Utilization Review Nurse jobs at Public Consulting Group

This is not a traditional RN role. This role is focused on training patients on how to use a medical device. Schedule: Flexible - you choose your weekly availability (0-5 trainings/week) ***MUST reside within 25 miles of hiring location Medford NY *** Schedule: Patient Trainers receive weekly assignment requests from the medical device company. They are allowed to accept or deny the request. Typically, they are allowed to take between 0-5 patients per week. This position allows for flexible scheduling. Example training session: 1 hour travel, 1 hour of training, 1 hour travel back, 30 minutes administrative time Assignments fluctuate- no guaranteed set number of assignments per week or per month. Assignments are auto assigned depending on trainer's roundtrip mileage on file Requested amount of assignments per week is not available, when trainer is Active, workload is expected to be completed. Pay Range: $35.00-$45.00 per hour. Patient Trainers are paid their hourly rate to travel to and from the patient's home. Additionally, they are paid the federal mileage reimbursement amount for travel. This job position does not offer any benefits. Job Description: A reputable medical device company is hiring a PRN Patient Trainers throughout the USA. Currently, one patient trainer is needed in each of the cities listed above. Patient Trainers go into patients' homes and train them on how to use INR (international normalized ratio, blood test) monitoring machines. Scheduling is very flexible and can be done anytime during the week. A typical training session takes about 1 hour. There is roughly 30 minutes of administrative paperwork to complete after each training session. The international normalized ratio (INR) blood test tells you how long it takes for your blood to clot. It is used to test clotting times in people taking warfarin (a medicine used to treat and prevent blood clots). Your doctor will use your INR result to work out what dose of warfarin you should take. RESPONSIBILITIES: The Trainer will: Remotely set up training appointment directly with the customer/caregiver Travel to the customers home setting within the general geographic location of the Trainer's home Provide personalized Face-2-Face training Explain reporting options and provide company resources Communicate and present themselves in a professional manner Accurately document and submit customer training records Maintain communications with the client by cell phone, email and internet access Work Environment: This is a remote position, requiring Patient Trainers to travel with their own reliable transportation. A typical travel radius is 50 miles from the listed work city. This varies depending on the location of patients. All supplies are provided to the trainer by the medical device company. The patient will have the INR machine and additional equipment already with them for the training. Masks are NOT required for this role but recommended. Preferred Qualifications: Home Health/In home care experience. Anticoagulation/ Cardiology experience. Medical Device training/ experience. If employed, has availability to train 0-5 customers per week in addition to primary employment (1 hour/ training). Availability to return phone calls, check systems and schedule trainings on a weekly basis. Requirements: Registered Nurse (RN) license. Pass a Background Check and Drug Test. Must be a resident of the hiring state or a neighboring state. Access to reliable transportation. COVID Vaccination or approved COVID Declination Form Techy Savvy Availability to train weekdays and weekends Must live within 15 miles of a hiring location (hiring locations listed above) If you have additional questions, please contact ****************************. HireGenics is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need reasonable accommodation to assist with your job search or application for employment, please contact us at ********************** or **************. status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics) does not discriminate against applicants based on citizenship. HireGenics does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b. The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws. #HGStaffing Benefits: 401(k) Work Location: In person

Full-Time | Monday-Friday | 8:00/8:30 AM - 5:00 PM Pay Range: $40-$50/hr (DOE) Travel Role - Must Have Reliable Transportation A leading ambulatory infusion organization is seeking an experienced Float Infusion Nurse (RN) to support multiple outpatient infusion centers across the St. Louis market. This is a full-time role offering autonomy, consistent weekday hours, and the opportunity for long-term or permanent placement. About the Role The Infusion RN will deliver outpatient infusion therapy to patients with chronic and complex conditions across several specialties, including neurology, rheumatology, gastroenterology, cardiology, and allergy/immunology. This role is ideal for nurses who thrive in a patient-centered, fast-paced infusion environment and enjoy working both independently and within small clinical teams. Key Responsibilities Prepare and administer IV and injectable medications in an outpatient setting. Access and manage central lines (PICC, port-a-cath). Provide patient and caregiver education regarding infusion therapies. Monitor patient response, safety, and treatment progression. Coordinate care with on-site teams, advanced practice providers, and ordering providers. Support daily center operations, including documentation, scheduling, and inventory. Float across multiple St. Louis locations as needed. Utilize WeInfuse EMR. Typical volume: 3-4 infusion chairs per site, 5-6 patients/day, small teams (1-2 RNs). Float Coverage Locations Flexibility available if one or two locations pose challenges. Richmond Heights, MO Ellisville, MO O'Fallon, MO Bridgeton, MO Required Qualifications Active, unencumbered Missouri RN license BSN required BLS (AHA) 2+ years of infusion, ICU, or ER experience (1 year infusion + 1 year other acute care considered) Valid driver's license and car insurance (for travel role) Strong IV therapy and vascular access skills Ability to work autonomously and communicate effectively Preferred Qualifications Ambulatory infusion experience CRNI, VA-BC, OCN certifications Home infusion or specialty infusion experience Soft Skills Strong customer service focus Reliable, punctual, and organized Adaptable to changing site needs Compassionate and patient-centered

