Registered Nurse In The ICU remote jobs - 438 jobs

Care Manager LPN LVN Remote Candidates residing in Oregon are encouraged to apply. The purpose of this position is to provide care coordination services to Providence Health Plans (PHP) members. Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease. Case management including: triage and referral, transition of care planning, end of life care planning, and other support to advocate for and assist the member in the achievement of optimal health, access to care, and appropriately utilizing resources. These services are offered to members and their families who have acute and complex health care needs; members with chronic conditions at risk for poor health outcomes and members who are terminal and nearing end of life. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Certificate/Diploma from a state approved practical nursing program (should go under education level) Major - Nursing Associate's Degree Healthcare or healthcare related field Upon hire: Oregon Licensed Practical Nurse Upon request: Additional state licensure as assigned Upon request: Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver's license and auto insurance upon request. 5 years of clinical nursing experience 2 years of experience working with physicians in the collaboration and management of patient care Preferred Qualifications: Bachelor's Degree in Health education or healthcare related field Experience in Care Management and/or Care Navigation in a healthcare setting. Experience with Health Insurance, CMS, OHA and other governing healthcare entities Salary Range by Location: Oregon: Non-Portland Service Area: Min: $32.92, Max: $51.11 Oregon: Portland Service Area: Min: $32.32, Max: $54.82 Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn /benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: Company: Providence Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 5018 HCS CASE AND DISEASE GOV PRGM OR REGION Address: OR Portland 4400 NE Halsey St Work Location: Providence Health Plaza (HR) Bldg 1-Portland Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. PandoLogic. Category:Healthcare, Keywords:Licensed Vocational Nurse (LVN), Location:Portland, OR-97204

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together This is a Field Based role with a Home-Based office. Must be open to traveling up to 50 miles from home office based on business need. If you are located in or within commutable driving distance from South Austin, TX, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, at least 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 What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current and unrestricted Registered Nurse license in the state of Texas 2+ years of experience working within the community health setting or in a healthcare role Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and ability to use multiple web applications Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Valid driver's license, access to reliable transportation and the ability to travel in this 'assigned region' to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices Reside in or within commutable driving distance from South Austin, TX Preferred Qualifications: 1+ years of experience with long-term care services and support, Medicaid or Medicare Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations Proven ability to create, edit, save and send documents, spreadsheets and emails Reside in South Austin, TX *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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.

Provides direct and indirect patient care in the assigned care setting. Communicates and collaborates with physicians, leadership, co-workers, and other multidisciplinary teams to enhance patient outcomes. Provides high quality patient care utilizing critical thinking, nursing processes, decision making, compassion, integrity, respect, and empathy. Preserves the patient's autonomy, dignity, and rights, and restores health whenever possible. Able to perform general nursing duties, patient education, and prioritization. Performs other duties as assigned. Responsibilities Assesses the patient appropriately and accurately based on their medical condition. Has knowledge of ordered medications and administers as prescribed. Provides care appropriate to the condition and age of the patient including basic self-care activities. Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate. Demonstrates ability to utilize nursing knowledge to perform treatments and provide services. Communicates/collaborates with multidisciplinary team in providing patient care. Demonstrates an ability to assist physicians with procedures and performs services requiring technical and manual skills. Identifies and addresses psychosocial needs of patients and family; communicates with social services regarding both hospital and post discharge needs. Demonstrates cost-effective practices and non-wasteful usage of supplies, linen, and charge items. Prioritizes patient care effectively and efficiently. Promotes patient safety by reducing the risk of unnecessary harm associated with health care. Assumes lifelong learning related to the nursing profession. Specifications Experience Minimum Required Preferred/Desired Education Minimum Required Graduate of an accredited nursing program. Preferred/Desired Training Minimum Required Preferred/Desired Special Skills Minimum Required Computer literacy Preferred/Desired Licensure Minimum Required RN;BLS CERTIFICATION WITHIN 14 DAYS OF HIRE Preferred/Desired ACLS/PALS Specialty Certification

Aicota Health Care Center is seeking a full-time registered nurse (RN) to serve as an MDS coordinator. The successful candidate will assure seamless transitions for residents of our building along with timely and accurate completion of the MDS that focuses on case mix maximization and regulatory compliance. This person will be responsible for supervising the nursing team in the coordination of the MDS and admissions processes. Preferred qualities would include being detail oriented, organized, self-sufficient, and excels in roles that require research, problem-solving and discovery. Starting wage: $50/Hour Current Minnesota Nursing Licensure. Prior experience in a long-term care is preferred but not needed. Job Type: Full-time Standard shift: Day shift Weekly schedule: 8-Hour Shift Monday-Friday On-Call as necessary Days/hours can be flexible Part-time remote option Benefits: 401(k) Continuing education credits Dental insurance Employee assistance program Health insurance Life insurance Paid time off Referral program Tuition reimbursement Vision insurance Scholarship Opportunities Ability to commute/relocate: Aitkin, MN 56431: Reliably commute or planning to relocate before starting work (Required) License/Certification: Nursing License Work Location: In person/Off-site QUALIFICATIONS: · Graduate from an accredited school of nursing and has current licensure by the State of Minnesota Board of Nursing as a Registered Nurse. · Experience in long term care facility, preferred · Commitment to quality care · Strong team building and interpersonal skills desired Our Mission To provide personalized care through high quality services to our community. Our Vision To be the recognized provider and employer of choice in the markets we serve. Our Core Values Customer Service Our team shows up each day inspired to make an impact on those we serve, within Aicota and our community, by going above and beyond expectations. Attitude Our teams leads with empathy, passion, and professionalism. Respect Our team respects the values of others. Excellence Our team believes that through continuous quality improvement, we can aspire to excellence. Stewardship Our team will use our talents and resources wisely, with honesty and integrity. Aicota Health Care Center is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Aicota Health Care Center is an EEO Employer - M/F/Disability/Protected Veteran Status Aicota Health Care Center is an EEO Employer - M/F/Disability/Protected Veteran Status View all jobs at this company

