PURPOSE AND SCOPE:
The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals' policies and procedures. Areas of practice are diverse, including, but not limited to, hemodialysis, peritoneal dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to the patient and deliver care that provides a positive patient experience.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Under limited supervision, applies considerable knowledge to perform a broad range of tasks which include but are not limited to direct patient care in multiple modalities not limited to hemodialysis, peritoneal dialysis, ultrafiltration, continuous renal replacement therapy, and Apheresis.
Provides supervision and direction of Patient Care Technicians and clerical staff; provides direction and education to ICU staff for CRRT.
Responsible for direct patient care of assigned patients in the Inpatient Renal Replacement and Apheresis Services setting and providing the appropriate treatment technique for assigned patients as prescribed in all modality procedures, as appropriately defined - hemodialysis, peritoneal, continuous renal replacement therapies, ultrafiltration, and Apheresis.
Assesses patients' responses to treatment therapy making appropriate adjustments and modifications to the treatment plan as indicated by the appropriately credentialed physician. Communicate problems or concerns to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated.
Delivers safe, effective care in a timely an efficient manner.
Gives organized, concise shift reports for patients on assigned shifts. Apply high level thinking skills to shift patient schedules to meet needs of more critical patients due to labs, MD order, or patient assessment.
Responsible for the implementation, administration, monitoring, and documentation of patient's response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier.
Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate daily patient care plan to ensure continuity of care.
Initiates and communicates to FMS facility nursing staff and appropriate hospital personnel as needed.
Accurately documents all treatment information in the individual patient record (ACES) and the hospital record, as needed.
Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding areas between treatments according to inpatient renal services policies and procedures.
Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate.
Performs all required pre-treatment dialysis machine alarm testing.
If applicable, initiates Solution Delivery System.
Operates all related equipment appropriately and safely and provides minor trouble shooting when necessary; efficiently utilizes supplies to prevent waste.
Understands, conducts, and documents appropriately Dialysis/Apheresis machine safety tests/alarm tests, equipment calibration, dialysate testing, machine safety tests, functional testing, and internal and external disinfection on all water & dialysis machines, and complies with the documentation/notification standards per FMS policies.
Completes and documents ongoing participation in QAI activities.
Participates in staff meetings as scheduled.
Participates in staff training and orientation as assigned.
Acts as a subject matter expert to hospital staff for dialysis related patient/equipment complications.
Responsible for reporting all new or unusual incidents, information, complaints, or problems to the inpatient manager and other parties per the Adverse Event Report requirements. May be assigned to in-center patient care on an as needed basis
Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
Assist with various projects as assigned by direct supervisor.
Other duties as assigned.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.
Direct patient care, interaction with patients, outpatient clinicians, hospital staff, and physicians. The position requires travel between assigned hospitals and facilities; as well as travel to regional meetings/educational events.
Position requires on call rotation including night, day, weekend, and holidays.
There is potential for exposure to potentially infectious material and contagious diseases/material.
Position provides direct patient care which regularly involves heavy lifting, moving of patient and/or equipment > 200lbs (with assistance); and may lift chemical and water solutions of up to 30lbs up as high as 5 feet.
SUPERVISION:
Provides supervision and direction of Patient Care Technicians (Certified Clinical Hemodialysis Technicians (CCHT)) and clerical staff; provides direction and education to ICU staff for CRRT.
EDUCATION:
Current appropriate state licensure.
Maintains acquired knowledge and remains current in advancements in nephrology, in particular, relative to inpatient care (hospitalized patients requiring varied treatment modalities, not limited to Renal Replacement, Apheresis, and Ultrafiltration services).
Must meet the practice requirements in the state in which employed.
Certification in Nephrology Nursing, Apheresis Nursing, or both is highly encouraged.
EXPERIENCE AND REQUIRED SKILLS:
One year RN experience required and required nursing skills.
Minimum 6 months nephrology experience required before working independently with no other Dialysis RNs to provide dialysis and ultrafiltration services.
Minimum 6 months Nephrology experience required before working independently with no other Apheresis RNs to provide Apheresis services.
Demonstrated strong assessment skills related to the critically ill patient.
ICU experience preferred but not required.
Successful completion of training course in the theory and practice of care of the ESRD patient - Progressive Renal Education Preparation.
BLS CPR Recognition.
ACLS CPR Recognition preferred, but not required.
Demonstrates organizational and time management skills, and a competency toward completing continuing and ongoing Renal/Nephrology education.
Displays leadership skills and ability to direct and supervise others (such as PCTs, CCHTs, clerical staff).
Successful completion of Nurses Technical Training.
Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.
EOE, disability/veterans
$39k-71k yearly est. Auto-Apply 60d+ ago
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Registered Nurse - Wound Specialist
Clinical Medical Services 4.8
Registered nurse job in Mayagez, PR
A RegisteredNurse administers skilled nursing care to patients on an intermittent basis in their place of residence. The RegisteredNurse - Wound Specialist, specializes in treating patients with wounds like burns, pressure ulcers, diabetic / arterial ulcers, and more this is performed in accordance with physician orders and plan of care under the direction and supervision of the agency.
________________________________________________________________
About Company:
CMS offers an Integrated Home Health System, which includes Durable Medical Equipment (DME), Respiratory Equipment, Home Health Services, Infusion Services, Orthotics and Prosthetics can count on CMS for their immediate, guaranteed.
Our service model is recognized by our business partners, positioning us with over three decades of experience as the market leader serving over 800,000 people in Puerto Rico.
Come and be part of CMS. Being part of our work team, where we are distinguished by the excellence of the service, we offer our patience.
Position Summary:
A RegisteredNurse administers skilled nursing care to patients on an intermittent basis in their place of residence. This is performed in accordance with physician orders and plan of care under the direction and supervision of the agency Director of Nursing and/or Administrator.
Minimum Requirements:
Graduate of an approved school of professional nursing and currently licensed in the state(s) in which practicing.
Wound Care Certification required.
Al least six (6) months' experience in a Wound Specialist position.
Acceptance of philosophy and goals of this Agency.
Ability to exercise initiative and independent judgment.
Our Benefits:
Benefit from our advanced documentation automation app-saving you time and effort so you can dedicate more energy to what matters most: your patients.