Registered Nurse - Mother Baby Nurse Salary: $90,000 per year (non-negotiable) with annual 3% cost of living increase Schedule: Full-time, Monday-Friday 9am - 5pm (35 hours per week) Additional Info: Mileage reimbursed, 14 paid holidays, strong benefits package About the Role: The Nurse-Family Partnership (NFP) program is a nationally recognized, evidence-based home-visiting program for first-time mothers and their families. As a Nurse Home Visitor, you will provide education, support, and case management from pregnancy through the child's second birthday. Key Responsibilities: Conduct home visits for first-time mothers and families in Northern Queens Build strong, goal-oriented relationships using motivational interviewing Assess physical, emotional, and social needs to create individualized care plans Coordinate community referrals and follow up to ensure services are received Maintain thorough and accurate documentation for Medicaid billing Qualifications: Current New York State RN license (in good standing) BSN or ASN Required Bilingual in English and Spanish CPR certification required Valid driver's license and insured vehicle Strong communication and computer skills Benefits: Hybrid work schedule Generous paid time off and 14 paid holidays Medical, dental, and vision coverage Ongoing training and professional development Supportive, mission-driven workplace that values work-life balance

The Medical Management Nurse is responsible for reviewing complex clinical cases that require advanced nursing judgment, critical thinking, and holistic assessment. This role evaluates whether requested services meet medical necessity criteria, collaborates with healthcare providers to clarify clinical information, and provides consultation on cases that require additional clinical insight. Key Responsibilities Review complex or challenging cases to determine medical necessity of requested services. Apply nursing judgment, clinical criteria, and holistic assessment to evaluate a member's overall clinical presentation. Communicate with healthcare providers to clarify the clinical picture and ensure appropriate care alignment. Serve as a consultation point for Medical Directors regarding unclear, atypical, or complex cases. Support clinicians by acting as a resource for clinical inquiries or escalations. Participate in special projects and contribute to the development and improvement of organizational policies and workflows. Analyze clinical information, interpret symptoms and documentation, and identify potential abnormalities or inconsistencies in care. Determine when services may not match diagnosis or expected level of care and recommend alternatives when appropriate. Collaborate with case management nurses on discharge planning, ensuring safe transitions with necessary equipment, education, and support. Provide nursing insight and guidance to providers and internal partners on select cases. Assist with orientation, training, and ongoing support for lower-level nursing staff. Participate in intradepartmental and cross-functional groups, initiatives, audits, and process-improvement efforts. Educate members about plan benefits and assist with case management tasks as needed. Contribute to quality audits and the development of corrective action plans. Qualifications ACMP experience preferred. Recent clinical experience in an acute care setting a plus. Associate's degree in Nursing (minimum). Minimum of 4 years of experience in care management or case management experience. Minimum of 2 years of clinical, utilization review, or managed care experience, or an equivalent combination of education and experience. Current, active, and unrestricted RN license in applicable state(s) or U.S. territory. Multi-state licensure required if providing services across multiple states. Must be in Tampa, Florida or the surrounding area.

