Registered Nurse Case Manager remote jobs - 574 jobs

Contract Duration: 03 Months Location: Miami-Dade County (Hialeah: 33010, 33012, 33013, 33014, 33015, 33016, 33018, 33142, 33147). We are seeking a Bilingual Case Management Coordinator (Spanish/English) to support Medicaid Long Term Care/Comprehensive Program members in Miami-Dade County, FL. This is a work-from-home position that requires significant field travel (50-75%) for face-to-face member visits in homes, Assisted Living Facilities, and Skilled Nursing Facilities. The Case Management Coordinator is responsible for assessing, planning, implementing, and coordinating care management activities for members with supportive and medically complex needs. The role focuses on improving short- and long-term health outcomes through care coordination, education, and integration of community resources. Key Job Duties Coordinate case management activities for Medicaid Long Term Care/Comprehensive Program members Conduct telephonic and face-to-face comprehensive member assessments Develop, implement, and monitor individualized care plans Coordinate care with Primary Care Providers, skilled providers, and interdisciplinary teams Facilitate services including prior authorizations, condition management support, medication reviews, and community resources Conduct multidisciplinary reviews to achieve optimal healthcare outcomes Utilize motivational interviewing and influencing skills to promote member engagement and behavior change Educate and empower members to make informed healthcare and lifestyle decisions Experience & Qualifications Required Qualifications Bilingual (Spanish/English) - fluent in speaking, reading, and writing 1+ year of experience in behavioral health, long-term care, or case management Preferred Qualifications Managed care experience Case management and discharge planning experience Long-term care experience Education Bachelor's degree required, preferably in Social Work or a related field 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. Recruter Details: Name: Umar Farooq Email: ********************************** Internal Id #26-00632