Hours: Flexible | Part-Time or Full-Time PharmD Live is seeking a Virtual Chronic Care Nurse to support patients with complex, ongoing health conditions through structured remote care programs. This role is designed for nurses who excel in patient engagement, education, and coordinated virtual care delivery. Responsibilities Deliver scheduled chronic care outreach and patient check-ins Reinforce care plans, treatment goals, and self-management education Monitor RPM data and identify trends requiring clinical intervention Coordinate follow-up care after hospitalizations or specialty visits Communicate effectively with interdisciplinary care teams Document all patient interactions accurately and compliantly Support adherence by identifying and addressing patient barriers Required Qualifications Active Virginia LPN or RN license in good standing At least 2 years of nursing experience (chronic care or telehealth preferred) Experience with CCM, RPM, or value-based care models is a plus Strong clinical assessment and patient communication skills Comfortable working independently in a remote clinical role

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

Job Description Director, Behavioral Health Transfer Center $90,000 to $140,000 Base compensation based on experience Must be a licensed clinician, such as Registered Nurse. Would possibly consider a Licensed Clinical Social Worker or Licensed Professional Counselor depending on experience Must hold a multi-state license (e.g., RN Compact or equivalent) Position Overview The Director of the Behavioral Health (BH) Transfer Center provides senior-level leadership for a centralized, 24/7 behavioral health access and admissions operation supporting multiple facilities across several states. This role is accountable for operational performance, clinical integrity, regulatory compliance, and relationship management across a multi-state healthcare system. The ideal candidate is an experienced Behavioral Health leader at the Director level, highly operationally focused, data-driven, and comfortable leading remote clinical and non-clinical teams. This leader serves as the subject matter expert for BH transfer operations and works closely with executive leadership, hospital CEOs, and clinical teams to ensure safe, timely, and compliant patient transfers. Company Overview The Behavioral Health Transfer Center functions as a centralized, 24/7 hub responsible for the timely and appropriate placement of patients requiring acute behavioral health care. The center streamlines the transfer process by conducting clinical assessments, confirming bed availability, and coordinating transportation to ensure patients are placed in the appropriate level of care without delay across 18 facilities. Staffed by a multidisciplinary team of 31 experienced behavioral health professionals-including licensed clinicians, nurses, EMTs, and case managers-the Transfer Center serves as the primary liaison for referring facilities and manages more than 6,000 patient transfers each month. The mission is to reduce wait times, eliminate gaps in care, and ensure safe, seamless transitions for individuals experiencing mental health or substance use crises. This role offers the opportunity to work remotely within a high-volume, fast-paced, and purpose-driven environment focused on clinical excellence and operational efficiency. Key Responsibilities Provide overall leadership and accountability for Behavioral Health Transfer Center operations, including remote clinical (RNs/licensed clinicians) and non-clinical staff. Drive operational excellence through metrics, KPIs, service-level management, and continuous process improvement. Ensure appropriate clinical decision-making and level-of-care recommendations for behavioral health patients across all age populations. Partner with hospital CEOs, Directors of Nursing, Directors of Assessment, and executive leadership to ensure consistent admissions and transfer processes across all facilities. Maintain full compliance with EMTALA, CMS, TJC, HIPAA, and applicable multi-state regulatory requirements; lead regular audits and corrective actions. Collaborate with Workforce Management and Finance to ensure appropriate staffing models and resource allocation. Build and maintain strong relationships with physicians, referral sources, internal stakeholders, and external partners. Work closely with Training and Quality teams to audit calls, referral packets, and documentation to ensure quality and consistency. Identify and resolve operational gaps, service failures, and process breakdowns in a timely manner. Lead performance management, coaching, and development of staff; conduct annual and real-time performance evaluations. Support recruiting, hiring, onboarding, and retention of clinical and non-clinical transfer center staff. 10% travel requirement Must-Have Qualifications Director-level leadership experience in Behavioral Health (required). Strong operational mindset, with demonstrated success managing metrics, workflows, and scalable processes. Active clinical license required, preferably Registered Nurse (RN). Must hold a multi-state license (e.g., RN Compact or equivalent). Candidates with LCSW or LPC licensure may be considered if they hold appropriate multi-state licensure and possess significant leadership experience. Proven ability to communicate effectively and build relationships across all levels of the organization, including executive leadership and frontline clinical teams. Experience supporting or leading 24/7 healthcare operations. Preferred Qualifications Experience leading a Behavioral Health Transfer Center, Access Center, or centralized admissions function. Background managing remote or distributed clinical teams. Direct experience supporting a multi-facility, multi-state behavioral health system. Master's degree in Nursing, Social Work, Psychology, or Healthcare Administration.