Liberty Cares With Compassion At Liberty Healthcare and Rehabilitation Services, we promote a challenging, but rewarding opportunity in a caring environment. We are currently seeking an experienced: SUPPORT NURSE - LPN Job Description: Assist in assuring the best patient care possible by assisting nursing personnel (including charge nurse and Director of Nursing) on a specified unit during their assigned work hours. May be required to take call for staffing coverage. Assist in providing resident care, in accordance with the Nursing Practice Act, and under the supervision of a Registered Nurse. Delegates duties to non-licensed nursing personnel and monitoring performance under the supervision of a Registered Nurse and assists in preparation of a work schedule as needed. Assist in Quality Assurance data collection for analysis and corrective action implementation by the Quality Assurance Nurse. Assist with infection control for unit. Adheres to all regulations pertaining to cleanliness, infection control and Standard Precaution. Assist with records, orders, and assessment of new admissions to the unit. Assist with assuring the initial nursing assessment is completed. Completed assigned resident assessments as assigned by MDS Nurse or Director of Nursing. Attends Nurse Department meetings as scheduled. Assist with monitoring and measuring decubiti weekly and completing integument watch assessment forms accurately and works with other departments to implement needs for the unit and needs of patients on the unit. Reports any possible performance issues by employees within the facility to the RN for determination if disciplinary action is required. May be asked by the RN to send an employee home for the remainder of the shift if the RN determines that further investigation is needed. May document the performance concern on the appropriate form for review and use by the RN in the disciplinary process. Assist with lab request as ordered per facility policy using appropriate techniques. Responsible for reposting lab work as ordered on unit, reviewing results and notifying attending MD per established policies, protocols, and physician orders. Assist with emergencies arising while on duty. Performs CPR if needed. Assist with emergencies on other units if needed. Assist with notifying attending MD of any change or illness of patients in the unit. Notifies attending physician of emergencies and death of patients in the unit. Implement order of changes in orders as instructed or ordered by MD. Assist with other general duties which include rounds with doctors; checking MD orders, including update of orders; verification of completeness of nursing summaries timely and verification that all nursing records are complete and timely. May be asked to provide hall coverage as needed. Assist with coordinating the health care team including the rehab aides duties and assignments. Other duties as assigned by Director of Nursing in accordance to NC Board Of Nursing Practice Acts. Job Requirements: Must be a high school graduate Must be a Licensed Practical Nurse (LPN) graduated from an accredited School of Nursing, with a current, valid license as a Licensed Practical Nurse in North Carolina and submit proof of license renewal. Must provide quality-nursing care to patients, follow doctor's orders, and have a genuine interest in geriatric nursing. Must be CPR certified yearly and attend in-service training and other staff meetings as required. Must have ability to make decisions regarding nursing and unit problems realizing that errors and incompetence may have serious consequences for patients and/or staff. Must be able to work well under pressure, problem solve, and perform various jobs. Must read, know and follow personnel, department and facility policies and procedures and adhere to local, state and federal requirements. Must be able to maneuver medication carts, treatment carts and other nursing equipment. Visit ********************************* for more information. Background checks/drug-free workplace. EOE. PIdd72e8632bb3-37***********1

Overview: At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Whether you're an experienced professional or just starting your career, we offer opportunities for growth, development, and advancement in a range of roles. Join us in our mission to enhance the well-being of our patients and residents while making a meaningful impact in the communities we serve. Responsibilities: After an orientation period and under the direction of a Registered Nurse, you will deliver efficient and effective nursing care while achieving positive clinical outcomes and patient, resident and family satisfaction. Manage patient care by performing nursing assessments delegating aspects of care to LPNs and Nursing Assistants. Collaborate with the nursing team and other disciplines, patients and families to develop effective plans of care. Communicate patient information with assigned staff during and between shifts. Qualifications: Must be a graduate of an approved school of nursing Must be currently licensed by the State Board of Nursing or awaiting licensure number Experience in rehabilitative or geriatric nursing is preferred. Benefits: Variable compensation plans Tuition, Travel, and Wireless Service Discounts Employee Assistance Program to support mental health Employee Foundation to financially assist through unforeseen hardships Health, Dental, Vision, Company-paid life insurance, 401K, Paid Time Off Free 24/7 virtual health care provided by licensed doctors for all Anthem medically-enrolled employees and their immediate family members On-Demand Pay Program that allows for instant access to a portion of the money you've already earned We also offer several voluntary insurances such as: Pet Insurance Term and Whole Life Insurance Short-term Disability Hospital Indemnity Personal Accident Critical Illness Cancer Coverage Restrictions apply based on collective bargaining agreements, applicable state law and factors such as pay classification, job grade, location, and length of service. Posted Salary Range: USD $36.00 - USD $36.00 /Hr.

