and documentation within the time frame required Strategic and analytic thinking to address gaps in care Help determine types of services including home health and hospice that are right for client and assist in engaging and monitoring those services Reviewing financial management or consulting with a clients accountant or Power of Attorney Help clients and families with insurance concerns, claims, and applications Assist client and families identify local resources as needed Provide effective advocacy for clients and their families, promoting the clients wishes with health care and other providers, ensuring that clients needs are being adequately addressed Refer to legal experts, elder law attorneys, estate planners as needed Provide crisis intervention as needed, supporting clients navigate through emergency departments and hospitalizations, rehabilitation stays, ensuring that adequate care is available to the client Provides continued ongoing assessment to support clients in attaining their maximum functional potential Promotes individual independence through encouragement, maintaining safety and security concerns Perform other duties as requested by Director of Care Management Required Knowledge: Knowledge of health care policies Knowledge of medical ethics Knowledge of quality assurance techniques Knowledge of written and verbal communication techniques Knowledge of effective teamwork techniques Knowledge of interpersonal sensitivity techniques Knowledge of leadership techniques Knowledge of management planning techniques Knowledge of problem solving techniques Knowledge of decision making techniques Knowledge of time management techniques Knowledge of stress management techniques Knowledge of prioritizing techniques A wide degree of creativity and latitude is expected Required Skills/Abilities: Ability to demonstrate effective interpersonal relations Ability to effectively communicate orally and in writing Ability to utilize strong clinical and psycho-social assessment skills Ability to gain respect and cooperation Ability to inspire and motivate Home Care Partners and Agency Caregivers Ability to direct work groups toward a common goal Ability to oversee the work of Home Care Partners Ability to plan and organize work Ability to resolve conflict Ability to administer policies and implement procedures Ability to identify problems and determine effective solutions Ability to work independently and in cooperation with others Ability to provide advice and consultation to others Physical and Mental Demands: Good physical and mental health. Mental fortitude and stability to handle stress Physical and mental ability to drive a vehicle Qualifications/Education: Nursing Degree or Equivalent Experience Current drivers license Proper Vehicle Insurance Coverage Licensed Nurse with at least one year of post graduate case management experience Training/Experience: Complex Care Management/Case Management/Managed Care experience Community-based or In-Home visit experience Experience working with either Geriatric, chronically ill or functionally challenged populations Computer skills and resources Ability to use a variety of electronic information applications/software programs, electronic medical records experience Intermediate to Advanced computer skills and proficiency with Microsoft Word, Outlook, and Excel, and web navigation skills Access to a secure computer in order to accommodate data entry within required timelines Access to High-speed internet connectivity Valid drivers license, car insurance, and access to an automobile for home visits to client is required

APPLY TODAY! We are looking for dedicated LVNs who want to provide quality care to home-based patients. You will work one-on-one with the patient and truly impact their life as well as their family's. The job is consistent, long-term, and can work with a variety of different schedules. We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care. The LVN is responsible for providing direct patient care under the supervision of a registered nurse. Responsibilities include following the plan of care, providing treatments, and working collaboratively with the members of the team to help meet positive patient care outcomes. Job description Prime Home Health is a leading provider of skilled in-home nursing care for patients. We are currently looking for a passionate, empathetic, motivated, and COMMITTED individual to fill our Licensed Vocational Nurse (LVN) position Position Available for This Ad: Hemet, CA Monday-Friday 5:30AM-2:30PM Qualifications LICENSED VOCATIONAL NURSE (LVN) QUALIFICATIONS: Current CA Vocational Nurse License. We accept NEW GRADS under the Flex Waiver Program Current PPD or chest x-ray if applicable Current State license, CPR certification and valid driver's license (local travel required) LICENSED VOCATIONAL NURSE (LVN) RESPONSIBILITIES: Provides direct patient care as defined in State's Nurse Practice Act Implements plan of care initiated by the registered nurse Provides accurate and timely documentation consistent with the plan of care Assesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of care Prepares and coordinates clinical notes and progress notes Additional Information PRIME HOME HEALTH OFFERS: Competitive Hourly Pay Flexible work schedules that empower our employees to work independently Benefits include: Medical and Dental insurance, Vacation/sick days, 401(k) Professional, fun, and positive work culture 24 hour on-call support Employee appreciation event & employee recognition Electronic charting All your information will be kept confidential according to EEO guidelines. We welcome you to submit your resume or if you would prefer, call us during office hours, Mon-Fri 8:30 am- 5:00 pm at ************. We are excited to add more fantastic LVNs to our Prime Home Health Family. Prime Home Health is an equal opportunity and affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans, and disabled individuals, as well as all other protected groups. COVID-19 CONSIDERATIONS: Prime Home Health is practicing extra safety measure to protect our employees. You will be also provided with gloves, masks and face shields if requested. If hired, you will NOT be working with COVID-19 positive patients. Additionally we work to minimize multiple interactions across different staff and patients which is possible since you will most likely be exclusively working with one patient. Job Types: Full-time, Part-time, Per diem Benefits: 401(k) Dental insurance Flexible schedule Health insurance Life insurance Paid time off Vision insurance Prime Providers is an amazing place to work!