Health Insurance, (Vision, Dental & Pharmacy)
10 days paid Holidays
12 days of Sick Leave
15 days Vacations Leave
401K with Company Contribution
Provide Uniforms
Recognition and Incentives Programs
Training Program paid by Company
“CMS Inc. and CMS Home Care, LLC. is an Equal Employment Opportunity Employer. Affirmative Action for Women, Minorities, Veterans, and People with Disabilities"
$39k-71k yearly est. Auto-Apply 60d+ ago
Care Manager, Telephonic Nurse
Humana 4.8
Registered nurse job in San Juan, PR
**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks.
Work schedule can be between 8am-6:30pm EST.
The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures
The Care Manager Telephonic Nurse employs a variety of strategies, approaches and techniques to assess, intervene, and resolve Access to Care (ATC) barriers related to immediate medical services. The nurse will facilitate verified eligible Humana benefits to a provider and/or member while effectively documenting through assessments and/or evaluations while maintaining compliance with CMS regulations. The Care Manager Telephonic Nurse must also assess for member physical, environmental, and psycho-social health issues and intervene appropriately.
**Use your skills to make an impact**
**Required Qualifications**
+ Minimum of an Associate's degree in Nursing
+ Licensed RegisteredNurse (RN) with no disciplinary action
+ Must have a valid Compact RN license in the state where they reside. **Candidates must reside in a Compact state (excluding CA, IL, MI, NY, OR, AK, DC (District of Columbia), HI, NV, MA, MN, and PR).**
+ 3 years or more of clinical acute care experience
+ Comprehensive knowledge of all Microsoft programs including but not limited to Word, Outlook, PowerPoint, SharePoint, OneNote and Excel
**Preferred Qualifications**
+ Bachelor's degree - BSN
+ Experience with case management, discharge planning, and patient education for adult acute care
+ Managed care experience
+ Previous Medicare/Medicaid experience
+ Bilingual English/Spanish
**Additional Information**
+ Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks.
+ Work schedule can be between 8am-6:30pm EST.
**Work At Home / Internet Statement:**
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**SSN Alert Statement:** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-04-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$71.1k-97.8k yearly Easy Apply 13d ago
RN Clinical Consultation
Sedgwick 4.4
Registered nurse job in San Juan, PR
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
RN Clinical Consultation
**We are looking to add 1 part time nurse to our team: If you can work any of these shifts, please apply right away!**
+ **8:30am-6:30pm CST Friday and Saturdays OR 8:30am-6:30pm CST Saturday and Sundays**
**PRIMARY PURPOSE OF THE ROLE:** To triage calls to assess needs, giving appropriate care advice and disposition to appropriate level of care treatment while promoting cost-effective outcomes and safely facilitate return to work.
**ARE YOU AN IDEAL CANDIDATE?** We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.
+ Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.
+ Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.
+ Enjoy flexibility in your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.
+ Enable our Caring counts mission supporting injured employees from some of the world's best brands and organizations.
+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
+ Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Applies all phases of the nursing process, i.e. assessment, planning, implementation and evaluation when triaging calls.
+ Identifies the needs of caller by triaging, obtaining general health information and/or physician services referral.
+ Evaluates need for alternative treatment through telephonic contact and assessment with service provider.
+ Triages patient using defined triage protocols to obtain pertinent data; and enters data into computer system.
+ Identifies life-threatening emergencies and recommends appropriate interventions.
+ Refers issues requiring physician interventions to physician in a timely manner; directs patients to appropriate level of care including but not limited to the nearest emergency room, urgent care facility, primary treating physician or selfcare. Demonstrates effective verbal communications skills.
+ Adheres to quality assurance standards.
+ Serves as resource to triage team members.
**EDUCATION AND LICENSING**
Bachelor's degree in nursing (BSN) preferred. Active unrestricted RN compact licensure required along with two year (2) years of recent clinical practice experience. Should be proficient in multiple screens and multiple computer applications,.
**TAKING CARE OF YOU BY**
+ Seeks innovative customer solutions .
+ Craves cutting edge opportunities.
+ Wants dynamic company culture.
+ Passion about creativity.
+ Seeks ongoing learning as a person and professional.
+ Thrives when solving challenging problems.
+ Wants achievements to be celebrated.
+ We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.
**NEXT STEPS**
If your application is selected to advance to the next round , a recruiter will be in touch.
\#NURSE
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $35.00-$36.00/hr . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
_"Always accepting applications"._
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
$35-36 hourly 60d+ ago
General Duty-Transitional
Service Corporation International 4.4
Registered nurse job in San Juan, PR
Our associates celebrate lives. We celebrate our associates. Consider the possibilities of joining a Great Place to Work! Responsibilities vary day to day based on business needs but consist of driving, courier, general building maintenance, grounds keeping, and custodial. Flexibility to work in a team environment and help where needed. Exhibit courteous and polite behaviors.
JOB RESPONSIBILITIES
* Couriers' documents, flowers, or other items. Cleans interior and exterior of vehicles, restocks tissues/water as needed, re-fuel vehicles, identify maintenance issues, and ensures vehicle is ready for use.
* Grounds keeping responsibilities may include mowing law, edging, removing debris, and clears walkways. Watering of plants or lawns, adjusting sprinkler heads or timers, and replacing sprinkler heads. Properly maintains and stores equipment after each use.
* Performs general facility maintenance that may include painting, unstopping plumbing, replacing light bulbs, or other minor repairs.
* Custodial duties including cleaning and sanitizing surfaces, mopping, vacuuming, emptying waste receptacles.
* Additional responsibilities as assigned or requested including loading or unloading caskets, those of Funeral Services Assistance
Requirements
Education & Licenses:
* High School Diploma or equivalent
Experience & Knowledge:
* At least one (1) year general work experience
* Current state issued driver's license with an acceptable driving record
Work conditions
When considering the work environment associated with this job, the following factors may apply:
* Environment - Professional attire required when in contact with families
* Postures - Frequent continuous period of time sitting or standing up to 6 hours per day; frequently climbing stairs to access buildings; climb on ladders
* Physical Demands - Physical effort required to push, pull, or hold/carry various grounds keeping equipment
* Safety - courteously and safely drive company owned vehicles; be aware of surroundings to promote safety; use personal protective devices as appropriate; safely use electrical equipment
* Hours - May work beyond standard hours or schedule as business needs arise; limited local travel required
Postal Code: 00909
Category (Portal Searching): Operations
Job Location: US-PR - San Juan
$38k-46k yearly est. Auto-Apply 42d ago
LPN
Montefiore 4.5
Registered nurse job in Puerto Rico
The Licensed Practical Nurse is responsible for the delivery of care to the pediatrics, adolescent, adult and/or elderly patients within their scope of practice. He/She participates in performance improvement, research activities and maintains clinical expertise. The LPN will pre-screen patients prior to their visits, educating patients on telemedicine platform where applicable, assist in scheduling and patient screening and assist in chronic disease and preventative care patient outreach.