Care Access is working to make the future of health better for all. With hundreds of research locations, mobile clinics, and clinicians across the globe, we bring world-class research and health services directly to communities that often face barriers to care. We are dedicated to ensuring that every person has the opportunity to understand their health, access the care they need, and contribute to the medical breakthroughs of tomorrow. With programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Through partnerships, technology, and perseverance, we are reimagining how clinical research and health services reach the world. Together, we are building a future of health that is better and more accessible for all. To learn more about Care Access, visit ******************* How This Role Makes A Difference The Registered Nurse, Clinical Delivery (RN) in this role will manage the communication of critical and abnormal lab results to patients, ensuring compliance with state licensure requirements. This includes contacting patients, documenting communications, following up on lab escalations, and collaborating with providers to ensure all patient interactions are appropriately managed and documented. This role is also responsible for patient education, ensuring patients understand their lab results and any necessary next steps in their care, as well as providing study specific information that is tailored to the patient. Furthermore, they serve as a point of escalation for the Member Services team, addressing complex inquiries related to lab results and assisting in the resolution of patient concerns by providing clinical insights and ensuring patients receive accurate information and appropriate follow-up. The RN will liaise with the Clinical Conduct Team to investigate and resolve issues related to duplicate lab results or other concerning findings, as advised by the Medical Director. Lastly, they will assist in training and educating the Member Services team to improve patient interactions and enhance service quality. This role is critical in ensuring timely patient communication and maintaining compliance with clinical and legal standards. How You'll Make An Impact Receive and Review Lab Results from Pre-screening Program: Autonomously evaluate flagged abnormal, urgent, or critical lab findings to prepare them for patient communication, ensuring accuracy and timeliness. Patient Communication: Proactively contact patients to discuss abnormal and critical lab outcomes. Ensure focused and uninterrupted communication, adhering to protocols while delivering only legally permissible information within the RN scope of practice. Use communication techniques to convey complex medical information clearly in a way non-medical patients will understand. Understand that the results shared with the patients may have serious health implications for them and relay them in a compassionate manner. Patient Education: Develop and implement patient education initiatives to enhance understanding of lab result significance and promote informed decision-making. Ensure patients understand their lab results and any necessary next steps in their care. Critical Thinking: Independently utilize critical thinking to assess the urgency and implications of abnormal and critical lab results, prioritizing patient communication based on clinical significance. Documentation: Maintain comprehensive and precise documentation of communications in patient progress notes. Record abnormal and critical results, patient concerns, and subsequent actions. Ensure compliance with regulatory signature requirements. Time Management: Exhibit exceptional time management skills to efficiently manage multiple lab results and patient communications, prioritizing urgent cases promptly. Problem Solving Expertise: Apply advanced problem-solving abilities using medical training and experience to troubleshoot issues related to lab result discrepancies or data integrity. Data-Driven Decision Making: Leverage data analytics to identify patterns and trends in lab results, contributing to evidence-based practice and enhanced patient outcomes. Regulatory Knowledge: Maintain up-to-date knowledge of healthcare regulations and compliance standards to ensure all communications adhere to legal and ethical guidelines. Escalation to Providers: For questions beyond the RN's medical scope, escalate to a licensed, on call provider (NP/PA/MD/DO) and manage the completion of result delivery and accompanying required documentation. Member Services Team Escalations: Address lab-related escalations from the Member Services Team, such as result clarifications, data discrepancies, or additional test requests, and communicate resolutions back to the patient, documenting the outcome. The Expertise Required Strong analytical capabilities, exceptional communication skills, and a commitment to fostering a patient centered environment. Strong attention to detail and ability to manage multiple patients efficiently. Ability to work independently while collaborating with a larger clinical team. This role is pivotal in upholding clinical and legal standards through meticulous communication and patient care management. Precision in data analysis and documentation to ensure accuracy in lab results and reporting. Certifications/Licenses, Education, and Experience: Education: Active RN licensure with a commitment to compliance and regulatory standards. Compact Licensure required. Additional licenses may be required in addition. BSN or equivalent degree preferred. Experience: Minimum of 3 years of experience as a working nurse, clinical research, medical communications, and/or related field. Proficiency in Salesforce or other EMR systems for documenting patient interactions. Licensure Requirement: Compact licensure required, non-compact state license preferred. Willingness to maintain and obtain additional state licenses as needed. Must hold all licenses in good standing. Compact States [42]: RNs with compact licenses can practice in all 42 states in the compact, including Alabama, Arizona, Arkansas, Colorado, Florida, Texas, and more. Non-Compact States [8]: California, Nevada, Illinois, Hawaii, Alaska, Oregon, Minnesota, New York. How We Work Together Location: Remote within the United States. This role requires 100% of work to be performed in a remote office environment. Travel: This is a remote position with less than 10% travel requirements. Occasional planned travel may be required as part of the role. Physical demands associated with this position Include: The ability to use keyboards and other computer equipment. PTO and On-Call Coordination: Work within a structured on-call system to ensure coverage when team members are on leave. The expected salary range for this role is $70,000 - $100,000 USD per year for full time team members. Benefits & Perks (US Full Time Employees) Paid Time Off (PTO) and Company Paid Holidays 100% Employer paid medical, dental, and vision insurance plan options Health Savings Account and Flexible Spending Accounts Bi-weekly HSA employer contribution Company paid Short-Term Disability and Long-Term Disability 401(k) Retirement Plan, with Company Match Diversity & Inclusion We work with and serve people from diverse cultures and communities around the world. We are stronger and better when we build a team representing the communities we support. We maintain an inclusive culture where people from a broad range of backgrounds feel valued and respected as they contribute to our mission. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to, and will not be discriminated against on the basis of, race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Care Access is unable to sponsor work visas at this time. If you need an accommodation to apply for a role with Care Access, please reach out to: ********************************