Prime Home Health is a leading provider of skilled in-home nursing care for patients. We are currently looking for a passionate, empathetic, motivated and COMMITTED individual to fill our Licensed Vocational Nurse (LVN) position! We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care. Job Description PHH OFFERS: Competitive Hourly Pay Flexible work schedules that empower our employees to work independently Benefits include: Medical and Dental insurance, Vacation/sick days, 401(k) Professional, fun, and positive work culture 24 hour on-call support Employee appreciation event & employee recognition Electronic charting LICENSED VOCATIONAL NURSE (LVN) RESPONSIBILITIES: Provides direct patient care as defined in State's Nurse Practice Act Implements plan of care initiated by the registered nurse Provides accurate and timely documentation consistent with the plan of care Assesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of care Prepares and coordinates clinical notes and progress notes We welcome you to submit your resume or if you would prefer, call us during office hours, Mon-Fri 8:30 am- 5:00 pm at ************, ask for Preston. We are excited to add more fantastic LVNs to the Prime Home Health family. Prime Home Health is an equal opportunity and affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans, and disabled individuals, as well as all other protected groups. COVID-19 CONSIDERATIONS: Prime Home Health is practicing extra safety measure to protect our employees. You will be also provided with gloves, masks and face shields if requested. If hired, you will NOT be working with COVID-19 positive patients. Additionally we work to minimize multiple interactions across different staff and patients which is possible since you will most likely be exclusively working with one patient. Qualifications LICENSED VOCATIONAL NURSE (LVN) QUALIFICATIONS: Current CA Vocational Nurse License We accept NEW GRADS under the Flex Waiver Program Current PPD or chest x-ray if applicable Current State license, CPR certification and valid driver's license (local travel required) Additional Information Job Types: Part-time, Full-time Pay: $29 - $31 an hour Benefits: 401(k) Dental insurance Flexible schedule Health insurance Paid sick time Vision insurance Medical specialties: Home Health Geriatrics Pediatrics GTube Trach Vent Standard shift: Day shift Evening shift Night shift Weekly schedule: Choose your own hours Monday - Friday Weekend availability License/Certification: LVN License (Required) BLS Certification (Required) Work Location: In person Prime Providers is an amazing place to work!

PRIME HOME HEALTH We are looking for dedicated LVNs who want to provide quality care to home-based patients. You will work one-on-one with the patient and truly impact their life as well as their family's. The job is consistent, long-term, and can work with a variety of different schedules. We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care. The LVN is responsible for providing direct patient care under the supervision of a registered nurse. Responsibilities include following the plan of care, providing treatments, and working collaboratively with the members of the team to help meet positive patient care outcomes. APPLY TODAY! Job description Prime Home Health is a leading provider of skilled in-home nursing care for patients. We are currently looking for a passionate, empathetic, motivated, and COMMITTED individual to fill our Licensed Vocational Nurse (LVN) position. LICENSED VOCATIONAL NURSE (LVN) RESPONSIBILITIES: Provides direct patient care as defined in State's Nurse Practice Act Implements plan of care initiated by the registered nurse Provides accurate and timely documentation consistent with the plan of care Assesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of care. Prepares and coordinates clinical notes and progress notes. Qualifications LICENSED VOCATIONAL NURSE (LVN) QUALIFICATIONS: Current CA Vocational Nurse License. We accept NEW GRADS under the Flex Waiver Program Current PPD or chest x-ray if applicable Current State license, CPR certification and valid driver's license (local travel required) Additional Information PRIME HOME HEALTH OFFERS: Competitive Hourly Pay Flexible work schedules that empower our employees to work independently. Benefits include Medical and Dental insurance, Vacation/sick days, 401(k) Professional, fun, and positive work culture 24 hour on-call support Employee appreciation event & employee recognition Electronic charting All your information will be kept confidential according to EEO guidelines. We welcome you to submit your resume or if you would prefer, call us during office hours, Mon-Fri 8:30am-5:00pm at *************. We are excited to add more fantastic LVNs to our Prime Home Health Family. Prime Home Health is an equal opportunity and affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans, and disabled individuals, as well as all other protected groups. COVID-19 CONSIDERATIONS: Prime Home Health is practicing extra safety measure to protect our employees. You will be also provided with gloves, masks and face shields if requested. If hired, you will NOT be working with COVID-19 positive patients. Additionally, we work to minimize multiple interactions across different staff and patients which is possible since you will most likely be exclusively working with one patient. Benefits: 401(k) Dental insurance Flexible schedule Health insurance Life insurance Paid time off Vision insurance Job Types: Full-time, Part-time, Per diem Prime Providers is an amazing place to work!