As a member of the nursing team and under the supervision of a Professional RegisteredNurse, or Doctor of Medicine will provide nursing care to patients/clients within assigned practices. Under the direction of a Registered Professional Nurse or Doctor of Medicine the Licensed Practical Nurse performs tasks and responsibilities within the framework of case finding, health teaching, health counseling and provision of restorative and supportive care, data collection, monitoring and observation, implementation of treatments, and therapies provided to Ambulatory Care patients throughout the age continuum (infants/geriatrics) that fall within the scope of practice.
Please note: This practice may have coverage needs in other offices) which would require you to travel.
This position is M-F and requests a flexible start time based on department needs 7:30am-4:00pm,8:00am-4:30pm, 8:30am-5:00pm, 9:00am-5:30pm, 9:30am-6:00pm,
EDUCATION, TRAINING, LICENSES, AND WORK EXPERIENCE:
Highschool Diploma/GED Required
One Year of related work experience
NYS LPN License Required
Licensed and registered as a Practical Nurse in the State of New York
Basic Life Support.
Effective English communication skills, written, oral and interpersonal.
Ability to use basic data entry and retrieval system.
Additional education required by specialty areas/patient care locations.
Department: Ophthalmology and Visual Sciences Bargaining Unit: 1199 Campus: MOSES Employment Status: Regular Full-Time Address: 3400 Bainbridge Avenue, Bronx
Shift: Day Scheduled Hours: HOURS VARY Req ID: 224842 Salary Range/Pay Rate: $34.72
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
To learn more about the “Montefiore Difference” - who we are at Montefiore and all that we have to offer our associates, please click here.
Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.
N/A; #LI-AA1; #LI-TM1; #LI-VK1
$34.7 hourly 60d+ ago
RN Clinical Reviewer (CPC Medical Coding Academy) - San Juan, PR
Unitedhealth Group Inc. 4.6
Registered nurse job in San Juan, PR
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Positions in this function investigates Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment.
Primary Responsibilities:
* Clinical Case Reviews -75%
* Perform clinical review of professional (or facility) claims vs. medical records to determine if the claim is supported or unsupported
* Maintain standards for productivity and accuracy. Standards are defined by the department
* Provide clear and concise clinical logic to the providers when necessary
* Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization
* Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
* Investigate and pursue recoveries
* Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
* Use pertinent data and facts to identify and solve a range of problems within area of expertise
* Other internal customer correspondence and team needs - 15%
* Attend and provide feedback during monthly meetings with assigned internal customer department
* Provide continuous feedback on how to improve the department relationships with internal team members and departments
* Continuing education - 10%
* Keep up required Coding Certificate and/or Nursing Licensure
* Complete compliance hours as required by the department
* ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION*
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:
* RegisteredNurse (RN), Coding Certificate or Nursing Licensure, for example:
* Puerto RicoRegisteredNurse
* Certified Professional Coder (CPC) + CPC A
* Certified Inpatient Coder (CIC)
* Certified Outpatient Auditor (COC)
* Certified Professional Medical Auditor (CPMA)
* Certified Coding Specialist (CCS)
* Demonstrated proficiency with computers, including Microsoft Suite of products
* Willing or able to work from Monday to Friday, 40 hours per week during our business operating hours of 8am - 7pm ATL
* Professional proficiency in both English and Spanish (Please note that an English proficiency assessment will be required for this position)
Preferred Qualifications:
* Experience in a hospital/inpatient setting, surgical or clinic
* Experience working with medical claims platforms
* Medical record coding experience with experience in Evaluation and Management Services in the outpatient/office setting
* Presentation or policy documentation experience
* Knowledge of CMS and AMA coding rules specific to CPT, HCPCS
* Knowledge of CMS Coverage, Federal and State Statues, Rules and Regulations
* Knowledge of Medicaid/Medicare Reimbursement methodologies
* Working knowledge of the healthcare insurance/managed care industry
* Working knowledge of medical terminology and claim coding
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.
$41k-46k yearly est. 8d ago
Intake RN (San Juan)
Centers Home
Registered nurse job in San Juan, PR
Responsible for assessing patient care needs and planning home health care services. JOB DUTIES /KNOWLEDGE
Coordinates, screens and assesses home health care needs of patients referred to Agency
Completes intake process within established time parameters
Collaborates with physicians, nurses and discharge planners to identify patient care needs and to establish the appropriate level of care for patients referred to the Agency
Establishes and completes an individualized Plan of Treatment in accordance with MD orders, patient care needs, insurance guidelines and Agency protocol, including the identification of formal/informal supports in carrying out plan
Ensures that the needed DME, medical supplies and ancillary services are ordered and documented
Contacts managed care personnel when appropriate to obtain necessary initial authorizations
Notifies referring party if patient will require alternative discharge plan
Delegates specific tasks to support staff providing clear, timely direction to ensure continuity of care
Serves as a resource to all persons contacting the agency for information
Treats all referral parties, patients, family members and hospital staff courteously and in a non-discriminatory manner
Demonstrates sound knowledge of reimbursement and billing practices for Medicare, Medicaid, managed care, charity care and other third-party payers
Demonstrates cultural sensitivity
Maintains patient confidentiality at all times
Demonstrates working knowledge of State and Federal regulations
Participates in Quality and Performance Improvement activities and in the orientation process for agency staff
Performs other related duties as required
Demonstrates a high degree of commitment to customer relations and quality service
Utilizes community resources as appropriate to meet patient care needs
JOB PERFORMANCE
Demonstrates ability to perform quality and effective services.
Demonstrates ability to set and meet objectives, and to find increasingly efficient ways to perform task.
Completes work, and documentation with accuracy and within agency time frames.
Requires minimal supervision and is self-directed.
Understands the delivery of service within home care.
$47k-59k yearly est. 60d+ ago
Registered Nurse I PR
Encompass Health Corp 4.1
Registered nurse job in San Juan, PR
The RegisteredNurse provides direct patient care to inpatients. This position assesses patients and creates a plan of care that is individualized and is reflective of each patient's needs and goals. The RegisteredNurse supervises activities of care, treatment and services of patient provided by LPN/LVNs, RNTs/CNAs, and other staff on assigned unit and shift.
This position communicates information with the interdisciplinary team and reports patient concerns and changes in condition to supervisor and/or physician in a timely manner.