Registered Nurse / Clinical Editor / Proofer - Remote, New York State (#25297) Employment Type: Full-time Hourly Rate: $45/hr Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: We are seeking a detail-oriented Registered Nurse with strong editorial skills to review NYS Dispute Resolution and External Review determinations. This remote position combines clinical expertise with editorial precision to ensure accurate, compliant, and professionally presented case documents while improving team performance through error tracking and staff training. Why Join Us? Competitive Compensation: Earn $45 per hour Comprehensive Benefits: Vacation Leave 6 Major Paid Holidays per year 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act License Reimbursement after 1 year of employment Health insurance is subject to plan eligibility requirements 401k Matching eligibility after 1 year of employment Benefits from Paychex, such as Payactive GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc Work Schedule: Full-time, Remote. Sunday to Thursday (9:00 AM - 5:30 PM) Professional Growth: Gain valuable experience in healthcare policy and medical editing Impactful Work: Ensure accuracy and compliance in state healthcare dispute resolutions Qualifications: Education: Baccalaureate degree in Nursing or a graduate of an approved RN program Licensure: Active New York State RN license Experience: Must have a minimum of 2 years of experience in an acute care facility, preferably in medicine/surgery or special care units, and one to 3 years of experience in acute care utilization review. Must have post-graduate studies demonstrating proficiency in writing, editing, and proofing skills. Technical Skills: Must have knowledge and experience with electronic medical records, including coding, quality, and clinical charting. Soft Skills: Must have the ability to oversee, problem-solve, and work collaboratively with peers, medical, analytical, and administrative support staff. Other requirements: A writing sample or publication is required. Key Responsibilities: This individual will review all NYS Dispute Resolution and External Review determinations for accuracy of decisions, mathematical determinations, content, grammar, punctuation, and state-required conventions. They will utilize their clinical knowledge and editorial skills to produce a final, clean copy for each case determination. They will track errors and retrain clinical and administrative staff to mitigate production errors. Conduct a thorough review of pre-final dispute determinations using checklist tools. Make clinical and mathematical edits to responses using provided case documentation, as necessary. Consult with team members and supervisors as necessary to improve the final product. Complete edits check of content, references, grammar, spelling, and punctuation before release of final product. Maintain tracking and trending of errors and use findings to analyze areas of concern and highlight areas of improvement. Will provide technical assistance and conduct/participate in staff huddles. Other activities as may be deemed necessary How to Apply: If you are an RN with strong editorial skills ready to apply your clinical expertise in a unique remote role, we want to hear from you! Submit your Resume/CV and writing sample to hr@glhstaffing.com or call our office at (800) 608-4025 to learn more about this opportunity. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives

Grow With Us! At Hilb Group, we recognize that our associates are our greatest asset. We promote a service-driven culture of high performance that encourages career and professional development. The Hilb Group is currently seeking a motivated and ambitious Benefits Clinical Nurse Advocate to join our team. This position will report to our agency located in Cranston, RI. The ideal candidate will be motivated to succeed, is well organized, able to prioritize, and able to work well with a team. This is a remote position. Responsibilities: Review of a variety of health plan data and the ability to develop clinical findings and projections of future spend. Use of clinical knowledge to work with health insurance carriers to ensure appropriate clinical care coordination. Work with employer to develop an appropriate a health risk management plan. Work closely with our Account Management Team to develop a cohesive plan to control costs within the health plan. Assist members in identifying participating providers that meet nd when appropriate, assist members in obtaining appointments with the provider. Assist members with access to medically necessary, quality healthcare in a cost-effective setting Assist member in answering their complex medical questions. Assist members in locating available community resources. Development of a variety of health care education topics for represented membership. Assist members with appealing health carrier's denial of medically appropriate care. Qualifications: Must be a Registered Nurse Certified Case Manager a plus At least 5 years of clinical experience preferably with an insurance company or Managed Care Company. Demonstrated proficiency using Microsoft Office applications Dynamic personality with excellent presentation skills. Comfortable working with various data analytics platforms to identify gaps in care and mitigatable risk. Excellent written and verbal communication skills Excellent time management and project management skills Ability to articulate thoughts and speak clearly and professionally Benefits: Company Paid Life Insurance, Long-Term and Short-Term Disability. Medical, Dental, Vision and FSA/HSA plans. 401(k) with company match. Additional voluntary benefits including Critical Illness, Accident Insurance, Hospital Indemnity and Supplemental Life Insurance, Legal and Identity Protection, and Pet benefits. Generous PTO. An awesome team of professionals! The Hilb Group is an equal opportunity employer, and we actively support and comply with all applicable federal, state, and local laws prohibiting all forms of discrimination in employment. Additionally, we have a zero-tolerance policy for all forms of harassment in violation of federal, state, and local laws.