Symetra has an exciting opportunity to join our team as aShort-Term Disability (STD) Case Manager! About the role In this role, you'll be responsible for making timely, accurate, and customer-focused decisions on STD, Statutory Disability Insurance (SDI), and Absence Management (AM) claims. You'll collaborate with internal and external partners to gather and analyze information, ensuring each claim is handled with care, efficiency, and empathy. What You Will Do Evaluate and manage new and ongoing STD, SDI, and AM claims with accuracy and timeliness. Gather and assess clinical, vocational, employer, and financial information to support claim decisions. Apply contract terms and procedural guidelines to determine claim outcomes. Maintain detailed and accurate documentation in claim systems. Communicate clearly and professionally with claimants, employers, and internal teams. Develop and follow claim management plans to achieve optimal outcomes. Deliver compassionate, customer-first service that builds trust and confidence. Foster a collaborative, respectful, and high-performing team environment. Why Work at Symetra Here's what some of our employees have to say about why they work at Symetra: "I chose Symetra because I heard it was a pro-employee company-and it's absolutely true. The work environment is supportive, the people are great, and the benefits are generous. Symetra truly cares about its employees. The relaxed atmosphere and opportunities to learn and grow-both within your role and beyond-make it a great place to build your career." - Alicia L., Claims Examiner "What I was searching for was a company that genuinely valued my voice-and I found that at Symetra. I truly enjoy working one-on-one with our customers, especially when they're going through life's toughest moments. Being able to offer support and hear their relief and gratitude when we help-it's deeply meaningful. That's what makes me proud to be part of the Symetra team." - Lilly H., Claims Team Lead What we offer you Benefits and Perks We don't take a "one-size-fits-all" approach when it comes to our employees. Our programs are designed to make your life better both at work and at home. Flexible full-time or hybrid telecommuting arrangements Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6% Paid time away including vacation and sick time, flex days and ten paid holidays Give back to your community and double your impact through our company matching Want more details? Check out our Symetra Benefits Overview Compensation Hourly Range: $22.00 - $36.23 plus eligibility for annual bonus program Who You Are High school diploma required. 3+ years of STD claims experience preferred. Knowledge of STD, SDI, and Absence management products and relevant regulations preferred. Understanding of medical terminology, anatomy, and pathology preferred. Excellent communication, decision-making, and organizational skills. Strong customer service and problem-solving skills. Able to manage multiple priorities concurrently with attention to detail. Proficiency with the Microsoft Office Suite required. Claim Vantage and/or Fineos experience a plus. NY Independent Adjuster license or industry certifications (e.g., FMLA Specialist) are a plus. We empower inclusion At Symetra, we aspire to be the most inclusive insurance company in the country. We're building a place where every employee feels valued, respected, and has opportunities to contribute. Inclusion is about recognizing our assumptions, considering multiple perspective, and removing barriers. We accept and celebrate diverse experiences, identities, and perspectives, because lifting each other up fuels thought and builds a stronger, more innovative company. We invite you to learn more about our efforts here. Creating a world where more people have access to financial freedom Symetra is a national financial services company dedicated to helping people achieve their financial goals and feel confident about the future. In our daily work, we're guided by the principles of Value, Transparency and Sustainability. This means we provide products and services people need at a competitive price, we communicate clearly and openly so people understand what they're buying, and we design products--and operate our company--to stand the test of time. We're committed to showing up for our communities, lifting up our employees, and standing up for diversity, equity and inclusion (DEI). Join our team and help us create a world where more people have access to financial freedom. For more information about our careers visit: careers Work Authorization Employer work visa sponsorship and support are not provided for this role. Applicants must be currently authorized to work in the United States at hire and must maintain authorization to work in the United States throughout their employment with our company. Please review Symetra's Remote Network Minimum Requirements: As a remote-first organization committed to providing a positive experience for both employees and customers, Symetra has the following standards for employees' internet connection: Minimum Internet Speed:100 Mbps download and 20 Mbps upload, in alignment with the FCC's definition of "broadband." Internet Type:Fiber, Cable (e.g., Comcast, Spectrum), or DSL. Not Permissible:Satellite (e.g., Starlink), cellular broadband (hotspot or otherwise), any other wireless technology, or wired dial-up. When applying to jobs at Symetra you'll be asked to test your internet speed and confirm that your internet connection meets or exceeds Symetra's standard as outlined above. Identity Verification Symetra is committed to fair and secure hiring practices. For all roles, candidates will be required (after the initial phone screen) to be on video for all interviews. Symetra will take affirmative steps at key points in the process to verify that a candidate is not seeking employment fraudulently, e.g. through use of a false identity. Failure to comply with verification procedures may result in: Disqualification from the recruitment process Withdrawal of a job offer Termination of employment and other criminal and/or civil remedies, if fraud is discovered

Full time opportunity - Monday through Friday 8:00 am - 5:00 pm Field based travel expected in Marion and Alachua Counties FL At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. As part of a Care Management team who will manage complex members, the Field Case Manager will be the primary care manager for a panel of members with complex behavioral health needs (i.e., mental health or substance use disorders). Additionally, this position will provide behavioral health support to the broader team. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. In this Field Case Manager role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. Expect to spend about 80% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. If you are located in the state of FL, you will have the flexibility to work remotely* as you take on some tough challenges Primary Responsibilities: Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 4-year degree plus 2+ years of relevant experience If no degree, 6+ years of relevant social service or case management experience 1+ years of experience with MS Office, including Word, Excel, and Outlook Driver's license and access to reliable transportation and the ability to travel within assigned territory to meet with members and providers Preferred Qualifications: LTC Case management experience Experience with electronic charting Experience with arranging community resources Field-based work experience Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders) Experience in long-term care, home health, hospice, public health, or assisted living Experience with local behavioral health providers and community support organizations addressing SDOH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.) Background in managing populations with complex medical or behavioral needs Bilingual Spanish *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