About the Job A full-service business law firm is seeking an experienced Nurse Paralegal to join its busy healthcare legal team. Duties and Responsibilities Review and summarize medical records for attorneys Create medical chronologies of a patient's medical events, procedures, and treatments Apply nursing judgment and clinical knowledge to all types of medical cases Conduct medical subject and expert witness research Provide opinions on medical care and assist in developing case strategy Organize electronic and physical files and support various litigation functions Must be highly organized, able to juggle multiple deadlines and priorities, familiar with billing entry, and proficient in Microsoft Office/Word and Excel 2-4 years of experience in a healthcare-focused practice group in a litigation firm is strongly preferred Nursing experience in emergency room, medical-surgical, neuro, telemetry/cardiac, oncology, or surgery/ICU is required Insurance defense experience preferred A full-service business law firm comprised of 240 attorneys headquartered in Chicago. As one of the fastest-growing law firms in the Midwest, the firm understands the entrepreneurial thinking that drives business decisions for its clients. This insight allows the team to respond to client needs creatively, expediently, and pragmatically. The firm handles transactional, labor and employment, and litigation needs of companies across the U.S. Offices are located in: Chicago, Crystal Lake, St. Charles, and Rockford, IL; Columbus, OH; Milwaukee, Appleton, Brookfield, Green Bay, and Madison, WI; St. Louis, MO; and Indianapolis, IN. This employer is an Equal Opportunity Employer. They support and encourage workforce diversity. They do not discriminate based on race, color, religion, gender, national origin, sexual orientation, gender identity or expression, ancestry, citizenship, creed, marital status, veteran status, age, family caregiving responsibilities, genetic profile or predisposition, pregnancy, or disability with respect to hiring, promotion, firing, compensation, or other terms, conditions, or privileges of employment.

Lutheran Services Florida (LSF) envisions a world where children are safe, families are strong, and communities are vibrant. LSF is looking for a talented Program Nurse who wants to make an impact in the lives of others. The preferred ideal candidate will be bilingual and have experience with Microsoft! The schedule for this position is night shift, weekends, and on-call on a rotating basis (4 x 10 hours). Purpose and Impact: This position's primary role is to treat and care for the youth in this program as well as providing information about any treatment procedures or any aspect of their care. This individual works closely with the Nurse Practitioner, Medical Providers, Program Director, Assistant Program Director, and other related departments. Essential Functions: Manage and monitor the delivery of services to patients ensuring compliance in the performance of all aspects of youth care in accordance with Company policy and procedures, State and Federal guidelines. Prepare youth for examinations and record the medical intake, take vital signs, height and weight. Initiate routine lab tests after triage of a youth such as pregnancy tests. Assist the medical providers staff with examination procedures when is needed such as patient screening and triage. Administer medications under the providers' orders. Update youth charts in regards to allergies, medication use, and immunization history at each visit. Administer immunizations under standing orders from provider. Educate and counsel youth concerning their disease, treatment, and prevention of disease. Answer youth's questions after consultation with the provider or as per established procedures in that regard (to include but not limited to: health questions, medication refills, and lab results.) Continually assess for areas of improvement and develop plans and evaluation criteria for such. Oversee and direct all youth care staff to ensure adequate monitoring. Ensure delivery of safe and efficient quality care. Assist in health education classes when necessary. Obtain, compile, and maintain medical files on each intake. Ensure proper daily documentation and maintain hard copy of required documents and medical record. Schedule and comply with required medical appointments and timelines. Respond and comply to individual emergency medical needs immediately. Maintain and review for accurate and complete list of medical supplies, prescribed medications, and over-the-counter medication. Order medical supplies, and medication when necessary. Collect, maintain, and submit weekly, monthly, quarterly, and annual reports and audits to the supervisors. Facilitate and conduct self-administration of medication and side effects training to employees as required. Provide a fail-safe plan with medication count, label accuracy, and self-administration of medication, including over-the-counter drugs. Schedule and provide transportation when is needed to clients on medical appointments with assistance from other staff when necessary. Submit, review and follow up all the Significant Incidents Report regarding Medical Issues. Participate in Quality Improvement as required. Other Functions: Able to react to change productively and handle other essential tasks as assigned. Develop and maintain effective communication and working relationships with staff, co-workers, physicians, and youth. Develop and expand medical, specialty and dental services with local providers. Maintain Health Information Privacy HIPAA. The ability to maintain control and work under pressure to meet deadlines. Physical Requirements: Bending, stooping, and lifting a minimum of 15-25 lbs. required to complete daily tasks. Must have the ability to remain in standing position for extended periods of the workday. Education: Register Nurse degree from an accredited college or university in Nurse or Health Sciences, RN License according to State requirements. Must have graduated from an