Registered nurse in the icu work from home jobs

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

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

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

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. The Registered Nurse creates & develops patient care plans to direct the safe and appropriate administration of medication in the home or alternate site setting. Working with Home Infusion staff the Registered Nurse helps identify patients capable of successful self-administration, educates patients & caregivers on proper administration techniques & methods, coordinates discharge activities, administers or supervises administration of medication, provides IV site dressing care and phlebotomy services as ordered. Job Description: Primary Responsibilities: 1. Practices in accordance with the state and federal laws, rules, and regulations, including but not limited to Massachusetts Board of Registration in Nursing, Department of Public Health, the Food and Drug Administration, the Drug Enforcement Administration, and the United States Pharmacopeia. 2. Assesses patient needs and capabilities for acceptance onto services for ordered therapies through physical assessment, chart review, patient interview. 3. Provides education with patient & caregiver as a condition of acceptance onto home infusion services (in person, via prerecorded videos or teleconference). 4. Collects necessary authorizations, paperwork, signatures when needed to support patient billing functions. 5. Effectively communicates with all members of patient discharge team (hospital based & pharmacy based). 6. Able to effectively manage patient census & demonstrate flexibility in scheduling to meet time sensitive patient needs. 7. Adheres to policies & procedures for medication handling, preparation, administration, disposal. 8. Advocates patient needs to prescribers or other clinicians through written or verbal communication. 9. Create patient specific care plan, documents patient progress towards goals. 10. Maintains accurate listing of all medications, supplements & diagnoses patient has. 11. Create discharge plan for patient upon completions of therapy as ordered, or if abrupt discontinuation is required. 13. Participates in continuous quality control exercises, policy & procedure review, performance improvement tasks. 14. Take part in clinical on-call rotation for after-hours patient support. Required Qualifications: 1. Current licensure from the Massachusetts Board of Registration in Nursing. 2. Flexibility with hours worked to provide support evenings/weekends/holidays. 3. Current BLS certification 4. 2 years of Infusion related experience required. 5. Valid Driver's license & auto insurance Preferred Qualifications: 1. CRNI certification 2. Current ACLS certification Competencies: Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance. Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents. Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager. Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers. Oral Communications: Ability to comprehend and converse in English to communicate effectively with staff, patients, families and external customers. Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations. Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members. Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations. Adaptability: Ability to work in a fast paced environment and adapt to acute change. Social/Environmental Requirements: Health Care Status: HCW 3: Regular provision of service in a patient care area. Sensory Requirements: Close work (paperwork, visual examination), Color vision/perception, Visual monotony, Visual clarity feet, Conversation, Monitoring Equipment, Telephone, and Background Noise. Physical Requirements: Medium work: Exerting up to 50 pounds of force occasionally and or up to 20 pounds of force frequently. Job is physical in nature and employee needs to stand and/or move around through the majority of their shift. This job requires constant walking, Endurance-working up to 4-6 hours without a break, frequent sitting, standing, twisting neck, twisting waist, Keyboard use, Reaching-above shoulder height, Reaching-below shoulder height, Lifting and carrying items weighing up to 10 lbs, pushing items weighing up to 10 lbs. There may be occasional bending neck, bending waist, Fine Manipulation using both hands, Pushing/Pulling using both hands. Pay Range: $37.00 - $66.70 The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law. As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.Equal Opportunity Employer/Veterans/Disabled