Raleigh General Hospital Registered Nurse (RN), Clinical Educator Job Type: FT | Days About our Health System Raleigh General is a 300 bed hospital located in Beckley, WV, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters. Your experience matters At Raleigh General Hospital, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but as a person. As a registered nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve. Job Summary The Clinical Educator is responsible for developing, planning, implementing and organizing a variety of education activities including individual, department and hospital wide programs. The Clinical Educator serves as consultant, facilitator, change agent and leader. This position supports clinical department leadership. Reports to: CNO FLSA: Exempt Job Requirements Minimum Education Bachelor of Science degree in Nursing Preferred: Master's degree Required Skills Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Licensed as a Registered Nurse Basic Life Support-Health Care Provider Basic Life Support-Health Care Provider Instructor within 3 years of accepting or transferring into the position. Minimum Work Experience 3-5 years of recent clinical experience with ongoing ability to demonstrate mastery of relevant clinical skills. Sufficient previous experience in adult education. Essential Functions Follows established policies and procedures, objectives, safety standards, and sensitivity to confidential information. Utilizes excellent customer service skills at all time. Complies with Federal and State law and accrediting and licensing agencies at all times, to include but not limited to, the Joint Commission and federal compliance regulations. Develops/coordinates orientation of new employee and transferred employee with active on-going involvement in the orientation process and continuing education materials. Develops, manages, and coordinates education programs and conducts training related to the needs of the organization including State, Federal, and accreditation mandatory programs. Works closely with Patient Safety Officer and responds to identified system changes or other identified needs to promote quality and patient safety. Works closely with Quality Director in developing and maintaining the quality program and the education of staff. Assists in managing data collection to evaluate organizational outcomes and submits accurate data in a timely manner as required by regulatory agencies; or as part of any volunteer/collaborative initiative. Assists in implementation of department quality initiatives and analysis of outcome data. Analysis shares and assists the interpretation of outcome data with appropriate staff, medical staff, and customers. Facilitates any action as indicated for noted undesirable data and/or negative trends. Facilitates teambuilding and leadership development in assigned areas. Responds to change in nursing practice and develops programs to support those changes. Maintains flexibility when managing multiple roles and responsibilities. Leads committees, work groups and/or projects related to the implementation of educational activities. Teaches content as needed and/or assigned within clinical expertise to facilitate orientation, staff development and/or safe practice. Performs managerial duties as needed, to support day to day activities, i.e., Kronos, daily productivity, etc. Responsible for planning, development, implementation, evaluation, and maintenance of continuing education activities as appropriate to various accrediting bodies, as assigned. Complies with continuing education accrediting body requirements. Participates as instructor in specialty courses as assigned. Is a subject matter expert in area of expertise. Develops education programs for clinical and non-clinical staff. Maintains and evaluates these programs on an ongoing basis. Provides consultation to department managers and staff on the education process, job competencies, and accrediting agency requirements. Maintains clinical knowledge in assigned areas and active involvement with orientation, on-going education and quality audits and initiatives. Maintains working knowledge of learning management systems and other data management systems in the department. Promotes collaborative relationships among health care professionals in the region. Assists in department budget preparation; contains expenditure within budget. Assists in the maintenance of employer education records for all disciplines. Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and professional conferences. Maintains confidentiality in accordance with HIPAA regulations. Support the culture of service excellence throughout the organization. Actively seek ways to demonstrate a commitment to continuous improvement and participate in professional development opportunities. Performs other related duties as assigned or requested. Functional Demands Population Served □ Does not treat or care for patients. X Neonate (X Infant (X Early Childhood (1 year and X Late Childhood (5 years and X Adolescent (13 and X Young Adult (17 to X Middle Adult (30 years to X Older Adult (>60 years) Protected Health Information Type of Protected Information Accessed: X Demographic X Clinical X Insurance X Financial X Complete Medical Record Bloodborne Pathogens Exposure: Rarely While performing this job, occupational exposure is present for all employees Physical Requirements - Physical Dexterity and Effort Bending/Stooping □ rarely, □ occasionally, X frequently, □ constantly Climbing □ rarely, X occasionally, □ frequently, □ constantly Keyboard Data Entry □ rarely, □ occasionally, □ frequently, X constantly Kneeling □ rarely, X occasionally, □ frequently, □ constantly Lifting/Moving Patients X rarely, □ occasionally, □ frequently, □ constantly Reaching □ rarely, X occasionally, □ frequently, □ constantly Repetitive Foot/Leg Movements □ rarely, □ occasionally, X frequently, □ constantly Repetitive Hand/Arm Movements □ rarely, □ occasionally, □ frequently, X constantly Running X rarely, □ occasionally, □ frequently, □ constantly Sitting □ rarely, □ occasionally, X frequently, □ constantly Squatting X rarely, □ occasionally, □ frequently, □ constantly Standing □ rarely, X occasionally, □ frequently, □ constantly Walking □ rarely, X occasionally, □ frequently, □ constantly Pushing / Pulling: 0-25 lbs. X rarely, □ occasionally, □ frequently, □ constantly Pushing / Pulling: 26-75 lbs. X rarely, □ occasionally, □ frequently, □ constantly Pushing/Pulling: over 75 lbs. X rarely, □ occasionally, □ frequently, □ constantly Lifting/Carrying (non-patient) : 0-25 lbs. X rarely, □ occasionally, □ frequently, □ constantly Lifting/Carrying (non-patient) : 26-75 lbs. X rarely, □ occasionally, □ frequently, □ constantly Lifting/Carrying (non-patient) : over 75 lbs. X rarely, □ occasionally, □ frequently, □ constantly Visual Acuity, Hearing and Speaking: Rarely Audible Speech □ rarely, □ occasionally, □ frequently, X constantly Hearing Acuity □ rarely, □ occasionally, □ frequently, X constantly Smelling Acuity X rarely, □ occasionally, □ frequently, □ constantly Taste Discrimination X rarely, □ occasionally, □ frequently, □ constantly Vision: Depth Perception □ rarely, □ occasionally, □ frequently, X constantly Vision: Distinguish Color X rarely, □ occasionally, □ frequently, □ constantly Vision: Seeing Far □ rarely, □ occasionally, □ frequently, X constantly Vision: Seeing Near □ rarely, □ occasionally, □ frequently, X constantly Biological: Rarely Biohazardous waste/ hazards X rarely, □ occasionally, □ frequently, □ constantly Blood and/or bodily fluids X rarely, □ occasionally, □ frequently, □ constantly Communicable diseases/pathogens X rarely, □ occasionally, □ frequently, □ constantly Chemical: Rarely Asbestos or lead X rarely, □ occasionally, □ frequently, □ constantly Cytotoxic Chemicals X rarely, □ occasionally, □ frequently, □ constantly Dust X rarely, □ occasionally, □ frequently, □ constantly Hazardous Chemicals X rarely, □ occasionally, □ frequently, □ constantly Gases/Vapors/Fumes X rarely, □ occasionally, □ frequently, □ constantly Hazardous Medication X rarely, □ occasionally, □ frequently, □ constantly Latex X rarely, □ occasionally, □ frequently, □ constantly Working Conditions: Subject to many interruptions Occasionally subjected to irregular hours Occasion exposure to blood borne pathogens. May periodically come into contact with fumes or airborne pathogens. Periodically work around hazardous waste. Works in moderate noise conditions. Nonessential Functions Proficient with computer and/or keyboarding skills required. Ability to work without direct supervision.