$41k-70k yearly est. 44d ago
LPN Staff I - Long Term Care.
Rochester Regional Health 4.3
Registered nurse job in Puerto Rico
Job Title: LPN Staff I Department: Long Term Care Hours Per Week: 40 Schedule: Nights, 11p-7a
As a Licensed Practical Nurse, you will provide professional patient care to long-term and post-acute care residents. You will direct and monitor the care provided by CNAs and consistently ensure proper documentation and recording is taking place. Your ability to lead is crucial in both the success of the CNAs and the care of the patients.
RESPONSIBILITIES:
Responsible for timely, accurate medication administration of assigned team and concurrent required documentation.
Performs treatments and documents progress of same as per physician orders and facility protocol.
Assures concise, pertinent and complete resident care documentation using computerized medical record process. Assures the initiation of appropriate care pathway tools.
Responsible for receiving/giving relevant reports, both written and verbal from/to appropriate staff as per departmental protocols.
Assures proper monitoring of residents and relevant condition status are reported to charge nurse/supervisor and/or physicians in a timely manner.
Completes pre-reviews of medication administration records as per facility protocols.
Completes required MDS documentation and all related observations in a timely manner.
Supports CNA team through assisting in direct ADL care of residents.
REQUIRED QUALIFICATIONS:
Graduate from an accredited School of Practical Nursing.
Current licensure in State of New York.
PREFERRED QUALIFICATIONS:
One year experience preferred.
EDUCATION:
LICENSES / CERTIFICATIONS:
BLS - Basic Life Support - American Heart Association (AHA) American Heart Association (AHA) American Heart Association (AHA), LPN - Licensed Practical Nurse - New York State Education Department (NYSED) New York State Education Department (NYSED) New York State Education Department (NYSED)
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$27.75 - $33.75
CITY:
Rochester
POSTAL CODE:
14626
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.
$27.8-33.8 hourly Auto-Apply 60d+ ago
Inpatient Registered Nurse - RN
Fresenius Medical Care North America 4.3
Registered nurse job in San Juan, PR
**PURPOSE AND SCOPE:** The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals' policies and procedures. Areas of practice are diverse, including, but not limited to, hemodialysis, peritoneal dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to the patient and deliver care that provides a positive patient experience.
**PRINCIPAL DUTIES AND RESPONSIBILITIES:**
+ Under limited supervision, applies considerable knowledge to perform a broad range of tasks which include but are not limited to direct patient care in multiple modalities not limited to hemodialysis, peritoneal dialysis, ultrafiltration, continuous renal replacement therapy, and Apheresis.
+ Provides supervision and direction of Patient Care Technicians and clerical staff; provides direction and education to ICU staff for CRRT.
+ Responsible for direct patient care of assigned patients in the Inpatient Renal Replacement and Apheresis Services setting and providing the appropriate treatment technique for assigned patients as prescribed in all modality procedures, as appropriately defined - hemodialysis, peritoneal, continuous renal replacement therapies, ultrafiltration, and Apheresis.
+ Assesses patients' responses to treatment therapy making appropriate adjustments and modifications to the treatment plan as indicated by the appropriately credentialed physician. Communicate problems or concerns to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated.
+ Delivers safe, effective care in a timely an efficient manner.
+ Gives organized, concise shift reports for patients on assigned shifts. Apply high level thinking skills to shift patient schedules to meet needs of more critical patients due to labs, MD order, or patient assessment.
+ Responsible for the implementation, administration, monitoring, and documentation of patient's response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier.
+ Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate daily patient care plan to ensure continuity of care.
+ Initiates and communicates to FMS facility nursing staff and appropriate hospital personnel as needed.
+ Accurately documents all treatment information in the individual patient record (ACES) and the hospital record, as needed.
+ Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding areas between treatments according to inpatient renal services policies and procedures.
+ Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate.
+ Performs all required pre-treatment dialysis machine alarm testing.
+ If applicable, initiates Solution Delivery System.
+ Operates all related equipment appropriately and safely and provides minor trouble shooting when necessary; efficiently utilizes supplies to prevent waste.
+ Understands, conducts, and documents appropriately Dialysis/Apheresis machine safety tests/alarm tests, equipment calibration, dialysate testing, machine safety tests, functional testing, and internal and external disinfection on all water & dialysis machines, and complies with the documentation/notification standards per FMS policies.
+ Completes and documents ongoing participation in QAI activities.
+ Participates in staff meetings as scheduled.
+ Participates in staff training and orientation as assigned.
+ Acts as a subject matter expert to hospital staff for dialysis related patient/equipment complications.
+ Responsible for reporting all new or unusual incidents, information, complaints, or problems to the inpatient manager and other parties per the Adverse Event Report requirements. May be assigned to in-center patient care on an as needed basis
+ Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
+ Assist with various projects as assigned by direct supervisor.
+ Other duties as assigned.
**PHYSICAL DEMANDS AND WORKING CONDITIONS** **:**
+ The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
+ Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.
+ Direct patient care, interaction with patients, outpatient clinicians, hospital staff, and physicians. The position requires travel between assigned hospitals and facilities; as well as travel to regional meetings/educational events.
+ Position requires on call rotation including night, day, weekend, and holidays.
+ There is potential for exposure to potentially infectious material and contagious diseases/material.
+ Position provides direct patient care which regularly involves heavy lifting, moving of patient and/or equipment > 200lbs (with assistance); and may lift chemical and water solutions of up to 30lbs up as high as 5 feet.
**SUPERVISION:**
+ Provides supervision and direction of Patient Care Technicians (Certified Clinical Hemodialysis Technicians (CCHT)) and clerical staff; provides direction and education to ICU staff for CRRT.
**EDUCATION:**
+ Current appropriate state licensure.
+ Maintains acquired knowledge and remains current in advancements in nephrology, in particular, relative to inpatient care (hospitalized patients requiring varied treatment modalities, not limited to Renal Replacement, Apheresis, and Ultrafiltration services).
+ Must meet the practice requirements in the state in which employed.
+ Certification in Nephrology Nursing, Apheresis Nursing, or both is highly encouraged.
**EXPERIENCE AND REQUIRED SKILLS** **:**
+ One year RN experience required and required nursing skills.
+ Minimum 6 months nephrology experience required before working independently with no other Dialysis RNs to provide dialysis and ultrafiltration services.
+ Minimum 6 months Nephrology experience required before working independently with no other Apheresis RNs to provide Apheresis services.
+ Demonstrated strong assessment skills related to the critically ill patient.
+ ICU experience preferred but not required.