The RN or SW Clinical Facilitator coordinates with Clinical Teams and other internal stakeholders to advance Healthfirst's clinical practice through technical assistance, education, and innovation solutions by applying adult learning theory. The technical assistance solutions will ensure efficient and effective quality of care in accordance to Healthfirst standards and rules/regulations set forth by state, and federal regulatory and compliance agencies. Within the Clinical Division at Healthfirst, the Clinical Technical Assistance Center (CTAC) will assist clinical employees and other internal stakeholders in tactically obtaining or improving the essential knowledge or skills needed to perform their jobs. The CTAC will also serve as the hub for ongoing adult learning and skills acquisition which supports Healthfirst's commitment to ensuring its teams are capable, engaged, and committed to their work.Leverages adult learning principles and clinical practice standards to move towards a culture of continuous technical assistance improvement and clinical capacity building with innovative learning solutions. Develops technical assistance goals that are congruent with the organization and the Clinical Department's mission, vision, and strategic direction. Provides technical assistance, resources and tools that define performance requirements, identify gaps between existing and required performance, analyze root causes that limit performance and recommend and/or implement learning solutions that focus on and deliver business results. Utilizes current literature, research, and evidence-based findings in the design, implementation and evaluation of technical assistance solutions and education programs for staff learning and development. Conducts onboarding, preceptorship, and ongoing professional training to ensure clinical staff are equipped to perform job responsibilities in accordance to Healthfirst standards and rules/regulations set forth by regulatory and compliance agencies. Facilitates with subject matter experts, instructional designers, training agencies and technical assistance facilitators to design and deliver innovative learning solutions for performance enhancements needed to support the clinical department's business objectives. Facilitates updating departmental training manuals, job aids, quick reference guides and the clinical department's policies/procedures. Develop, implement, and evaluate a preceptorship training program curriculum to standardize the quality of preceptorship practices among the clinical teams. Conducts field assessments as needed to evaluate clinical staff and update the preceptorship training program curriculum. Minimum Qualifications: Licensure: Current Registered Professional Nurse or Registered Social Worker (i.e. LMSW or LCSW) in the State of New York. Education: Bachelor's in nursing or social work preferred with previous work experience in education. Three to five years of clinical experience in a specialty area, or combination of staff nurse/leadership experience in the specialty area, i.e. Care Management, Utilization Management, Clinical Eligibility. Excellent skills in the following areas: verbal and written communication, critical thinking, creativity, interpersonal relationships and team building; change management. Demonstrates knowledge base in professional nursing or social work and evidence based practice; participatory leadership, continuous learning environment, current issues and trends in care management and clinical practice, nursing and social work education and development. Ability to travel about 10% of time around downstate New York including Westchester County and Long Island to conduct clinical observations. Preferred Qualifications: Master's degree in Education and understanding of Adult Learning Theory applications to enhance the technical assistance and education of care management and care coordination activities. Ability to assess educational needs and design and develop responsible curricula. Highly developed verbal and written communication skills and the ability to present effectively to small and large groups. Strong interpersonal skills and ability to work effectively at all levels in a collaborative team environment. Certification in relevant clinical area and Nursing or Social Work Professional Development preferred. Intermediate Microsoft Word, Excel, Outlook and PowerPoint skills WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to *********************** or calling ************ . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services. EEO Law Poster and Supplement All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process. Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $81,100 - $117,470 All Other Locations (within approved locations): $71,600 - $106,505 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

MOBILE PRIMARY CARE - Remote $23.00hr - $27.00hr About us: Mobile Primary Care is a home-based primary care practice that specializes in geriatric healthcare, serving New York State. About the Opportunity: A healthcare organization seeking a licensed LVN, LPN or RN to join their growing staff as a new Care Management Nurse. This role will be providing telephonic Care Management for patients throughout the health system under the direction of a patient's provider. The nurse utilizes nursing process to evaluate patient needs over the telephone and provide guidance and education to patients, adhering to organizational policies, procedures and guidelines. Provides high risk patients with chronic disease management and liaises between the patient, patient's family or caregiver, provider, provider's office, hospital, home care agency etc. This position is telephonic care coordination as directed by the patients provider. Position Responsibilities: Cooperatively develop and integrate patient centered provider care plan and goals with the client/family and other providers Work collaboratively with team members to provide outreach and engagement with the patient Work closely with in-office providers/staff members to: Provide patient education to assist with self-management Identify gaps or barriers in treatment plans Coordinate care enrolled patients including scheduling appointments Coordinate referrals Coordinate community resources as needed (ie: home health, DME etc) Educate members on disease processes Encourage members to make healthy lifestyle changes Actively maintain assigned caseload of patients Make outbound calls to assess members current health status Receive and respond to telephone calls from patients. Collecting health data and providing medical guidance under the direction of the patients provider Document calls according to established guidelines Connects patient's care team together with updated information as received Participation in education and in-service programs Performs on-call for region that you are assigned Additional duties as assigned Required Qualifications: Unrestricted and current license to practice as LVN/LPN/RN with a New York State license. 3 years of experience within Care Management setting or Case Coordinator either in the homecare, inpatient, physician practice or in-home case management setting Strong working knowledge of chronic disease states including chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease and congestive heart failure and basic medical management of these states Must be highly motivated, result-oriented with strong skills in presenting, communicating, organizing and time management skills Strong organizational and interpersonal skills Excellent customer service skills demonstrated by positive feedback from patients/team Ability to identify problems and recommend solutions Demonstrates progressive proficiency with the utilization of available computer technology, including typing skills Demonstrates; leadership, communication, interpersonal and problem-solving skills Experience working with Electronic Health Record (EHR) Ability to sit and work at a computer for extended periods of time 60 words per minute typing Preferred Qualifications: Bilingual in Spanish

Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. Educate healthcare providers on the importance of accurate and complete clinical documentation. Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. Ensure compliance with regulatory requirements and guidelines. Participate in multidisciplinary team meetings to discuss documentation improvement strategies. Provide feedback to healthcare providers on documentation practices and areas for improvement. Maintain up-to-date knowledge of clinical documentation standards and best practices. Responsibilities * Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. * Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. * Educate healthcare providers on the importance of accurate and complete clinical documentation. * Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. * Ensure compliance with regulatory requirements and guidelines. * Participate in multidisciplinary team meetings to discuss documentation improvement strategies. * Provide feedback to healthcare providers on documentation practices and areas for improvement. * Maintain up-to-date knowledge of clinical documentation standards and best practices. Qualifications * Registered Nurse (RN) with a current license from any state. * Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification. * Certified Coding Specialist (CCS) certification if they have the CCDS 2 certification. * Minimum of 3 years of clinical nursing experience. * Strong knowledge of clinical documentation standards and regulatory requirements. * Excellent communication and interpersonal skills. * Ability to work collaboratively with healthcare providers and multidisciplinary teams. * Proficiency in electronic health record (EHR) systems. Additional Skills * Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification. * Certified Coding Specialist (CCS) certification if they have the CCDS 2 certification. Work Environment Fully remote role. Schedule: Monday-Friday 9am-5pm with potential for flexibility as long as 40-hour weeks are maintained. Pay and Benefits The pay range for this position is $70000.00 - $120000.00/yr. Health, Vision, Dental, 401k If we find a local candidate (CT RN license in CT, they will receive Middlesex Health Benefits, If we find someone national w/o CT RN License then they will receive benefits through 3rd party organization- Mindlance (have been told this is very expensive so they prefer local). Have all the benefit info in a PDF when needed Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on May 9, 2025. 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.

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 Payactiv 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

Methodist Hospital is looking to hire a Registered Nurse to join our Cardiovascular Advanced Care team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day. Position Summary: The Registered Nurse (RN) manages the episode of patient care in partnership with persons, care givers, groups and other providers to reach a shared goal of delivering safe, quality health care. This patient care may be through direct care by the RN, or it may be through coordinating and supervising patient care delegated to, Nursing Assistants and other unlicensed assistive personnel. The Advanced Care Unit is a 20-bed unit that serves acute and/or chronically ill patients requiring close observation, management, and monitoring. We care for patients having acute MI's, unstable arrhythmias, or require temporary pacemakers. Patients having respiratory distress-requiring bipap or hi flo. Medical patients such as GIB, DKA, or pulmonary hypertension. We also care for vascular surgical patients such as CEA's, LE bypass, endovascular AAA. Nurse-patient ratios 3:1 or 2:1. Individualized orientation for each new hire, ECCO, and ACLS certification. Work Schedule: 0.9 FTE, Rotating Day/Night 12-hour shift WSP position - Every Weekend/Weekend Only (Friday, Saturday, Sunday) Required Qualifications: Completion of an associate, baccalaureate, or master's degree program in Nursing. BSN preferred and generally expected that BSN is obtained within 2 years of hire. Valid Minnesota Registered Nurse License BLS provider status in accordance with American Heart Association (AHA) guidelines Preferred Qualifications: Demonstrates knowledge of age-related growth and development principles necessary to provide appropriate service and assure safety of patients Recommended 1+ year experience of medical-surgical/telemetry but will consider new grad, BSN, or currently enrolled in BSN program encouraged. Excellent critical thinking, multi-tasking, and prioritizing skills. Ability to work in a fast-paced environment. Benefits: Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!