The Case Manager III (CM III), a key member of the primary care interdisciplinary team, provides services for patients with complex care needs. This position conducts patient outreach, engagement and psychosocial service assessment, assists in developing a patient-centered care plan, is the lead implementer of Enhanced Case Management (ECM) and coordinates service referrals and delivery. The case manager meets clients in home, clinic, or community as appropriate or required by the specific program/site. The CM III provides services to specific populations that have multiple complex health and social services needs and often provides care outside of a traditional health center setting, such as home visits, hospitals, supportive housing sites, encampments and shelters. In addition they provide comprehensive housing navigation support to clients. This is a grant funded, full time, benefit eligible opportunity, at our Oakland locationS (Medical Respite & Street Medicine) This position is represented by SEIU-UHW. Salaries and benefits are set by a collective bargaining agreement (CBA), and an employee in this position must remain a member in good standing of SEIU-UHW, as defined in the CBA. LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. Benefits Compensation: $29.20 - $33.85/hour. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan. Responsibilities Outreach, via telephone and in person at LifeLong, community and residential sites, to patients who meet case management program eligibility criteria or are prioritized by LifeLong for this service Proactively meet and engage with patients to build effective relationships and assess strengths and needs through use of standard intake, screening tools, and health, and social services records review Actively involve patients and caregivers, as appropriate, in designing and delivering services, including development of care plans, assuring alignment with patients' values and expressed goals of care Provide and facilitate referrals for internal and external resources, and collaborate with the patient to complete required applications, forms, or releases of information Maintain a patient caseload in accordance with LifeLong standards for the specific population served or site requirements Utilize data registries and reports to manage caseload, meet program requirements, maintain grant deliverables, and promote high quality care Provide health education and training to patients, including but not limited to, harm reduction and disease risk-mitigation strategies that empower patients to manage their own health and wellness (e.g. overdose prevention, mitigating spread of communicable diseases) Assist patients with accessing and retaining public benefits and insurance (e.g. MediCal, SSI/SSDI, CalFresh, General Assistance), and affordable/subsidized housing Respectfully and routinely communicate with patients, their care team members, external partners, and identified social supports Maintain knowledge of patients' medical/behavioral health treatment plans and facilitate utilization of services by providing resources such as accompaniment, transportation, in-home care, reminder calls etc. Participate in team meetings to coordinate care, support patient goals, and reducing barriers to accessing services Provide case management services to patients with multiple complex acute or chronic medical or behavioral health conditions (e.g. HIV/AIDS, Hep C, congestive heart failure, severe diabetes, severe hypertension, psychosis, pregnancy, and homelessness) Provide general housing case management services that includes document readiness, housing problem solving, and assessments for Coordinated Entry System Assess patients to identify cognitive and/or behavioral health needs and provide brief interventions and short-term support using standardized tools and effective approaches for patient care Co-facilitate patient groups Provide intensive case management to a caseload size in accordance with site or program standards focusing on a subset of the highest acuity patients Provide specialized housing navigation services to patients who are matched to a housing resource through Coordinated Entry System Lead crisis intervention response, de-escalation procedures, notification of the local mental health department and/or crisis response team, and follow-up care Provide and document billable services to eligible populations that result in revenue generation for LifeLong Advocate on behalf of patients to get their needs met and/or support patients to learn advocacy strategies for themselves. Keep current on community resources and social service supports to effectively serve the target population Document patient contacts/services in required data systems (EHR, HMIS etc.) according to LifeLong policy Specific activities may vary depending on the requirements of the program and funder. Promote diversity, equity, inclusion, and belonging in support of patients and staff Represent LifeLong positively in the community and advocate on behalf of underserved populations Qualifications Commitment to working directly with low-income persons from diverse backgrounds in a culturally responsive manner Commitment to harm reduction, recovery, housing first, age-friendly and patient centered care Strong organizational, administrative and problem-solving skills, and ability to be flexible and adaptive to change while maintaining a positive attitude Excellent interpersonal, verbal, and written skills Ability to prioritize tasks, work under pressure, and complete assignments in a timely manner Ability to seek direction/approval on essential matters, yet work independently, using professional judgment and diplomacy Works well in a team-oriented environment Conducts oneself in external settings in a way that reflects positively on your employer Ability to be creative, mature, proactive, and committed to continual learning and improvement in professional settings Job Requirements High School diploma or GED At least three (3) years of progressively responsible work or volunteer experience in a community-based health care or social work setting or at least one (1) year of experience as a Case Manager II or equivalent position or registration or certification as a Certified Alcohol and Drug Counselor by one of the two certifying bodies in California Proficient skills using Microsoft Office applications like Word, Excel, and Outlook, as well as the ability to work in and/or manage databases Access to reliable transportation with current license and insurance Bilingual English/Spanish Job Preferences Bachelor's Degree in Social Work, Health or Human Services field Lived experience of homelessness, incarceration, foster care, mental health services, substance use services or addiction, or as a close family member of someone who has this experience