+ Successful completion of training course in the theory and practice of care of the ESRD patient - Progressive Renal Education Preparation.
+ BLS CPR Recognition.
+ ACLS CPR Recognition preferred, but not required.
+ Demonstrates organizational and time management skills, and a competency toward completing continuing and ongoing Renal/Nephrology education.
+ Displays leadership skills and ability to direct and supervise others (such as PCTs, CCHTs, clerical staff).
+ Successful completion of Nurses Technical Training.
**Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.**
**EOE, disability/veterans**
$41k-64k yearly est. 60d+ ago
Supervisor-Nurse RN
Acadia Healthcare Inc. 4.0
Registered nurse job in San Juan, PR
San Juan Capestrano Hospital is an Acadia facility that takes pride in giving quality patient care. We offer competitive benefits and pay. Please join our team and help change the future of Puerto Rico. PURPOSE STATEMENT: Responsible for day-to-day operations of the unit and ensure staffing is adequate to provide care.
ESSENTIAL FUNCTIONS:
* Provide, delegate, coordinate and evaluate care of patient through the collaborative efforts of team members and in accordance with the nursing process and standards of care and practice. Provide general nursing care in a facility.
* Function as the lead nurse on assigned shift.
* Responsible for staff assignments and/or direction of duties, tasks or projects.
* Provide professional and administrative leadership to staff.
* Accountable for the oversight of staffing performance.
* Coordinate nursing, medical and/or behavioral health care activities with all staff to ensure smooth and complete coordination of efforts during shared shift.
* Supervisory responsibility for assigning staff according to education and ability.
* Provide mentoring and training as needed.
* Coordinate all care rendered to patients, including physician orders and diagnostic information, and ensure consultations are ordered.
* Document medical, behavioral health information and nursing care.
* Administer medications and maintain records in accordance with company policies and procedures.
* Assist in developing a plan of care with specific and measurable goals, objectives and interventions defining actions unique to each patient's needs. Assist in updating and revising the plan of care as goals/objectives are met or when the patient's condition changes.
* Provide structure and maintain a therapeutic environment in collaboration with the patients and other care providers.
* Consistently utilize universal precautions, environmental safety guidelines and applicable level system as applicable.
OTHER FUNCTIONS:
* Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
* Graduation from an accredited school of nursing required.
* Three or more years' experience in nursing practice required.
* Two or more years' experience in behavioral health preferred.
* One or more years' experience in a hospital supervisory or charge position preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
* Current RN license as required by state.
* CPR certification required (training available upon hire and offered by facility).
* De-escalation/restraint certification required (training available upon hire and offered by facility).
* First aid may be required based on state or facility.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. null
$49k-56k yearly est. 35d ago
Nurse Educator - Puerto Rico (National)
Iqvia 4.7
Registered nurse job in San Juan, PR
As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians and patients. A significant part of our business is acting as the biopharma's sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.
We are excited to announce that at this time we are looking for a Field based Nurse Educator to join our team of over 10,000 global field representatives in several regions making over 20 million product details annually for our pharmaceutical and biotech clients.
**Multi-Therapeutic Ambassadors:**
**Background:**
Care Specialist:
Background: Patients are at the center of AbbVie's business strategies. The Care Specialists serve as an extension of the AbbVie service platform. Care Specialists have primary responsibility/accountability for providing appropriate product related training and education for patients prescribed PRODUCT. Care Specialists will serve as the link for each patient enrolling in the PROGRAM to better understand and utilize other PRODUCT services, including but not limited to PRODUCT training and adherence education. Each Care Specialist may interact with enrolled patients by telephone, email, in patient home settings, and/or in a public setting that would be conducive to education and protection of privacy. These interactions will be conducted in one on one, group and caregiver included education forums, with patients deciding how and whether to participate.
Job Duties:
Each Care Specialist is responsible to follow the program's written structure as outlined in the AbbVie document PD21-01-002 Practice Standards for Care Specialists and Care Specialist's Program and PD21-01-001 Practice Standards for Advocates and Advocate's Programs as may be amended from time to time. The Care Specialist will offer only AbbVie approved support, tools, resources and information to enrolled patients.
The Care Specialist will be responsible to assist in the development of patient product support programs that will focus on treatment on-boarding and product related education, including supporting adherence to the treatment plan as prescribed. All materials used for this program for any purpose will be approved through the divisional review and approval process (STAR).
Additional Multi-therapeutic Care Specialist Duties:
· Assistance in the development of STAR-reviewed education plans covering a variety of topics, including: on boarding, product administration, adherence and compliance education to improve the patient-doctor dialogue for patients prescribed PRODUCT
· Product related training and patient disease education to patients prescribed PRODUCT
· Provide education to support improved health literacy and dialogue between patients prescribed PRODUCT and their respective health care providers
· Never provide medical advice, instead referring patients to contact their healthcare provider
· Do not interfere with treatment decisions made between the patient and healthcare provider
· Education to support prescribed therapy - supplemental injection and administration training, disease state and product-related information,
· Educational programs for HCP and office staff introducing the Multi-therapeutic Care Specialist patient support program
· Support physician peer-to-peer engagement opportunities about the Care Specialist program by providing input to AbbVie concerning program content and/or by appearing as a speaker using STAR-approved content to introduce physicians to the program and resources available to patients
· Managing accounts and patients case-load in a large geography
· Management of assigned travel and commercial budgets within OPPF standards
· Follow all AbbVie-provided guidelines and policies and procedures
· Participate in, complete and follow all assigned training, from AbbVie and Service Provider
· Any additional duties as assigned by program management and approved through the STAR team
Multi-therapeutic Care Specialist Job Qualifications:
Minimum:
· BA/BS degree, preferably in behavioral/social sciences, public health, or business-related disciplines
· A minimum of 3 years professional experience in social work, case management or disease management in a patient/ health related field
· Willing to travel extensively (75-90%)
· Very strong time management skills
· Strong planning and prioritization skills
· Strong and effective presentation skills; excellent communications skills - both written and verbal
· Proven success working with or within Community Based Organizations or other patient health-related, community focused organizations providing services to targeted populations
· Ability to work and drive for results in cross-functional teams
· Initiative and vision: challenge existing assumptions and interpretations
· Drive and enthusiasm
· Exceptional interpersonal skills
· Ability to build relationships with third parties using good negotiation skills
· Well-developed networking and influencing abilities to leverage relationships within and outside of the company.