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: $60/hr onsite and $50/hr travel time Work Location: Chicago, Illinois; 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!

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member's performance objectives as outlined by the Team Member's immediate Leadership Team Member. Location: Remote within the United States ONLY Schedule: Monday - Friday, 8:00 AM - 5:00 PM As a Clinical Review Specialist (RN), you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor. You will perform retrospective clinical case reviews and draft appeals that focus on establishing the Medical Necessity of the services performed, both Inpatient and Outpatient. Essential Duties and Responsibilities: · Performs retrospective medical necessity reviews to determine appeal eligibility of clinical disputes/denials. · Constructs and documents a succinct and fact-based clinical case to support appeal utilizing appropriate medical necessity criteria and other pertinent clinical facts. o Pertinent clinical facts include, but are not limited to, documentation preventing a safe transfer/discharge or documentation of medical necessary services denied for no authorization. · Demonstrates ability to critically think, problem solve and make independent decisions supporting the clinical appeal process. Minimum Qualifications & Competencies: · RN License with strong clinical knowledge - Active unrestricted clinical license in at least one state within the United States. · Minimum of 2-3 years of writing appeals letters and clinical auditing. · Minimum of 2-3 years Utilization Review / Case Management experience within the last 5 years. · Must be familiar with the payer guidelines and EMR systems like Epic, Cerner or Meditech. · Managed care payor experience a plus in either Utilization Review, Case Management or Appeals. · Must have excellent attention to detail, written communication skills and be computer proficient. PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A is only intended as a guideline and is only part of the Team Member's function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

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 $67,270.40 - USD $88,271.00 /Yr.