OverviewAt Advocate, our mission is to empower Americans to obtain the government support they've earned. Advocate aims to reduce long wait times and bureaucratic obstacles of the current government benefits application process by developing a unified intake system for the Social Security Administration, utilizing cutting-edge technologies such as artificial intelligence and machine learning, crossed with the knowledge and experience of our small team of EDPNA's and case managers. We are seeking a highly organized and dedicated Case Manager to join Advocate and oversee the progress of disability cases at the Initial Application (IA) and Reconsideration (Recon) levels. You will manage a large caseload and work directly with claimants, ensuring they receive regular updates and assistance throughout the process. Your role will include analyzing medical records, filing recon appeals, and collaborating with SSA/DDS to resolve case-related issues. If you have strong time-management skills and thrive in a fast-paced, client-focused environment, this position will allow you to make a meaningful impact on the lives of claimants.Job Responsibilities Conduct Welcome Calls, file appeals, take action on claims needing attention, respond to Claimant calls, SMS, and emails, and other claim management work streams Offer an empathetic, best-in-class experience for our claimants Proactively communicate with claimants, ensuring they are informed of the progress of their cases. Collaborate with SSA/DDS to resolve case-related issues and keep the case on track. Use our technology to support claimants through the application and adjudication process Help improve our technology and operations, providing feedback to strengthen our ability to help claimants Proactively identify challenges and offer solutions. Qualifications Minimum of one year of SSDI/SSI case management experience is required. Strong organizational and time-management skills to handle a large caseload. Thorough knowledge of Social Security's disability process and familiarity with DDS/SSA forms. Ability to work in a fast-paced environment while maintaining attention to detail and task completion. Preference for a small start-up environment with high ownership and high responsibility. Desire to transform the disability application and adjudication process. Ability to quickly pivot, change process, and adopt new ways of doing things. Familiarity with Salesforce or a similar CRM This is a remote position and Advocate is currently a fully remote team. Advocate is an equal opportunity employer and values diversity in the workplace. We are assembling a well-rounded team of people passionate about helping others and building a great company for the long term.