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Clinical, Supervisor - RN - Full-time (Remote U.S.) to join our growing team. Job Summary * As the Clinical Supervisor - RN - Full-time (Remote U.S.), this individual plays a pivotal role in overseeing and managing the Utilization Management (UM) activities within the organization. With a strong clinical foundation and leadership acumen, the Clinical Supervisor ensures that UM processes are executed efficiently, consistently, and in alignment with regulatory and contractual standards. A key focus of the role is to uphold excellence in clinical programs, fostering continuous improvement and innovation in care management practices. Additionally, the Clinical Supervisor is instrumental in cultivating and maintaining strong relationships with customers and stakeholders, ensuring that service delivery meets or exceeds expectations and contractual obligations. The Clinical Supervisor will also have oversight of direct reports. The Clinical Supervisor and direct reports are expected to work Monday through Friday, with participation in a rotating schedule that includes weekends and holidays. Responsibilities * Lead and oversee all Utilization Management (UM) activities including prior authorization and retrospective reviews, ensuring accuracy, consistency, and timely completion. * Conduct utilization reviews as needed to support workload demands and program requirements. * Monitor daily work queues and adjust staffing schedules to align with departmental demands. * Evaluate productivity and performance metrics of nurse reviewers to maintain high standards of efficiency and quality. * Identify onboarding and ongoing learning needs for Clinical Reviewers; collaborate with leadership to design and implement effective development plans. * Actively participate in leadership meetings, committees, and cross-functional workgroups to promote shared decision-making and continuous improvement. * Oversee quality assurance activities such as audits, Quality Improvement Plans (QIPs), database management, and Inter-Rater Reliability (IRR) support. * Identify areas for process and clinical improvements; develop and execute action plans to enhance outcomes. * Serve as a liaison to customers and providers, ensuring timely resolution of issues and promoting service excellence. * Stay current with clinical best practices and UM protocols, act as the primary resource for nurse reviewers regarding clinical review inquiries. * Support departmental and organizational goals by performing additional duties as assigned. * Read, understand, and adhere to all corporate policies, including policies related to HIPAA and its Privacy and Security Rules. The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary. Qualifications Required Qualifications/Experience: * Active, unrestricted Registered Nurse (RN) license in the state of Indiana or a valid compact state license. * Associate degree or equivalent experience directly applicable to clinical practice. * 5+ years of experience as a practicing RN. * 5+ years of supervisory experience in a healthcare setting with a minimum of 2+ years in Utilization Management. * 2+ years of experience applying InterQual and/or MCG clinical criteria in utilization review processes. Preferred Qualifications/Experience: * Bachelor's degree preferred. * Strong verbal and written communication skills, with the ability to convey complex information clearly and professionally. * Demonstrated customer-centric approach with a focus on achieving results and fostering positive relationships with internal and external stakeholders. * Excellent organizational and time management skills, with the ability to prioritize multiple tasks effectively. * Proven ability to work both independently and collaboratively within a team environment. * Proficiency in Microsoft Office Suite and other relevant software applications essential to the role. * Ability to provide technical guidance and leadership support to management and clinical teams. #LI-SD1 Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Compensation The pay range for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at Acentra Health EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Pay Range USD $84,088.00 - USD $88,271.00 /Yr.

Are you a skilled, compassionate nurse looking for flexible work in clinical research? As a Clinical Research Nurse - Home Visits (PRN), you'll provide high-quality nursing care directly in patients' homes while supporting important research studies. This role is ideal for nurses who value flexibility, independence, enjoy local travel, and want to supplement their income with meaningful work. Key Points to Know: • You'll use your own vehicle to visit patients in their homes, typically within 1-2 hours of your location. • Shifts are PRN / per diem, meaning you'll work only when projects are available in your area; project frequency may vary. • Orientation, training, and project-specific instructions are provided before each assignment. • You will be compensated for all time spent on training, travel, and patient visits, including documentation. We are posting this role now and will be reviewing applications on a rolling basis between now and Christmas. Interviews will begin in the New Year , so you may experience a brief delay in hearing back from us during the holiday period. Thank you in advance for your patience - we look forward to connecting in January. Position: Clinical Research Nurse - Home Visits (PRN) Job Type: Contract, PRN, Per Diem Hourly Rate: $65/hr onsite and $50/hr travel time Work Location: Los Angeles, California; Drive up to 1-2 hours to patient homes in your area (travel time compensated!) Job Description: As a Clinical Research Nurse - Home Visits (PRN), you will play a crucial role in ensuring the successful execution of research studies in patient homes. You will be responsible for administering investigational medications/products, conducting patient assessments, collecting vital information, and adhering to study protocols with utmost accuracy and ethics. Your expertise and caring nature will help us maintain compliance with each study's protocol and safeguard the well-being of study patients. Principal Duties and Responsibilities: Deliver competent, high-quality nursing care to study patients in their homes. Accountable for the competent and confident delivery of high-quality clinical care to patients/participants. Ensure compliance with each study's protocol by providing thorough review and documentation at each subject study visit. Administer investigational medications/products as needed; Perform patient assessments to determine presence of side effects; notify Principal Investigator of findings/issues. Perform medical tests as outlined in protocol, including, but not limited to: vital signs, specimen collection, electrocardiograms; Process specimens and ship specimens per protocol. Provide patient education and medical information to study patients to ensure understanding of proper medication dosage, administration, and disease treatment. Responsible for adherence to clinical research policies to ensure ethical conduct and protect vulnerable populations. Communicate effectively, promoting open and trusting relationships. Qualifications: Relevant Nurse Licensure CH-GCP Certificate Graduate from an accredited BSN or Associate Degree in Nursing or Nursing Diploma program Minimum 2 years' post qualification acute care experience Clinical Research experience preferred BLS certification required Experience and knowledge of working in clinical research trials with ICH-GCP (Good Clinical Practice) Certification - (training can be provided) Good basic IT skills, utilizing mobile devices and Microsoft systems Trained in Handling and Transport of Hazardous Substances (training can be provided) A flexible schedule is essential Unencumbered driver's license, reliable car Benefits: Competitive hourly pay rate, including compensation for travel time. Flexible schedule to maintain work-life balance. Mileage reimbursement for travel expenses. Ongoing training and support to growth your clinical research skills Opportunity to make a meaning impact on patients' lives while contributing to cutting-edge medical research. Join our team and contribute to groundbreaking medical advancements through clinical research!