Description & Requirements Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract. In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed. This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making. About the Program: Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible. TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting. The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life. Why Maximus? * Work/Life Balance Support - Flexibility tailored to your needs! * Competitive Compensation - Bonuses based on performance included! * ️ Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. * Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching. * ️Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage. * Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). * Recognition Platform - Acknowledge and appreciate outstanding employee contributions. * Tuition Reimbursement - Invest in your ongoing education and development. * Employee Perks and Discounts - Additional benefits and discounts exclusively for employees. * Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs. * Professional Development Opportunities-Participate in training programs, workshops, and conferences. * Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees. Essential Duties and Responsibilities: * Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. * Issue approvals, denials or recommendations based on contract requirements. * Identify need for additional clinical documentation or consultation. * Complete documentation of activities within contract systems. * Communicate with providers, individuals and their designees, or state workers as required. * Performs other related duties as assigned. Minimum Requirements * Current Registered Nurse (RN) license valid in the state of practice is required * High School Degree or equivalent required * Minimum 2 years of clinical experience required * Minimum of one (1) year of registered nurse experience Preferred Requirements * Knowledge of mental health principles and practices * Experience in physical rehabilitation * Attention to detail Home Office Requirements * Maximus provides company-issued computer equipment and/or cell phone * Reliable high-speed internet service * Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity * Minimum 5 Mpbs upload speeds * Private and secure workspace #ClinicalServices EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Job Summary: The Clinical Auditor 2 performs audits of medical records on behalf of hospital clients for denials review, defense audits, disallowed charges, and utilization reviews. This position requires critical thinking and judgment and must demonstrate the ability to appropriately use standard criteria such as InterQual and Milliman (MCG) in addition to criteria established by state Medicaid programs or hospital policy. Audit and analysis must be accurate and consistently ensure a high level of quality, knowledge of laws, rules, regulations and guidelines necessary to ensure compliance and protection of information. Primary / Essential Functions: The Primary/ essential job duties may not be exhaustive. Clinical Staff Responsibilities: Performs audits of medical records to identify and/or defend charges, including: o Defense Audits o Patient Inquiry Audits o Disallowed Charges o Biller Requested Audits Completes analysis of records against established criteria, (e.g., InterQual, MCG, Medicare, Medicaid criteria), to determine if patient condition and/or care meets that criteria, including: o Avoidable day studies o Managed care, Medicare or Medicaid reconsiderations/appeals o Medicare or Medicaid RAC appeals or other specialized Audit Appeals (e.g. CERT, ZPIC, SMRC) Determine, request, and obtain appropriate supporting documentation from hospital, physicians, current medical literature and patient. Will compose appeal letters addressing and appealing both contract issues and medically related issues Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution. Enter audit findings and/or data into Client's computer based system. Proficiently utilize multiple computer based systems to complete and document work (both Savista and client) Client based billing, Internal based billing, medical record and quality systems Microsoft Outlook, Word and Excel Function in a professional, efficient and positive manner Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession Will help identify issues or challenges in the department, and come up with solutions or ideas to improve Maintain confidentiality of patient information and abide by all HIPAA related guidelines Competencies: · Puts Clients First · Drives for Results · Understands our Business · Thinks Innovatively · Values Differences · Builds Teamwork · Gains Trust · Communicates Effectively · Shows Accountability · Takes Action · Embraces Change · Makes Quality Decisions Physical / Mental Demands, Environment: 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. Must be able to use hands to finger, handle or feel, sit, stand, walk, lift up to 20 pounds, stoop, clean, bend, and reach with hands and arms. Must communicate clearly in English. Requires the ability to speak, read, write, see, and hear to perform essential duties of the job. Effective and positive human relations skills are required, including confidentiality, in order to appropriately interface with staff and clients. Must be able to perform multiple tasks and detailed work, problem solve, reason, and perform basic mathematical calculations. Equipment Used: Telephone, fax, calculator, computer, monitor, printer, hardware and software packages, computer peripheral equipment i.e. mouse and keyboard; and Microsoft software. Minimum Qualifications: Must be RN/Case Management /Utilization Review/Coding clinical certification with a BS/BA preferred otherwise equivalent years of technical experience 3 to 5 years of clinical experience or 3 to 5 years of clinical auditing experience in either case management, Medicare appeals, utilization review or denials management Knowledge of Milliman (MCG) or InterQual criteria preferred Experience in medical records review, claims processing or utilization/case management in a clinical practice or managed care organization Fundamental knowledge of Medicare/Medicaid Guidelines Proficiency in navigating the internet and multi-tasking with multiple electronic documentation systems simultaneously (toggling) Skilled with Microsoft Outlook, Word, Excel and EMR Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $28.00 to $38.00. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills. SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class. California Job Candidate Notice