· Fully competent in MS Office (Word, Excel, PowerPoint)
· Received injection training
· Must be licensed nurse (either LPN or RN)
AbbVie Contigo Team members are expected to spend approximately ninety percent (90%) of their time in the field and ten percent (10%) of their time on administrative work.
**Location:** Field-based (extensive travel required)
We know that meaningful results require not only the right approach but also the right people. Regardless of your role, we invite you to reimagine healthcare with us. You will have the opportunity to play an important part in helping our clients drive healthcare forward and ultimately improve human health outcomes.
We look forward to the prospect of working with you! Please apply on-line at: *************
IQVIA offers a friendly, progressive work atmosphere and a comprehensive benefits package including medical, dental, life insurance and vision coverage, tuition assistance, bonus plan and 401(k).
**\#LI-CES**
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at **********************
IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. **********************/eoe
The potential base pay range for this role is $60,000 - $65,000 annually. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
EEO Minorities/Females/Protected Veterans/Disabled
$60k-65k yearly 41d ago
RN Branch Director, Home Health
Centerwell
Registered nurse job in San Juan, PR
**Become a part of our caring community and help us put health first** Reports To: Market Executive - Director, Area Home Health Branch Administration FLSA: Exempt **Work Schedule** : Full-time/40 Hours Type** : On-site **Branch Location** : Stockbridge, GA
**** $15,000 Associated Sign-on Bonus ****
**** This position is eligible for relocation assistance. The specific package offered will vary based on individual circumstances and company policy. ****
**This is not a remote or work-from-home position. This position requires you to sit on-site at our Stockbridge, GA branch location.**
The **Branch Director** is accountable for managing the day-to-day branch operations to ensure the following: operational efficiencies, quality of patient care, regulatory compliance, support of business development & patient base growth, achievement of key performance indicators, and people management/development. The Branch Director supervises the branch/clinical staff. Direct responsibility of ensuring the branch meets applicable Federal, State, and local laws regarding the certification and licensure process at all times. Responsible for long-range planning, fiscal viability, and quality of care provided by the branch. Recruits, interviews, and hires staff and monitors quality care and organizational performance. Assist other disciplines in coordinating activities when necessary, assuming responsibility for continuity, appropriateness, and quality of services delivered.
**Essential Functions:**
+ Develops, plans, implements, analyzes and organizes operations for the Branch.
+ Responsible for the delivery of care for all patients served by the Branch by providing supervision and support to the Clinical Manager(s).
+ Works in conjunction with the Area Director of Operations or the AVP of Operations and Finance Department to establish Branch's revenue and budget goals.
+ Recognizes the clinical leadership and provides support and supervision to the Clinical Manager(s) to promote more effective performance and delivery of quality home care services.
+ Maintains office operations in an efficient, productive, effective, and organized manner, which provides a safe working environment for employees, meeting local ordinances and fire and safety regulations in compliance with the company policies.
+ Conducts continuous quality improvement quarterly committee meetings, reviews all patient satisfaction data, and follows up on negative patient satisfaction surveys and follow-up visits with referral sources.
+ Communicate with the Area Director of Operations or the AVP of Operations for direction, problem-solving, and implementation of programs and protocols.
+ Partners with Sales Directors and Account Manager(s) to meet budgeted admission goals. Participates in sales and marketing initiatives.
**Use your skills to make an impact**
**License/Certifications:**
+ Active and unrestricted RegisteredNurse (RN) license with authorization to practice in the state of Georgia.
**Required Experience/Skills:**
+ Valid driver's license, auto insurance and reliable transportation.
+ Two years as a RegisteredNurse (RN) with at least one-year of management experience in a home care, hospice or equivalent environment.
+ Home health experience is required.
+ Management and people leadership experience is required. Outstanding leadership skills with demonstrated experience motivating, educating, supervising, and supporting staff and developing a cohesive team.
+ OASIS experience is preferred. OASIS certification (HCS-O, COQS, and/or COS-C), preferred.
+ Homecare Homebase (HCHB) experience is preferred.
+ CMS PDGM billing knowledge and/or experience is preferred.
+ Revenue/Fiscal management experience is required. Ability to manage multi-millions in revenue is strongly preferred.
+ Knowledge of business management, governmental regulations, and accreditation standards.
+ Experienced with quality improvement monitoring and reporting tools and methods.
+ Excellent verbal and written communication skills.
+ Must be proficient with Microsoft Word and Excel.
**Additional Information**
+ Normal Hours of Operation: M-F / 8a-5p (ET)
+ On-Call Expectation: Yes, rotating on-call shift.
+ Branch Size: 600+ Census (5.0 STAR rating)
+ Annual Bonus Eligible: Yes, eligible for the annual incentive bonus.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$93,000 - $128,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-13-2025
**About us**
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
$46k-55k yearly est. 22d ago
Bilingual Call Center Nurse
Insight Communications 4.6
Registered nurse job in San Juan, PR
Job Description
Department
Human Resources
Location
342 San Luis St., Suite 304, San Juan, PR 00920
Position
Bilingual Nurse
Reports to
María Miranda De Jesús
Title
HR & Finance Director
Position type:
Full time
Part time
Contract
In house
Shift hours: 40 weekly
Operating: Monday to Friday: 8:00 am to 5:00 pm
Extent
No extent
General purpose
The call center and telemedicine nurse will act as a link with the patient, providing effective remote patient monitoring (RPM) and telemedicine services and channel any request or problem that requires attention, providing the corresponding guidance to the attending physician. Among the essential qualities is to promote the use of the health monitoring devices and to provide the patient all the necessary information an empathic way, in order to educate the patient regarding the RPM program. maintaining their ability to have control of the call and efficiently communicate the information. The goal is to ensure quality care and compliance with the RPM and telemedicine services, respond effectively to patient inquiries, and ensure high patient satisfaction. Generate outgoing calls in order to verify patient information and vitals in accordance with the RPM program, through the effective use of the RPM and Telemedicine Software. Also, provide the necessary feedback if in the case of emergent patient care situations, by seeking assistance of the Medical Director or attending physician.
RESPONSIBILITIES AND COMPETENCES
Administrative, organizational, data management and communication skills.
Knowledgeable and able to effectively manage the Remote Patient Monitoring platform system
Knowledgeable of all Medicare Guidelines regarding the Remote Patient Monitoring program and Telemedicine programs
Manage a large number of outgoing and incoming calls
Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance, of the clinical director or MD.
Monitor the patient's condition and assess their needs to provide the best care and advice according to their responsibilities.
Identify and evaluate the needs of patients to achieve their satisfaction.