Remote Clinical Review Nurse - Prior Authorization Employment Type: Full‑Time About the Role We are seeking an experienced Registered Nurse to join our team within a leading Managed Care Organization. This role is fully remote and focuses on reviewing clinical documentation to determine medical necessity, appropriateness of care, and alignment with established guidelines. The ideal candidate brings strong clinical judgment, excellent communication skills, and the ability to work independently in a fast‑paced environment. Key Responsibilities * Conduct clinical reviews of prior authorization requests for medical services, procedures, and medications. * Evaluate clinical documentation to determine medical necessity based on evidence‑based criteria and MCO guidelines. * Collaborate with providers, internal teams, and medical directors to gather additional information when needed. * Document all review decisions clearly, accurately, and in compliance with regulatory and organizational standards. * Maintain up‑to‑date knowledge of clinical guidelines, utilization management policies, and industry best practices. * Support quality improvement initiatives and contribute to process optimization within the UM department. Required Qualifications * Active Compact RN License (multistate). * 5+ years of recent acute care experience in a hospital setting, specifically on ER or ICU floors. * Strong understanding of clinical workflows, medical terminology, and acute care decision‑making. * Excellent critical thinking, assessment, and documentation skills. * Ability to work remotely with reliable internet access and a distraction‑free workspace. * Comfortable navigating electronic medical records and utilization management systems. What We Offer * Fully remote work environment. * Competitive compensation and benefits package. * Opportunities for professional growth within a large, mission‑driven organization. * Supportive team culture and strong clinical leadership. Job Type & Location This is a Contract position based out of San Antonio, TX. Pay and Benefits The pay range for this position is $35.00 - $40.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Jan 24, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

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

Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before they happen for patients with two or more chronic conditions. We believe every patient with chronic disease deserves consistent check-ins, follow-up, and support. The position of the Nurse Chronic Care Coordinator, Remote will perform telephonic encounters with patients on behalf of our partners each month and develops detailed care plans within our care plan templates in the electronic health record. This begins as an Independent 1099 Contractor position but offers the potential to reach full-time W2 employment (with employee benefits). Esrun Health is seeking Nurses to work part-time from their home office while complying with HIPAA privacy laws. You will set your own hours and will not be held to a daily work hour schedule. You will be contracted to work a minimum of 20hrs/wk. Esrun Health wants its team members to have the flexibility to balance their work-life with their home life. Part-time team members will typically need to dedicate an average of 20-30 hours per week to care for their assigned patients. This unique business model allows you to choose what days and what hours of the day you dedicate to care for your patients. The Care Coordinator will be assigned a patient panel based on skill and efficiency level and is expected to carry a patient panel of a minimum of 100 patients per calendar month. Care Coordinators will be expected to complete encounters on 90 percent of the patients they are assigned. Esrun Health utilizes a productivity-based pay structure and pays $10.00 per completed patient encounter up to 99 encounters/month, $10.25/encounter from 100-149 encounters/month, $12/encounter from 150-199 encounters/month, $14/encounter from 200-249 encounters/month, and $16/encounter for >250 encounters/month. Payment tier increases require 2 months consistency to achieve. A patient encounter will take a minimum of 20 minutes (time is cumulative including chart review, call times/attempts/texts, care plan development, care coordination, and documentation time). What your impact will be: The role of the Care Coordinator is to abide by the plan of care and orders of the practice. Ability to provide prevention and intervention for multiple disease conditions through motivational coaching. Develops a positive interaction with patients on behalf of our practices. Improve revenue by creating billable CCM episodes, increasing visits for management of chronic conditions. Develops detailed care plans for both the doctors and patients. The care plans exist for prevention and intervention purposes. Understand health care goals associated with chronic disease management provided by the practice. Attend regularly scheduled meetings (i.e., Bi-Monthly Staff Meetings, monthly one on one's, etc.). These “mandatory” meetings will be important to define the current scope of work. What we are looking for: Graduate from an accredited School of Nursing. (LPN, LVN, RN, BSN, etc.) Current license to practice as an RN/ LVN/LPN with no disciplinary actions noted A minimum of two (2) years of clinical experience in a Med/Surg, Case Management, and/or home health care. Hands-on experience with Electronic Medical Records as well as an understanding of Windows desktop and applications (Microsoft Office 365, Teams, Excel, etc.), also while being in a HIPAA compliant area in home to conduct Chronic Care Management duties. Ability to exercise initiative, judgment, organization, time-management, problem-solving, and decision-making skills. Skilled in using various computer programs (If you don't love computers, you won't love this position!) High Speed Internet and Desktop or Laptop computer (Has to be operation system of Windows 10 or higher or Mac) NO Chromebooks and no iPad. Excellent verbal, written and listening skills are a must. What will make you stand out: Quickly recognize condition-related warning signs. Organized, thorough documentation skills. Self-directed. Ability to prioritize responsibilities. Demonstrated time management skills. Clear diction. Applies exemplary phone etiquette to every call. Committed to excellence in patient care and customer service. What we offer: Contract position with opportunity to become a full-time position, to include benefit options (Medical, Dental, Vision, 401K, Life). Streamline designed technology for your Chronic Care operations. Established and secure company since 1976, providing critical software solutions for many verticals in countries ranging from North America, Europe, Asia, and Australia Core Values that unite and guide us. Autonomous and Flexible Work Environments Opportunities to learn and grow. Community Involvement and Social Responsibility About us: Esrun Health, a division of Harris Computer, is on a mission to redefine remote care. Our program offers a customized model of remote care services that blends Chronic Care Management (CCM), Remote Therapeutic Monitoring (RTM), Remote Physiologic Monitoring (RPM), Behavioral Health Integration (BHI), and/or Transitional Care Management (TCM) for each client based on their specific practice needs. As a Harris healthcare business, we are able to maintain a people-focused, small company experience with the financial security of a large organization.