Under general direction, review delivery of behavior programs to subcontracted vendor participants based on the principles of Applied Behavior Analysis (ABA). Ensure subcontractors provide adequate caregiver training; assure the development and delivery of specific intervention activities in accordance with the treatment plan by auditing subcontracted vendors and monitoring development of children diagnosed on the autism spectrum disorder. Apply today! Starting Pay $84,000- $90,000 Annually Responsibilities Evaluate subcontracted vendor's programs for quality assurance by observing procedures at locations throughout the organization's territory. Review and approve treatment plans and progress reports submitted by the subcontracted vendor. Assure authorization is active for each participant receiving subcontracted therapy and participant is making progress toward established goals. Submit annual quality assurance reports for services for each participant focused on reducing the number of participant concerns that result in a grievance with the subcontractor. Troubleshoot and resolve subcontracted vendor/parent concerns, e.g. expired authorization, monitoring vendor productivity, or ensuring participant receives appropriate level of care. Evaluate effective subcontracted vendor service by reviewing participant assignments to a subcontracted vendor and the adequacy of communication to relevant parties (e.g., family, administrative assistant, etc.). Participate in monthly CSCM meetings. Conduct annual vendor audits and corresponding written follow-up as assigned by the Director. Prepare and report monthly caseload status including participant concerns and progress, and vendor concerns. Perform other duties as assigned. Qualifications Master's degree from an accredited college or university with a concentration in early childhood education/development, early childhood special education, special education, psychology or related field. Must be a Board Certified Behavior Analyst (BCBA); Marriage Family Therapist (MFT) or licensed psychologist preferred. Three years of related professional experience working with children with Autism Spectrum Disorders (ASD) in a multi-disciplinary team setting preferred. Advanced knowledge of scientifically-validated methodologies and approaches found to benefit children with ASD; familiar with current related research findings. Expertise in approaches to intervention based on the science of Applied Behavior Analysis. Competent in employing and directing behavior analytic methodologies including Pivotal Response Training (PRT), Natural Environment Teaching (NET), Picture Exchange Communication System (PECS), Behavior Skills Training (BST), and Experimental Functional Analysis (EFA). Expertise in all empirically evaluated assessment and intervention strategies related to program and service delivery for individuals with ASD. Strong clinical, administrative, and leadership skills. Case management experience required. Ability to speak a foreign language e.g., Spanish, Chinese, etc. preferred. Able to interpret and implement policies, procedures, and regulations. Able to consistently demonstrate good judgment and decision-making skills. Ability to maintain customer service orientation and professionalism in all interactions. Ability to communicate effectively, through oral and written skills, and work cooperatively with a variety of individuals and groups. Must relate well to children and their families and maintain positive affect. Ability to exercise discretion and maintain a high level of confidentiality to handle sensitive and confidential situations and documentation. Very good working knowledge of Microsoft Office (Outlook, Word, Excel, etc.) and related computer software. Able to obtain and maintain a criminal record/fingerprint clearance from the Department of Justice and Federal Bureau of Investigation per Easter Seals Southern California and/or program requirements. Must have and maintain current CPR certification card. Ability to travel locally with reliable transportation, maintains driving record in compliance with Transportation Safety Standards, and must have and maintain proper auto insurance and vehicle registration. The position will be a mix of working from home and out in the field

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Location: Fully Remote (Must be licensed in California) (HIPAA compliant work space) Schedule: Monday-Friday, 8:00 AM - 5:00 PM PT Language: Bilingual candidates strongly preferred (Spanish and Vietnamese) Join the Team That's Redefining Healthcare! Are you a compassionate Registered Nurse with a passion for improving the lives of seniors and complex care patients? Join Alignment Health as a Telephonic RN Case Manager for our Special Needs Plan (SNP) members - all from the comfort of your home! This is a fully remote, phone-based position where you'll play a vital role in helping members navigate their care journeys, close gaps in care, and overcome barriers to better health. (HIPAA compliant work space) What You'll DoAs an RN Case Manager (SNP), you will: Provide telephonic case management to medically complex and chronically ill members Conduct comprehensive health assessments and create individualized care plans Coordinate care with internal and external partners, including physicians and specialists Educate members and caregivers on disease management and preventive care Monitor member progress and advocate for timely, appropriate interventions Identify and help resolve service or access issues impacting care quality RequirementsMust-Haves: Active, unrestricted RN license in California (Non-Compact) Minimum 2 years of clinical nursing experience At least 1 year of case management experience Proficiency with Microsoft Office (Word, Excel, Outlook) Nice-to-Haves: Bilingual (Spanish, Korean, Mandarin, etc.) Previous health plan or IPA experience Bachelor's Degree in Nursing (BSN) Licensure Requirement Upon Hire: Must be willing to obtain RN licensure in Nevada, Arizona, North Carolina, and Texas (company reimburses costs) Work Environment Fully remote - work from anywhere in the U.S., but must work Pacific Time hours All communication is conducted via phone, email and Teams. Company-provided equipment and IT support included Why Join Alignment Health?At Alignment, we're changing the way healthcare is delivered for the most vulnerable populations. We're committed to innovation, compassion, and delivering meaningful outcomes - and we want you to be a part of that journey.Benefits & Perks Competitive compensation Full suite of health benefits (medical, dental, vision) 401(k) with employer match Generous PTO and paid holidays Career growth and continuing education support Rewarding referral bonuses for successful hires Apply TodayBe part of something bigger. Bring your skills and compassion to a team that values connection, service, and innovation.Apply now or refer a colleague who would thrive in this role:*********************************** Note: This position is not open to LVNs. California RN license is required. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $77,905.00 - $116,858.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