Manage multiple database systems provided by the company to document all interactions with patients as established.
Provide accurate, valid, and complete information.
Comply with the level of service and productivity goals established by the campaign / company for which the calls are being answered.
Maintain quality and productivity in accordance with the provisions of the Company.
Inform your immediate supervisor of any situation that arises, both customers and employees that may affect the proper functioning of the company.
Correctly register the information in the contact system.
Follow communication procedures, guidelines, and policies.
Fully Bilingual ( English and Spanish) - Written and Oral
Any other task designated by your supervisor or immediate manager, not limited to the aforementioned.
WORK EXPERIENCE REQUIREMENTS
Nurse experience
Knowledge of EMR system
Excellent knowledge of nursing care procedures and methods.
Ability to demonstrate empathy, motivation, attention, and support for the patient's needs.
Honest and responsible for their actions.
Great capacities to maintain telephone contact and for active listening.
Customer orientation and ability to adapt / respond to different types of personalities.
Knowledge and domain with computerized equipment.
Excellent in keyboard handling and data entry.
Trained to work under pressure and able to respond to high volume of work.
Ability to work in a team.
Excellent verbal and written communication skills.
Good diction.
Schedule availability and rotating shifts.
Possess high professionalism and ability to deal with clients and colleagues.
Academic requirements
Associate or bachelor's degree in nursing
DEMANDS
- Work mostly seated for approximately 7 to 8 hours to be able to successfully fulfill essential functions
- Number of people directly supervised 2 maintenance people.
- Exposed use of computerized equipment at all times, to perform its functions.
- Vision, speaking, and listening are required to perform their functions and capable of being understood.
- Be available to work overtime in cases of operational need that may be required.
- Travel requirement if necessary, to the other facilities.
APPROVED by
Maria Miranda De Jesús
Title
HR & Finance Director
Employee sing
Date
Affirmative Action Plan Statement / Equal Employment Opportunity
Insight Communications, Corp. offers equal employment opportunity to all employees and job applicants and prohibits discrimination and harassment of any kind without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruitment, hiring, placement, promotion, termination, firing, retirement, transfer, absence, compensation, and training.
Insight Communications, Corp.
342 San Luis St., Suite 304, San Juan, PR 00920
Tels. ************, ************, ************ Fax. ************
$28k-38k yearly est. Auto-Apply 60d+ ago
Registered Nurse (RN) - Clinical Research
Headlands Research
Registered nurse job in San Juan, PR
At Headlands Research, we are dedicated to enhancing clinical trial delivery within our communities. As a leading network of advanced clinical trial sites, we leverage cutting-edge technology and exceptional support services to broaden outreach and participation. Founded in 2018, our rapidly growing company currently operates 20+ sites across the US and Canada, with plans for further expansion.
About Us:
CMRC Headlands is a premier clinical research site in San Juan, Puerto Rico. We conduct cutting-edge clinical trials in collaboration with global pharmaceutical sponsors, bringing medical innovation to our local communities. Our mission is to advance science while centering the patient experience at every stage of research.
Position Summary:
CMRC is seeking a seasoned, full-time RegisteredNurse (RN) with strong clinical acumen and hands-on experience in both adult and pediatric settings. The ideal candidate has a background in hospital or private clinical practice, is passionate about patient-centered care, and thrives in a fast-paced, ambiguous, research-driven environment. This role requires a proactive self-starter who can navigate complex protocols with clinical judgment, independence, and attention to detail. Bilingual fluency in English and Spanish is essential.
Responsibilities:
Perform and document pediatric and adult phlebotomy procedures
Administer and document vital signs and clinical assessments
Support all phases of patient interaction including screening, enrollment, dosing, and follow-ups
Act as clinical support during study visits-monitor, document, and report on patient status and adverse events
Manage specimen handling, labeling, storage, and timely shipment according to protocol
Provide clinical oversight for study-related procedures to ensure safety and compliance
Coordinate and schedule research visits and procedures with precision and patient sensitivity
Review and interpret study protocols through a clinical lens to anticipate patient care needs
Communicate effectively with investigators, monitors, sponsors, and internal teams
Support study recruitment and patient outreach strategies
Maintain and organize source documentation and regulatory binders
Prepare for monitoring visits and assist during sponsor or regulatory audits
Other duties as needed to support study execution
Required Qualifications:
Active and unrestricted RegisteredNurse license in Puerto Rico
Minimum of 6 years of experience in a clinical setting (hospital or private practice)
Minimum of 4 years drawing blood from both pediatric and adult patients
Solid understanding of Good Clinical Practice (GCP) and/or willingness to undergo training
Comfort working within protocol-driven environments with shifting timelines
Demonstrated ability to operate autonomously and take initiative within a small, agile team
Proficient with electronic medical records, clinical data entry, and laboratory documentation
Exceptional organizational and multitasking skills
Strong interpersonal skills and compassionate bedside manner
Fluent in English and Spanish (written and verbal)
Preferred Qualifications:
Prior experience in clinical research or investigational trials is a plus
Familiarity with FDA, ICH-GCP, and HIPAA compliance standards
Experience preparing for and interacting with clinical trial monitors
$47k-57k yearly est. Auto-Apply 43d ago
Appeals Nurse
Evolent 4.6
Registered nurse job in San Juan, PR
**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
**What You'll Be Doing:**
The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures while complying with timeliness guidelines. Our team values collaboration, continuous learning, and a customer-centric approach, ensuring that every team member contributes to providing better health outcomes for the Clients and Members we serve.
**Collaboration Opportunities:**
The Specialty Appeal nurses work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators who set up the appeal, Physicians and other Clinicians who review the appeal, and managers for direction and leadership. The Appeals teamwork strategies and opportunities for collaboration include all-team and individual team meetings, Teams chats, and monthly communication on team metrics and accomplishments.
**What You Will Be Doing:**
+ Practices and maintains the principles of utilization management and appeals management by adhering to company policies and procedures.
+ Documents communications with medical office staff and/or MD provider as required.
+ Interfaces with other departments to satisfactorily resolve issues related to appeals and retrospective reviews.
+ Provides optimum customer service through professional and accurate communication while maintaining accreditation and health plan's required timeframes.
+ Refers cases to appropriate internal reviewers according to the business needs of the particular health plan.
+ Reviews requests for Urgent appeals compared to expedited criteria for downgrade to Standard processing, documenting accordingly.
+ Works closely with the appeals-dedicated Clinical Reviewers to ensure timely adjudication of processed appeals.