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

Pine Park Health is a value-based primary care practice revolutionizing healthcare for residents of senior living communities across Arizona, California, and Nevada. We empower seniors to get healthy, stay healthy, and lead lives they love through a care model designed with everyone in mind - patients, families, community staff, providers, and payers. Our innovative approach brings healthcare directly to seniors' homes, offering prevention, screening, chronic condition management, lab work, and diagnostic testing in the comfort of their apartments. With weekly community visits, our teams provide consistent care while collaborating closely with facility staff to address comprehensive health needs. We've eliminated unnecessary barriers to urgent care through same-day and next-day appointments, helping seniors avoid emergency rooms and hospitalizations. Today, over 185+ communities trust Pine Park Health, and we're rapidly expanding our reach and impact. If you're mission-driven and passionate about transforming senior healthcare, this is your opportunity to make a meaningful difference! The Opportunity: We're clinicians, operators, product designers, and technologists that are passionate about redesigning the way people receive care. We provide care for residents of senior living communities and are looking for driven, compassionate, clinicians like you to join us. Our focus is on giving our patients evidence-based, person-centered care that aligns with their values and what matters to them. Over the last three years, we've experienced tremendous growth and are looking for a Registered Nurse excited to help lead us into the future. As an RN in our new team, you will be the hub of our care team structure and model of care. You will collaborate with our PCPs, Medical Directors, Technology Team, partners, and of course our patients as we work to build a company that delivers the best quality geriatric care available. In addition to providing great care, and working in a dynamic team environment, you'll have the chance to influence the development of healthcare technologies that enable our unique model. What You'll Do: Collaborate with a dedicated team of Primary Care Providers (PCPs), Medical Directors, and Medical Assistants supporting a patient panel. Triage inbound communications, including calls, faxes, emails and instant messages from teammates, patients, and partners. You will aim for "one touch" call resolution, escalate to the PCPs when necessary, and route sub-clinical tasks to our Medical Assistants. Act as a support system and escalation point for LVNs/LPNs/MAs within the team, enhancing our team's efficiency and effectiveness. Engage in comprehensive chart preparation before patient appointments. Oversee post-appointment processes, including diagnostic orders, referrals, medication orders, and provide crucial patient education on care plan adjustments when needed. Participate in daily team huddles, offering guidance and fostering efficient teamwork in support of patients & partners. Conduct virtual patient assessments, developing personalized care plans and monitoring health outcomes. Promote patient health through education on preventive care and self-management strategies consistent with the patient's care plan and wishes. Participate in crisis intervention and palliative care discussions, focusing on patient comfort and quality of life. Engage in ongoing quality improvement initiatives and contribute to research efforts aimed at enhancing geriatric care. What We're Looking For: A current unrestricted RN license in CA (preferably AZ and NV as well) with at least 2 years of clinical experience, preferably in geriatrics or related fields. Strong experience in remote roles, showcasing proficiency with technology and digital communication platforms. A track record of high accountability, exceptional communication, and the ability to thrive in a fast-paced environment. Experience with geriatric patients, particularly in settings like senior living communities or skilled nursing facilities. Familiarity with chronic care management and a solid understanding of geriatric-related diseases and treatments. A collaborative mindset, valuing the contributions of a multidisciplinary team and committed to improving patient outcomes. Why You'll Love Us: We're a smart, heart-centered, low-ego group motivated to make waves in the lives of seniors and the healthcare industry. We're solving complex, vital problems that affect real people and need bright, focused, driven minds like yours to help us achieve our goals. We empower team members to act like owners and have designed a learning-focused environment where you get ongoing support and regular feedback to help you grow. You'll get to invest in integrating technology with geriatric care, offering a unique opportunity to influence healthcare innovation. This is a dynamic and high-impact position at the core of our care delivery model. We work to create a supportive and collaborative environment where your contributions are valued and encouraged. Pine Park Health is an opportunity to be part of a fast-paced, mission-driven, startup organization focused on enhancing the health and well-being of geriatric patients. At Pine Park Health, we're passionate about transforming geriatric care and empowering our team to make a lasting impact. If you're dedicated to advancing healthcare through innovation and compassionate care, we'd love to hear from you. Pine Park Health is an equal opportunity employer - we aim to recruit, hire, develop, compensate, and promote regardless of race, religion, country of origin, gender, sexual orientation, age, marital status, veteran status, or disability.

Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY. Remote Registered Nurse (RN) Clinical Training Specialist 1-2 yrs of Clinical and 1 yr+ of Home Care experience required. 2-4 yrs of training clinical staff Ability to be on site for new Joint Venture Implementation Training Agency: Alternate Solutions Health Network SUMMARY Clinical Training Specialist, Registered Nurse will be responsible for training new hire field employees and internal staff during the on-boarding process as needed based on onboarding schedule and need. The Clinical Training Specialist, Registered Nurse will deliver structured training of operational procedures, homecare guidelines and workflow training to clinical field employees and internal support employees. This role will ensure competency evaluations of skills required for home health care. The Clinical Training Specialist, Registered Nurse will provide training for joint venture (JV) implementations to ensure quality training and patient outcomes; this role requires up to 60% of travel. This position serves as a resource and provides corporate support through extensive knowledge of the regulatory guidelines governing home health agencies. Complies with all agency policies and legal rules and regulations. The Clinical Training Specialist, Registered Nurse ensures compliance with all federal, state, and agency rules and regulations. QUALIFICATIONS & ATTRIBUTES: Current Registered Nurse compact licensure. 1-2 years of clinical experience required; homecare experience preferred. 2-4 years of experience in training/education of adult learners preferred. Ability to be onsite during JV implementation training. Ability to travel as needed for NHO at current agencies. Ability to identify adult learning and communication needs to enhance the quality of training provided to individual team members. Proficient in multiple systems; including but not limited to Microsoft Office, HCHB, SmartSheet, HealthStreams and Learning Management Systems (LMS). Experience in presenting training materials, programs, and ongoing education. Skilled in providing constructive feedback to new hire staff members and to improve the educational experience. Excellent written and verbal communication skills with leadership and field employees. Proficient in utilizing change management skills to coordinate, collaborate, and communicate effectively with team members. Ability to prioritize tasks, work efficiently and oversee multiple responsibilities. MAJOR AREAS OF RESPONSIBILITY: Effectively educate newly hired employees during orientation, for both field and internal support staff roles. Successfully train new hire and JV employees on the clinical processes and procedures of the agency. Provide training either in-person or remotely for clinical field and internal support staff. Expertise in CMS guidelines to ensure proper training and documentation techniques are taught to staff. Communicate with agencies on updates, outcomes, and competencies during the new hire process. Facilitate New Hire and Annual competencies within scope of practice of RN licensure. On occasion, be willing to alter work schedule to accommodate new hires that may need additional assistance. Attend in-service trainings and mandatory agency meetings. Collaborate with department leaders and team for process improvement (PI) initiatives. Maintain a professional appearance as a representative of the company. Educate on, understands, and practices agency policies and procedures. Actively promote the values, mission, and culture of the Company. Travel during Joint Venture training (onsite) and at agencies when in person training is needed. MANAGEMENT RESPONSIBILITY: N/A HEALTH QUALIFICATIONS: Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without accommodation. Constantly (66%-100%):Reading, Speaking, Writing EnglishCommunications SkillsComputer/PDA UsageSittingHand/finger dexterity Hearing/SeeingHearing in person Talking in person Vision for close work Frequently (34%-66%) WalkingBendingStandingDrivingLifting up to 50 lbs. with or without assistance Stretching/Reaching Occasionally (2%-33%) ClimbingStooping (bend at waist) Hearing on the phone Talking on the phone Rarely (1% or less) Distinguish smell/taste #INDASHN3 We'll help you put your passion for patient care to work. Apply today! This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice. We are an Equal Opportunity Employer.

Pinehurst Medical Clinic (PMC) PMC is a recognized healthcare provider in the communities of Moore County, Lee County, Cumberland County, Chatham County, and the surrounding six counties. Locally owned and managed, PMC offers a broad range of primary and specialty care services to the communities we serve. The physicians and healthcare team of professionals at PMC share a commitment to patient-centered care that is physician-led and utilizes the latest advances in medical technology. This combination of leading-edge medicine and deep compassion for the people we serve has been a hallmark of PMC since 1952. PMC consists of over 130 providers, approximately 750 employees, and 16 locations. What will you do as a PMC Transitional Care Coordinator (RN) Pinehurst Medical Clinic is seeking a Transitional Care Coordinator (RN) to join our Primary Care section in Pinehurst, NC. This position plays a key role in patient care working with our providers in providing the best in patient care by providing telephonic Care Management (non-face-to-face) services to multiple chronically ill patients recently discharged from an inpatient hospital stay. This is a part-time day shift position and does not require weekend or holiday hours. A day in the life of a PMC Transitional Care Coordinator (RN) may include: Works closely with the hospital discharge team & nursing staff to review daily discharges and contact patients within two business days. Assesses patient's understanding of healthcare needs and assesses patient's compliance with healthcare. Performs reconciliation of medications. Ensures patients have to follow up appointments with their providers. Communicates patient needs with the medical team as needed. Follows up closely with the patient as needed for 30 days to ensure needs are met post-hospital discharge. Assesses patient's needs and makes appropriate referrals Performs other related duties as required. What we can offer PMC is proud to support the total health and well-being of our team members so they can thrive personally and professionally. That's why, as part of the PMC team, you'll have a package of benefits that covers your health, well-being, family, and future. For more information regarding our benefits click here Benefits Information Required Qualifications Education (Including Licenses and Certifications): Licensed as a Registered Nurse in the State of North Carolina. BLS/CPR certification required. Experience: Two years of Case Management experience preferred Two years of clinical/ambulatory nursing experience preferred. **Position is fully remote, but will require in-person training during the onboarding process.