approved RN nursing program approved by the National Council of State Boards of Nursing (NCSBN) Must have passed the appropriate NCLEX-RN Exam Experience: Minimum 1 years of full-time direct service delivery experience Must possess medical assessment and treatment skills with diverse populations of children/adolescents. One (2-3) year of full-time experience in a hospital, clinic, medical record department or physician's office. One (2-3) year experience in file maintenance working with troubled adolescents or youth services; may include part-time, volunteer or internship experience. Why work for LSF? LSF offers 60 programs across the state of Florida serving a wide range of populations in need. Mission Driven staff members become part of the LSF community while transforming the lives of those in need. Our staff additionally find growth opportunities as they explore areas of interest within the organization. Amazing benefits package including : Medical, Dental and Vision Telehealth (24/7 online access to Doctors) Employee Assistance Program (EAP) Employer paid life insurance (1X salary) 13 paid holidays + 1 floating holiday Generous PTO policy (starting at 16 working days a year) Note: Head Start employees paid time off and holiday schedule may differ 403(b) Retirement plan with 3% discretionary employer match OR 3% student loan repayment reimbursement Tuition reimbursement LSF is proud to be an equal opportunity employer. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Must be located in the state of California Schedule: 9:30am-6:00pm PST, ability to work weekends if necessary. New Grads are encouraged to apply! The Nurse Reviewer I will be responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. * Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. * Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. * Partners with more senior colleagues to complete non-routine reviews. * Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment. How you will make an impact: * Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review. * Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network. * Notifies ordering physician or rendering service provider office of the preauthorization determination decision. * Follows-up to obtain additional clinical information. * Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics. Minimum Requirements: * AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. * Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities, and Experiences: * Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred. * BA/BS degree preferred. * Previous utilization and/or quality management and/or call center experience preferred. * Knowledge in Microsoft office. For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $31.54/hr - $56.77/hr Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Schedule: Monday through Friday, 9:30 AM - 6:00 PM CST or PST (Local time) A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. The Appeals Nurse Reviewer I is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. How you will make an impact: * Validating appeal requests. * Manage Appeal requests that come via email, fax, mailed in letters, or live live. * Opening and closing appeal requests following established appeal processes to maintain quality, turnaround time, and compliance requirements. * Outreach to providers with appeal process instructions. * Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers and/or members of appeal decisions. * Maintain personal log all appeal requests assigned to ensure completion, as needed. * Other duties as assigned. Minimum Requirements: * Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. * A current unrestricted RN license in applicable state(s) required. Preferred Experience, Skills, and Capabilities: * Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PPO and POS plans strongly preferred. * BA/BS degree preferred. * Previous utilization and/or quality management and/or call center experience preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $34.69 to $54.41. Locations: California, Illinois. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information provided by the facilities to determine medical necessity when our members admit. You will also be involved with discharge planning and transfers as needed for higher levels of care or out of network admissions. Your Knowledge and Experience Bachelors of Science in Nursing or advanced degree preferred. Requires a current California RN License Requires at least 5 years of prior relevant experience Requires strong communication and computer navigation skills Desires strong teamwork and collaboration skills Requires independent motivation and strong work ethic Requires strong critical thinking skills Your Work In this role, you will: Perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare and FEP Conducts clinical review of claims for medical necessity, coding accuracy, medical policy compliance and contract compliance Ensure discharge (DC) planning at levels of care appropriate for the members needs and acuity and determine post-acute needs of member including levels of care, durable medical equipment, and post service needs to ensure quality and cost-appropriate DC planning Prepare and present cases to Medical Director (MD) for medical director oversight and necessity determination and communicate determinations to providers and/or members to in compliance with state, federal and accreditation requirements Develop and review member centered documentation and correspondence reflecting determinations in compliance with regulatory and accreditation standards and identify potential quality of care issues, service or treatment delays and intervenes or as clinically appropriate Refer to Case Management when there are acute inpatient needs affecting discharge Attend staff meetings, clinical rounds and weekly huddles Maintain quality and productivity metrics for all casework Buddy or support new employees Maintaining HIPAA compliant workspace for telework environment