PRIME HOME HEALTH We are looking for dedicated LVNs who want to provide quality care to home-based patients. You will work one-on-one with the patient and truly impact their life as well as their family's. The job is consistent, long-term, and can work with a variety of different schedules. We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care. The LVN is responsible for providing direct patient care under the supervision of a registered nurse. Responsibilities include following the plan of care, providing treatments, and working collaboratively with the members of the team to help meet positive patient care outcomes. APPLY TODAY! Job description Prime Home Health is a leading provider of skilled in-home nursing care for patients. We are currently looking for a passionate, empathetic, motivated, and COMMITTED individual to fill our Licensed Vocational Nurse (LVN) position. Position Available for This Ad: Fontana, Ca Sat 8am-4pm Sun 4pm-12am LICENSED VOCATIONAL NURSE (LVN) RESPONSIBILITIES: Provides direct patient care as defined in State's Nurse Practice Act Implements plan of care initiated by the registered nurse Provides accurate and timely documentation consistent with the plan of care Assesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of care. Prepares and coordinates clinical notes and progress notes. Qualifications LICENSED VOCATIONAL NURSE (LVN) QUALIFICATIONS: Current CA Vocational Nurse License. We accept NEW GRADS under the Flex Waiver Program Current PPD or chest x-ray if applicable Current State license, CPR certification and valid driver's license (local travel required) Additional Information PRIME HOME HEALTH OFFERS: Competitive Hourly Pay Flexible work schedules that empower our employees to work independently. Benefits include Medical and Dental insurance, Vacation/sick days, 401(k) Professional, fun, and positive work culture 24 hour on-call support Employee appreciation event & employee recognition Electronic charting All your information will be kept confidential according to EEO guidelines. We welcome you to submit your resume or if you would prefer, call us during office hours, Mon-Fri 8:30 am- 5:00 pm at ************ Ashley. We are excited to add more fantastic LVNs to our Prime Home Health Family. Prime Home Health is an equal opportunity and affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans, and disabled individuals, as well as all other protected groups. COVID-19 CONSIDERATIONS: Prime Home Health is practicing extra safety measure to protect our employees. You will be also provided with gloves, masks and face shields if requested. If hired, you will NOT be working with COVID-19 positive patients. Additionally, we work to minimize multiple interactions across different staff and patients which is possible since you will most likely be exclusively working with one patient. Benefits: 401(k) Dental insurance Flexible schedule Health insurance Life insurance Paid time off Vision insurance Job Types: Full-time, Part-time, Per diem Prime Providers is an amazing place to work!

Hourly rate: $27-$30 We are looking for dedicated LVNs who want to provide quality care to home-based patients. You will work one-on-one with the patient and truly impact their life as well as their family's. The job is consistent, long-term, and can work with a variety of different schedules. We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care. The LVN is responsible for providing direct patient care under the supervision of a registered nurse. Responsibilities include following the plan of care, providing treatments, and working collaboratively with the members of the team to help meet positive patient care outcomes. APPLY TODAY! Job Description Prime Home Health is a leading provider of skilled in-home nursing care for patients. We are currently looking for a passionate, empathetic, motivated, and COMMITTED individual to fill our Licensed Vocational Nurse (LVN) position LICENSED VOCATIONAL NURSE (LVN) RESPONSIBILITIES: Provides direct patient care as defined in State's Nurse Practice Act Implements plan of care initiated by the registered nurse Provides accurate and timely documentation consistent with the plan of care Assesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of care Prepares and coordinates clinical notes and progress notes Qualifications Current CA Vocational Nurse License. We accept NEW GRADS under the Flex Waiver Program Current PPD or chest x-ray if applicable Current State license, CPR certification and valid driver's license (local travel required) Additional Information PRIME HOME HEALTH OFFERS: Competitive Hourly Pay Flexible work schedules that empower our employees to work independently Benefits include: Medical and Dental insurance, Vacation/sick days, 401(k) Professional, fun, and positive work culture 24 hour on-call support Employee appreciation event & employee recognition Electronic charting All your information will be kept confidential according to EEO guidelines. Prime Home Health is an equal opportunity and affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans, and disabled individuals, as well as all other protected groups. Prime Providers is an amazing place to work!