Hi, we're Oscar. We're hiring a Case Management Nurse to join our Case Mangement team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: You will educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with support teams to ensure exceptional care for our members. You will report into the Associate Director, Clinical. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $39.28 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Assist in the coordination of care across a variety of settings (inpatient, outpatient, post acute, ER, home care) Actively reach out to members undergoing difficult health challenges and develop care plans Proactively reach out to hospital case managers to assist with discharge planning Communicate with members via phone or secure messaging to provide education on health conditions, new medications, and procedures. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license Ability to obtain additional state licenses to meet business needs 2+ years of clinical experience to include payer, hospital, outpatient or community based care management 1+ years of experience in Care Coordination and Navigation Bonus points: CCM Certification Bilingual in Spanish and/or creole reading, writing, speaking BSN Working knowledge of Milliman Guidelines This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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

SYNERGY HEALTHCARE: Nurse Case Manager/Advocate - LOUISVILLE, KY (Remote) Job Summary: We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees. The ideal candidate will be located in the greater Louisville area, have a thorough understanding of the healthcare system, and will be responsible for providing guidance and support to members in navigating the complex healthcare landscape. As the dedicated Nurse Advocate, you will be responsible for resolving a myriad of issues for their members and allow you the flexibility to “think outside the box”. With your clinical experience and background, you will help members better understand their health status, and will play a pivotal role in promoting patient wellness, managing chronic conditions, and enhancing overall health outcomes through personalized coaching and education. This position requires a blend of clinical expertise, strong communication skills, and a passion for helping others achieve their health goals. While this specific client has a a couple primary offices in KY, this opportunity allows for remote work so can be flexible on location. Minimal travel within the State for periodic client visits may be required. Most if not all work will be done virtually out of the convenience of your own home office. The key to your success will rely on your ability to cultivate trusted relationships with stakeholders, members, and their families. Our growing Synergy team is passionate about delivering an exceptional healthcare experience that is personal, data driven, and value based to help every person live their healthiest life. Key Responsibilities: Serve as the primary point of contact for members seeking assistance with navigating the healthcare system. Work with members to identify their healthcare needs and provide clinical support. Liaison with TPAs and insurance companies to resolve claim and billing issues. Educate members on healthier lifestyle, member benefits and how to effectively utilize them. Advocate for members so they can receive improved healthcare outcomes, including referrals to specialists and timely access to care. Collaborate with other healthcare professionals, including physicians and nurses to ensure seamless coordination of care. Monitor member health status and progress towards achieving their healthcare goals. Maintain accurate and up-to-date records of member interactions and healthcare interventions. Client facing reporting with the potential for limited travel to client worksites. Health Risk Assessment review to encourage lifestyle modification and improve overall wellness. Qualifications: Active nursing license with a Bachelor of Science in Nursing (BSN) degree preferred. Minimum of 3 years of experience as a nurse case manager or in a related healthcare field. CCM certification or CCM eligible. Commit to CCM exam within the first year. In-depth knowledge of the healthcare and insurance systems. Strong analytical and problem-solving skills with the ability to identify and resolve complex healthcare issues. Excellent communication and interpersonal skills with the ability to interact effectively with employees and healthcare professionals. Ability to work remotely, independently, and as part of a team in a fast-paced, dynamic environment. Strong organizational skills with the ability to manage multiple tasks and priorities simultaneously. Proficient in the use of electronic health records (EHRs), Outlook, Excel, and other healthcare-related software. If you are passionate about helping others and have a solid understanding of the healthcare system, we encourage you to apply for this exciting opportunity as a Case Manager Nurse Advocate with our growing organization. Questions... Please reach out to *************************** today!