Schedule: Monday - Friday, 8:00 AM - 5:00 PM No weekends Work Arrangement: 100% Remote (candidate must go onsite once to receive equipment) The Utilization Nurse (UR Nurse) is responsible for providing monitoring and technical assistance to ensure compliance with contractual, regulatory, and statutory obligations for FFS/SMI members' physical, acute care, and behavioral health needs. This role involves reviewing and analyzing utilization data, coordinating care, and providing clinical oversight to ensure appropriate service delivery. The UR Nurse will also collaborate with internal and external stakeholders, participate in clinical staffing, and serve as a resource for medically necessary covered services. Key Responsibilities: Monitor overutilization and underutilization of services. Conduct case reviews, audits, and utilization monitoring. Provide oversight, guidance, and technical assistance to ensure compliance. Gather, organize, and evaluate information from multiple data sources. Coordinate care with internal and external stakeholders. Make referrals as appropriate and participate in clinical staff meetings. Ensure members receive medically necessary covered services. Experience Required: Bachelor of Science in Nursing (BSN) Minimum of 2 years of RN experience At least 1 year of experience in behavioral health Requirements: Active RN license in the State of Arizona Fingerprint Clearance Card (FPCC)

· Participates in the development and ongoing implementation of QM Work Plan activities. · Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives Responsibilities: · Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. · Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation. · Data gathering requires navigation through multiple system applications. · Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information. · Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines. · Responsible for the review and evaluation of clinical information and documentation. · Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues. · Works Potential Quality of Care cases across all lines of business (Commercial and Medicare). · Independently coordinates the clinical resolution with internal/external clinician support as required. · Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data · Prepares and completes QM documents based on interpretation and application of business requirements · Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements · Assists in the development and implementation of QM projects and activities · Accountable for completing and implementation of QM Work Plan Activities Experience: · 3+ years of experience as an RN · 1+ years of inpatient hospital experience · Registered Nurse in state of residence · Must have prior authorization utilization experience · Able to work in multiple IT platforms/systems Skills: · MUST HAVE MEDCOMPASS or ASSURECARE exp. · MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience, inpatient utilization management review. · MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. · MUST HAVE 6 months of Prior Authorization. Education: · Active and unrestricted RN licensure in state of residence **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (*********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

**his position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management.** **Responsibilities:** 1. Assesses patient's clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay. 2. Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided. 3. Coordinates and assists in implementation of plan for members. 4. Monitors and coordinates services rendered outside of the network, as well as outside the local area, and negotiate fees for such services as appropriate. Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome. 5. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care. 6. Monitors patient's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. 7. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. 8. Encourages member participation and compliance in the case/disease management program efforts. 9. Documents accurately and comprehensively based on the standards of practice and current organization policies. 10. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care. 11. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. 12. Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes. 13. Completes other assigned functions as requested by management. Core Individual Contributor Competencies. Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus, Accountable, Learn, Communicate. **Qualifications:** **Education/Experience** 1. Requires an associate's or bachelor's degree (or higher) in nursing and/or a health related field OR accredited diploma nursing school. 2. Requires a minimum of two (2) years clinical experience. **Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. - Prefers working knowledge of case/care management principles. - Prefers working knowledge of principles of utilization management. - Prefers basic knowledge of health care contracts and benefit eligibility requirements. - Prefers knowledge of hospital structures and payment systems. **Skills and Abilities:** - Analytical - Compassion - Interpersonal & Client Relationship Skills - Judgment - Listening - Planning/Priority Setting - Problem Solving - Team Player - Time Management - Written/Oral Communication & Organizational Skills **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

+ Participates in the development and ongoing implementation of QM Work Plan activities. + Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. + Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation. + Data gathering requires navigation through multiple system applications. + Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information. + Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues. + Works Potential Quality of Care cases across all lines of business (Commercial and Medicare). + Independently coordinates the clinical resolution with internal/external clinician support as required. + Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data + Prepares and completes QM documents based on interpretation and application of business requirements + Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements + Assists in the development and implementation of QM projects and activities + Accountable for completing and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST HAVE MEDCOMPASS or ASSURECARE exp. + MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + Active and unrestricted RN licensure in state of residence **Questionnaire:** + Do you have experience with Medcompass? + Do you have experience with Prior Authorization? + Do you have experience with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Full-time Description Leader of Nurses Needed!!!! Are you a Registered Nurse and looking to put your leadership skills to the test? Can you manage multiple sites? Do you love developing future nurses? Are you a subject matter expert on Long Term Care? If you answered yes on these questions, CES has an opportunity for you!! Come be our Regional Nurse Consultant for five long term care facilities in West Tennessee. What do we do? Connect People 2 Life! How do we Connect People 2 Life? Through reconnecting them to the relationships that make life full: S(Sprint) N(Nature) O(Others) W(Work) S(Self)! We make it SNOW every day! Requirements • Visible commitment to the CES vision. • Emphasize and model the need for collaboration and teamwork. • Participate in collaborative efforts to identify and develop new programs and services in furtherance of the company's vision. • Assist RDO and facility management with implementation of appropriate resident care policies and procedures. • Conduct and/or assist with assessment of level of care and make recommendation regarding staffing, assignments, referrals and admissions, and training. • Provide education and training, to assist facilities with the oversight and maintenance of staff development programs, including staff efficacy with systems utilization and documentation. • Assist with recruiting, selection, and orientation of facility Director of Nurses and other clinical staff as requested. • Assist facilities in maintaining a constant state of readiness for all regulatory surveys. • Assist facilities in creating and achieving survey Plan of Corrections. • Provide integration support of resident care services involving staff, therapists, Medical Directors, and other consultants/care providers. • Conduct consistent reviews of facility QI reports to ensure and maintain compliance. • Assist facility Administrator in performance review of DON, making recommendations as needed. • Assist Regional Director of Operations in interpreting, identifying, and applying how reimbursement programs impact nursing services and documentation. • Consistently attend QA/PI and PAR meetings for each facility. • Maintain open and consistent dialog with Medical Directors. • Present timely reports on clinical performance as requested. • Assist RDO and/or Director of Clinical Services with development and/or improvement of clinical policy, process and/or procedure. • Ensure that the facility adheres to clinical policies, procedures, and systems set forth by the company. • Assist the facility Administrator and the Director of Nursing with reporting and investigating unusual occurrences. EDUCATION and/or EXPERIENCE • Master's degree in nursing or related field preferred bachelor's degree required. • 2-4 years related experience and/or training or equivalent combination of education and experience required. • Must be a Registered Nurse (RN) licensed in good standing with the State. • Must have prior experience as a Director of Nursing. KNOWLEDGE, SKILLS AND ABILITIES • Excellent written and verbal communication skills. • Outgoing and energetic personality. • Ability to multi-task while being detail-oriented. • Intermediate computer skills. • Experience with MS Office Word, Excel, and PowerPoint preferred. • Experience with PointClickCare preferred.