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we encourage you to explore a future with ThedaCare. Benefits, with a whole-person approach to wellness - * Lifestyle Engagement * e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support * Access & Affordability * e.g. minimal or zero copays, team member cost sharing premiums, daycare About ThedaCare! Summary : The RN Clinical Nurse (Ambulatory) provides patient-centered, specialized, evidence-based nursing care across the continuum through an interprofessional approach to treatment, research, education, and advocacy. Contributes to the goals of the department by being accountable for the delivery of compassionate and safe care within the scope of practice as defined by the Wisconsin Board of Nursing and ThedaCare policy. Through collaborative practice with members of the care team, is responsible for patient outcomes that meet the high quality of care provided by ThedaCare. Furthers the professional practice of nursing at ThedaCare by promoting a culture of innovation and a commitment to growth and professional development. Job Description: Schedule: * Night shift: 11:00 PM - 7:30 AM * Variable Monday-Friday * Weekend and holiday rotation KEY ACCOUNTABILITIES: * Utilizes the nursing process, evidence-based practice, and specific competencies to assess the physical condition and nursing needs of patients, and develops a plan of care in a collaborative practice with the patient and interprofessional team. * Plans for the care needs of the patient in collaboration with the interprofessional team to provide the highest quality of care and clinical outcomes. * Demonstrates clinical expertise in the provision of care in the clinical specialty assigned, and performs all functions of the professional clinical nurse (RN), which are age appropriate, developmentally sensitive, and culturally specific. * Identifies ways to improve the patient's experience of care, streamline care processes, and lower costs while promoting quality to improve patient, family, and team member satisfaction. * Contributes to a professional environment that encourages mentoring, engagement, and development to retain expert clinicians. * Provides consultation and maintains positive relationships with physicians and other interprofessional team members, collaborating to problem solve and improve patient care. * Demonstrates, anticipates, and proactively manages risk to prevent crises. * Performs skillfully in life threatening emergencies, matching demands and resources during crises situations. QUALIFICATIONS: * Bachelor of Science in Nursing (BSN) preferred * Associate's Degree in Nursing (ADN) required * Current Wisconsin RN Licensure * American Heart Association Healthcare Provider Basic Life Support (BLS). PHYSICAL DEMANDS: * Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of Fifty (50) pounds without assistance * Job classification is exposed to blood borne pathogens (blood or bodily fluids) while performing job duties • Manual dexterity and hand-eye coordination to perform patient care procedures WORK ENVIRONMENT: * Frequent exposure to sharp objects and instruments * Occasional exposure to moving mechanical parts, fumes or airborne particles, toxic or caustic chemicals, and risk of electrical shock * Occasional high noise level in work environment * Standing and/or walking for extended periods of time * Transporting, transferring, positioning patients and/or equipment from one location to another; little likelihood for injury if proper body mechanics and procedures are followed * Possible exposure to communicable diseases, hazardous materials, and pharmacological agents * Occasional contact with aggressive and or combative patients. Position requires compliance with department specific competencies. Scheduled Weekly Hours: 24 Scheduled FTE: 0.6 Location: CIN 3 Neenah Center - Appleton,Wisconsin Overtime Exempt: No

Job DescriptionCLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic and well-respected organization offering tremendous career growth potential. At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply. 100% REMOTE! Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering). SUMMARY STATEMENT The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in meeting national and local policies as well as accepted medical standards of care. The incumbent applies clinical knowledge to assess the medical necessity, level of services and appropriateness of care which may include cases requiring prior authorization, complex pre-payment medical review or post-payment medical review. ESSENTIAL DUTIES & RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary. 90% of time will be spent on one or more of the following activities depending on assignments: Review and analyze pre and post pay complex health care claims from a medical perspective, inclusive of prior authorization: Perform clinical review work as assigned; may provide guidance to other team members and accurately interpret and apply broad CMS guidelines to specific and highly variable situations. Conduct review of claim data and medical records to make clinical decisions on the coverage, medical necessity, utilization and appropriateness of care per national and local policies, as well as accepted medical standards of care. Review provider practices and identify issues of concern, overpayment and need for corrective action as necessary; includes surfacing potential fraud and abuse or practice concerns. May develop recommendations for further corrective action based on medical review findings. May refer for review, or implement, corrective action related to medical review activities. May process claims and complete project work in the appropriate computer system(s). The remaining 10% of time will be spent on the following activities depending on assignments: Identify providers needing education and individually educate providers who are subject to medical review processes: Initiate or participate in provider teaching activities, creating written teaching material, providing one on one education or education to a group as a result of a medical review (e.g., probe, progressive corrective action, consent, etc.) or appeal. This may involve discussion with CMS leaders and leaders in the provider community. Participate in special projects as assigned. REQUIRED QUALIFICATIONS * Valid nursing degree * 2 years' clinical experience * Excellent written and oral communication skills * Demonstrated experience with evaluating medical and health care delivery issues (e.g., Inpatient Rehab Facility) * Strong computer skills to include Microsoft Office proficiency * Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Inpatient Rehabilitation Facility Experience * Bachelor of Science in Nursing (BSN) * Insurance industry experience * Certified Coder ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed. At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is offered with no fee to candidate.