+ Other duties as assigned.
**Qualifications Required and Preferred:**
+ 1-3 years' experience and as an RN - **Required**
+ Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality improvement environment- **Required**
+ Able to work in a rotation to work 10:30am to 7pm CST (which includes 30-minute unpaid lunch break) 3 days/week, to meet the business needs of nurses providing coverage until 7:00pm CST. - **Required**
+ Must be able to exercise independent and sound judgment in clinical decision making. - **Preferred**
+ Able to navigate through internal and external computer systems. Working knowledge of Microsoft Office Product Suit - **Preferred**
+ Strong organizational and effective time management skills; demonstrated ability to manage multiple priorities. - **Preferred**
+ Outstanding interpersonal and negotiation skills to effectively establish positive relationships both internally and externally, including strong written and verbal communication skills. - **Preferred**
To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.
**Technical Requirements:**
We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
**Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.**
The expected base salary/wage range for this position is $37- $42/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.
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$37-42 hourly 60d+ ago
Supervisor-Nurse RN
Acadia External 3.7
Registered nurse job in San Juan, PR
PURPOSE STATEMENT:
Responsible for day-to-day operations of the unit and ensure staffing is adequate to provide care.
ESSENTIAL FUNCTIONS:
Provide, delegate, coordinate and evaluate care of patient through the collaborative efforts of team members and in accordance with the nursing process and standards of care and practice. Provide general nursing care in a facility.
Function as the lead nurse on assigned shift.
Responsible for staff assignments and/or direction of duties, tasks or projects.
Provide professional and administrative leadership to staff.
Accountable for the oversight of staffing performance.
Coordinate nursing, medical and/or behavioral health care activities with all staff to ensure smooth and complete coordination of efforts during shared shift.
Supervisory responsibility for assigning staff according to education and ability.
Provide mentoring and training as needed.
Coordinate all care rendered to patients, including physician orders and diagnostic information, and ensure consultations are ordered.
Document medical, behavioral health information and nursing care.
Administer medications and maintain records in accordance with company policies and procedures.
Assist in developing a plan of care with specific and measurable goals, objectives and interventions defining actions unique to each patient's needs. Assist in updating and revising the plan of care as goals/objectives are met or when the patient's condition changes.
Provide structure and maintain a therapeutic environment in collaboration with the patients and other care providers.
Consistently utilize universal precautions, environmental safety guidelines and applicable level system as applicable.
OTHER FUNCTIONS:
Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
Graduation from an accredited school of nursing required.
Three or more years' experience in nursing practice required.
Two or more years' experience in behavioral health preferred.
One or more years' experience in a hospital supervisory or charge position preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
Current RN license as required by state.
CPR certification required (training available upon hire and offered by facility).
De-escalation/restraint certification required (training available upon hire and offered by facility).
First aid may be required based on state or facility.
$46k-52k yearly est. 35d ago
General Duty-Transitional
SCI Shared Resources 3.7
Registered nurse job in Puerto Rico
Our associates celebrate lives. We celebrate our associates.
Consider the possibilities of joining a Great Place to Work!
Responsibilities vary day to day based on business needs but consist of driving, courier, general building maintenance, grounds keeping, and custodial. Flexibility to work in a team environment and help where needed. Exhibit courteous and polite behaviors.
JOB RESPONSIBILITIES
Couriers' documents, flowers, or other items. Cleans interior and exterior of vehicles, restocks tissues/water as needed, re-fuel vehicles, identify maintenance issues, and ensures vehicle is ready for use.
Grounds keeping responsibilities may include mowing law, edging, removing debris, and clears walkways. Watering of plants or lawns, adjusting sprinkler heads or timers, and replacing sprinkler heads. Properly maintains and stores equipment after each use.
Performs general facility maintenance that may include painting, unstopping plumbing, replacing light bulbs, or other minor repairs.
Custodial duties including cleaning and sanitizing surfaces, mopping, vacuuming, emptying waste receptacles.
Additional responsibilities as assigned or requested including loading or unloading caskets, those of Funeral Services Assistance
Requirements
Education & Licenses:
High School Diploma or equivalent
Experience & Knowledge:
At least one (1) year general work experience
Current state issued driver's license with an acceptable driving record
Work conditions
When considering the work environment associated with this job, the following factors may apply:
Environment - Professional attire required when in contact with families
Postures - Frequent continuous period of time sitting or standing up to 6 hours per day; frequently climbing stairs to access buildings; climb on ladders
Physical Demands - Physical effort required to push, pull, or hold/carry various grounds keeping equipment
Safety - courteously and safely drive company owned vehicles; be aware of surroundings to promote safety; use personal protective devices as appropriate; safely use electrical equipment
Hours - May work beyond standard hours or schedule as business needs arise; limited local travel required
Postal Code: 00909Category (Portal Searching): OperationsJob Location: US-PR - San Juan
$18k-34k yearly est. Auto-Apply 60d+ ago
Admitting Nurse
Alivia Health
Registered nurse job in Ponce, PR
Job Description
The Infusion Admitting / Evaluating Nurse is responsible for providing specialized infusion therapy care in the patient's home, performing clinical evaluations to determine eligibility and continuity of treatment. Administers intravenous therapies, educates the patient and their family, and documents in accordance with clinical, regulatory, and accreditation standards (ACHC, CMS, and Puerto Rico Department of Health). The admitting nurse must foster Alivia's values, support the vision of the infusion department, and actively contribute towards the unit's success.
Responsibilities include, but are not limited to the following:
Conduct initial clinical assessments at home to determine the feasibility and safety of infusion treatment.
Admit patients within 24 hours of receiving the referral. In accordance with regulatory and accreditation standards.
Coordinate medication reconciliation and develop the initial care plan in conjunction with the prescribing physician and multidisciplinary team.
Monitor the patient's response to treatment and document clinical findings in the electronic system.
Educate the patient and family about treatment, devices, infection control, warning signs, and patient rights and responsibilities.
Obtain and document the patient's informed consent in the medical record.
Identify and report adverse events, incidents, complaints, deviations, or clinical risks to the quality and compliance committee in a timely manner.
Required:
Bachelor's degree in nursing from an accredited university.
Current nursing license in Puerto Rico.
Participation in continuing education and documented annual clinical competencies.
Valid driver's license in Puerto Rico and availability of a motor vehicle.
Minimum of 2 years of experience in home health, infusion, or acute care services. Preferably in a home setting.
Knowledge of infusion pumps, central and peripheral catheters.
***Equal Opportunity Employer M/F/V/D***