Full-time Description Leader of Nurses Needed!!!! Are you a Registered Nurse and looking to put your leadership skills to the test? Can you manage multiple sites? Do you love developing future nurses? Are you a subject matter expert on Long Term Care? If you answered yes on these questions, CES has an opportunity for you!! Come be our Regional Nurse Consultant for five long term care facilities in West Tennessee. What do we do? Connect People 2 Life! How do we Connect People 2 Life? Through reconnecting them to the relationships that make life full: S(Sprint) N(Nature) O(Others) W(Work) S(Self)! We make it SNOW every day! Requirements • Visible commitment to the CES vision. • Emphasize and model the need for collaboration and teamwork. • Participate in collaborative efforts to identify and develop new programs and services in furtherance of the company's vision. • Assist RDO and facility management with implementation of appropriate resident care policies and procedures. • Conduct and/or assist with assessment of level of care and make recommendation regarding staffing, assignments, referrals and admissions, and training. • Provide education and training, to assist facilities with the oversight and maintenance of staff development programs, including staff efficacy with systems utilization and documentation. • Assist with recruiting, selection, and orientation of facility Director of Nurses and other clinical staff as requested. • Assist facilities in maintaining a constant state of readiness for all regulatory surveys. • Assist facilities in creating and achieving survey Plan of Corrections. • Provide integration support of resident care services involving staff, therapists, Medical Directors, and other consultants/care providers. • Conduct consistent reviews of facility QI reports to ensure and maintain compliance. • Assist facility Administrator in performance review of DON, making recommendations as needed. • Assist Regional Director of Operations in interpreting, identifying, and applying how reimbursement programs impact nursing services and documentation. • Consistently attend QA/PI and PAR meetings for each facility. • Maintain open and consistent dialog with Medical Directors. • Present timely reports on clinical performance as requested. • Assist RDO and/or Director of Clinical Services with development and/or improvement of clinical policy, process and/or procedure. • Ensure that the facility adheres to clinical policies, procedures, and systems set forth by the company. • Assist the facility Administrator and the Director of Nursing with reporting and investigating unusual occurrences. EDUCATION and/or EXPERIENCE • Master's degree in nursing or related field preferred bachelor's degree required. • 2-4 years related experience and/or training or equivalent combination of education and experience required. • Must be a Registered Nurse (RN) licensed in good standing with the State. • Must have prior experience as a Director of Nursing. KNOWLEDGE, SKILLS AND ABILITIES • Excellent written and verbal communication skills. • Outgoing and energetic personality. • Ability to multi-task while being detail-oriented. • Intermediate computer skills. • Experience with MS Office Word, Excel, and PowerPoint preferred. • Experience with PointClickCare preferred.