Job Responsibilities: The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs. They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the online messaging platform. The Care Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members health across the care continuum. Should have a Compact/Multistate License. Requirements: Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member's outcomes. Empathetic, supportive and a good listener. Proficient in motivational interviewing skills. Must have intermediate computer knowledge, typing capability and proficiency in MS programs (Excel, OneNote, Outlook, Teams, Word, etc.). EEO Employer LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.

Home Infusion Registered Nurse - Accredo Specialty Pharmacy Join Accredo Specialty Pharmacy, part of Evernorth Health Services, and bring your nursing expertise to patients where they feel most comfortable-their homes. As a Home Infusion Registered Nurse, you'll deliver life-changing care while building meaningful relationships and driving positive health outcomes. Responsibilities: * Provide safe and effective administration of IV infusion medications in patients' homes. * Partner with pharmacists and care teams to ensure holistic patient well-being. * Document assessments, treatments, and progress to maintain accurate patient records. * Serve as the primary point of contact for patient updates and care coordination. * Demonstrate autonomy in clinical decision-making to achieve optimal outcomes. Required Qualifications: * Active RN license in the state of practice. * Minimum 2 years of RN experience. * At least 1 year in critical care, acute care, or home healthcare. * Proficiency in IV insertion and infusion techniques. * Valid driver's license and ability to travel within a large geographic region. * Availability for a 40-hour workweek, including evenings and weekends as needed. Preferred Qualifications: * Bachelor of Science in Nursing (BSN). * Experience with specialty pharmacy or infusion therapy programs. 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 annual salary of 79,200 - 132,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, 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), 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, click here. 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.