Full-time Description Leader of Nurses Needed!!!! Are you a Registered Nurse and looking to put your leadership skills to the test? Can you manage multiple sites? Do you love developing future nurses? Are you a subject matter expert on Long Term Care? If you answered yes on these questions, CES has an opportunity for you!! Come be our Regional Nurse Consultant for five long term care facilities in West Tennessee. What do we do? Connect People 2 Life! How do we Connect People 2 Life? Through reconnecting them to the relationships that make life full: S(Sprint) N(Nature) O(Others) W(Work) S(Self)! We make it SNOW every day! Requirements • Visible commitment to the CES vision. • Emphasize and model the need for collaboration and teamwork. • Participate in collaborative efforts to identify and develop new programs and services in furtherance of the company's vision. • Assist RDO and facility management with implementation of appropriate resident care policies and procedures. • Conduct and/or assist with assessment of level of care and make recommendation regarding staffing, assignments, referrals and admissions, and training. • Provide education and training, to assist facilities with the oversight and maintenance of staff development programs, including staff efficacy with systems utilization and documentation. • Assist with recruiting, selection, and orientation of facility Director of Nurses and other clinical staff as requested. • Assist facilities in maintaining a constant state of readiness for all regulatory surveys. • Assist facilities in creating and achieving survey Plan of Corrections. • Provide integration support of resident care services involving staff, therapists, Medical Directors, and other consultants/care providers. • Conduct consistent reviews of facility QI reports to ensure and maintain compliance. • Assist facility Administrator in performance review of DON, making recommendations as needed. • Assist Regional Director of Operations in interpreting, identifying, and applying how reimbursement programs impact nursing services and documentation. • Consistently attend QA/PI and PAR meetings for each facility. • Maintain open and consistent dialog with Medical Directors. • Present timely reports on clinical performance as requested. • Assist RDO and/or Director of Clinical Services with development and/or improvement of clinical policy, process and/or procedure. • Ensure that the facility adheres to clinical policies, procedures, and systems set forth by the company. • Assist the facility Administrator and the Director of Nursing with reporting and investigating unusual occurrences. EDUCATION and/or EXPERIENCE • Master's degree in nursing or related field preferred bachelor's degree required. • 2-4 years related experience and/or training or equivalent combination of education and experience required. • Must be a Registered Nurse (RN) licensed in good standing with the State. • Must have prior experience as a Director of Nursing. KNOWLEDGE, SKILLS AND ABILITIES • Excellent written and verbal communication skills. • Outgoing and energetic personality. • Ability to multi-task while being detail-oriented. • Intermediate computer skills. • Experience with MS Office Word, Excel, and PowerPoint preferred. • Experience with PointClickCare preferred.

Job DescriptionDescription: Leader of Nurses Needed!!!! Are you a Registered Nurse and looking to put your leadership skills to the test? Can you manage multiple sites? Do you love developing future nurses? Are you a subject matter expert on Long Term Care? If you answered yes on these questions, CES has an opportunity for you!! Come be our Regional Nurse Consultant for five long term care facilities in West Tennessee. What do we do? Connect People 2 Life! How do we Connect People 2 Life? Through reconnecting them to the relationships that make life full: S(Sprint) N(Nature) O(Others) W(Work) S(Self)! We make it SNOW every day! Requirements: • Visible commitment to the CES vision. • Emphasize and model the need for collaboration and teamwork. • Participate in collaborative efforts to identify and develop new programs and services in furtherance of the company's vision. • Assist RDO and facility management with implementation of appropriate resident care policies and procedures. • Conduct and/or assist with assessment of level of care and make recommendation regarding staffing, assignments, referrals and admissions, and training. • Provide education and training, to assist facilities with the oversight and maintenance of staff development programs, including staff efficacy with systems utilization and documentation. • Assist with recruiting, selection, and orientation of facility Director of Nurses and other clinical staff as requested. • Assist facilities in maintaining a constant state of readiness for all regulatory surveys. • Assist facilities in creating and achieving survey Plan of Corrections. • Provide integration support of resident care services involving staff, therapists, Medical Directors, and other consultants/care providers. • Conduct consistent reviews of facility QI reports to ensure and maintain compliance. • Assist facility Administrator in performance review of DON, making recommendations as needed. • Assist Regional Director of Operations in interpreting, identifying, and applying how reimbursement programs impact nursing services and documentation. • Consistently attend QA/PI and PAR meetings for each facility. • Maintain open and consistent dialog with Medical Directors. • Present timely reports on clinical performance as requested. • Assist RDO and/or Director of Clinical Services with development and/or improvement of clinical policy, process and/or procedure. • Ensure that the facility adheres to clinical policies, procedures, and systems set forth by the company. • Assist the facility Administrator and the Director of Nursing with reporting and investigating unusual occurrences. EDUCATION and/or EXPERIENCE • Master's degree in nursing or related field preferred bachelor's degree required. • 2-4 years related experience and/or training or equivalent combination of education and experience required. • Must be a Registered Nurse (RN) licensed in good standing with the State. • Must have prior experience as a Director of Nursing. KNOWLEDGE, SKILLS AND ABILITIES • Excellent written and verbal communication skills. • Outgoing and energetic personality. • Ability to multi-task while being detail-oriented. • Intermediate computer skills. • Experience with MS Office Word, Excel, and PowerPoint preferred. • Experience with PointClickCare preferred.