Inova Fairfax Medical Campus is looking for a dedicated Registered Nurse Case Manager to join the team. This role offers full-time, part-time and PRN availability. Hours are Monday - Friday 8:30am - 5:00pm with every 5th weekend and 1-2 holidays per year. Relocation assistance is available for eligible candidates. Candidates may be considered for current and future opportunities. Inova Fairfax Hospital is proud to announce that the American Nurses Credentialing Center (ANCC) awarded Magnet designation, the most prestigious accolade for nursing excellence, to our hospital in December 2020. Currently, only 8.5% of hospitals in the nation hold Magnet designation and Inova Fairfax Hospital is proud to be part of this select group. The new Magnet designation is in addition to several other prestigious recognitions which include: a five star rating from the Centers for Medicare and Medicaid Services (CMS), being named by IBM Watson Health as one the nation's highest performing hospitals, and among the top 10 Major Teaching Hospitals, an A for Patient Safety by The Leapfrog Group, the #1 hospital in the DC metro area by U.S. News & World Reports, and being nationally ranked in gynecologic care. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Please see the link below for additional information regarding Inova Fairfax Hospital. ************************************************************ Featured Benefits: • Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. • Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. • Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans. • Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. • Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities. Registered Nurse (RN) Case Manager 1 Job Responsibilities: Collects delay and other data for specific performance and/or outcome indicators. Assists in the collection and reporting of resource and financial indicators including acute and post-acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals. Collects, analyzes and addresses variances from plans of care and care paths with physicians and/or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes. Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g. discharge planning, chronic disease planning). Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently. Ensures safe care to patients by adhering to policies, procedures and standards within budgetary specifications including time management, supply management, productivity and accuracy of practice. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency. Supports department based goals which contribute to the success of the organization. Provides discharge planning and continuity of care for assigned patients in the acute and post-acute setting. Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated. Collaborates with the interdisciplinary healthcare team, patients and families in the assessment and coordination of discharge planning needs, delivery of post-discharge planning needs, delivery of post-discharge services and transition of patients from hospitals to the discharge setting as well as ongoing care in the community. Documents relevant discharge planning information in medical records according to department standards and/or care management plans. Collaborates/communicates with internal and external case managers. Understands pre-acute and post-acute resources. Provides coordination of services and acts as a key Liaison between patients, families and the interdisciplinary healthcare team members. Work closely with members of patients' healthcare teams to manage and coordinate all areas of patients' care. Works holistically to ensure that healthcare plans and discharge plans meet the physical, social and emotional needs of patients. Provides educational resources and/or referrals to patients and patients' families to address identified needs such as social or financial. Acts as an advocate for patients to resolve barriers to care progression. Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Discusses payer criteria and issues on a case by case basis with clinical staff and follows-up to resolve problems with payers as needed. Applies approved clinical criteria to monitor appropriateness of admissions, continued stays or post-acute setting appropriateness and documents findings based on department standards. Identifies at risk populations by using approved screening tools and following established reporting procedures. Monitors LOS and ancillary resource use, depending on inpatient stay or outpatient program criteria, on an ongoing basis and takes actions to achieve continuous improvement efficiencies in both areas. Refers cases and issues appropriately to resolve barriers to care progression. Participates in the assessment of patients' clinical and psychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary healthcare team members. Communicates routinely with patients, families, interdisciplinary healthcare team members and other appropriate parties with regard to the status of patients' care plans and progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary. Works with the multidisciplinary team to address/resolve system problems impeding diagnostic or treatment progress. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge. Ensures that all elements critical to patients' care plans have been communicated to the patients/families and members of the healthcare team. Minimum Qualifications: Education: BSN from an accredited school of nursing. If RN has an associate's degree (ADN); must complete BSN within 5 years of start date. Experience: Requires a minimum of 1-year Case Management and/or Clinical Care experience. Certification: Currently licensed as a Registered Nurse in the State of Virginia or hold a privilege to practice in the State of Virginia under the Enhanced Nurse Licensure Compact (eNLC). Basic Life Support (BLS) for Healthcare Provider certification from the American Heart Association required upon start. Preferred Qualifications: One (1) year of previous inpatient case management experience is highly preferred. About Inova Health System We are Inova, Northern Virginia's leading nonprofit healthcare provider. Every day, our 24,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better - to shape a more compassionate future for healthcare. Inova's Anti-Discrimination Employment Policy Inova Health System is an Equal Opportunity. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.

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

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

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

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

Registered Nurse - PRN visits Leave Shift Work Behind Consider our per diem opportunity to earn additional income as a Nurse Interviewer visiting clients at their place of residence. Complete questionnaires on their medical, functional and cognitive status. Flexible scheduling - The nurses can schedule visits Monday - Sunday, mornings, afternoons or evenings based on the client's and nurse's schedule. Flexible work - you can cover up to a 75 mile radius and work as little or as much as you want per month based on available cases in your area. Extra income - Work with illumifin whenever you need a little extra money, even if you have another job. No blood draws or specimen collections required. About the Role: As a RN with illumifin, you will utilize your critical thinking and assessment skills to complete the following: Obtain thorough cognitive and health assessment information as required. Comply with all assessment instructions and accurately complete assessments. Communicate promptly with illumifin regarding file status and appointment times. Return the assessment within 24 hours after the appointment. Respond promptly to any follow-up and clarification questions on submitted assessments. With E-Assessments training, you can complete assessments electronically using your cell phone, tablet, iPad or Laptop

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