HEDIS Review Nurse - Remote - Contract
Remote job
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
Remote NP Primary Care Opportunity in Arizona making over $140k
Remote job
Job Description
Nurse Practitioner Advanced Primary Care (Remote)
Arizona | $145K+ Total Potential | MondayFriday Schedule
Compensation
Base Salary: $116,000$145,000 (depending on experience)
Annual Bonus Eligible
Position Overview
This Remote Nurse Practitioner role supports patients across Phoenix and broader Arizona through virtual care (phone and video). The NP provides advanced primary care, chronic disease management, preventive care, and palliative support while collaborating closely with a supervising Primary Care Physician.
This is an excellent opportunity for a self-driven NP who thrives in a highly autonomous environment and wants to make a meaningful impact on complex patient populationswithout nights, weekends, or call.
Schedule
MondayFriday
No nights, weekends, or call
Key Responsibilities
Conduct virtual patient assessments and develop individualized care plans
Provide chronic condition management and preventive health services
Deliver palliative care support as needed
Maintain clear, professional communication with patients, families, and facility staff
Navigate multiple facility partnerships while building strong clinical relationships
Order, review, and interpret diagnostic tests
Educate patients on disease prevention, medication adherence, and lifestyle changes
Prescribe medications and treatments within state scope
Accurately document all encounters in the EMR
Collaborate with physicians and interdisciplinary team members as needed
Requirements
Masters Degree in Nursing (MSN)
Current, unrestricted RN and NP licenses in Arizona
Minimum 1 year of NP experience (Primary Care, Geriatrics, or Palliative Care preferred)
Telemedicine experience preferred
Strong communication, clinical judgment, and patient relationship skills
Ability to work independently while maintaining team collaboration
Experience managing chronic conditions in adult or geriatric populations preferred
For more information contact:
****************************** ************
#pm #pl
Easy ApplyWound Care Nurse - Telehealth Coordinator
Remote job
We are seeking a dedicated and compassionate Wound Care Nurse, Telehealth Coordinator within the skilled nursing environment.
The Wound Care Nurse, Telehealth Coordinator is the link between healthcare providers and patients while providing dressing changes to wounds, under direct supervision, utilizing real-time, imaging technologies.
If you are passionate about excellent wound care and recognize the role telehealth has for consistent, convenient attention to patients in need, we encourage you to apply for the Telehealth Coordinator position and join our dedicated team.
Responsibilities:
Act as the in-person, hands on assistant to conduct weekly virtual wound rounds using technology under the guidance of wound care specialists, nurses, or healthcare providers.
Photograph wounds using designated telehealth technology and ensure accurate documentation of images for clinical review.
Aid patients in navigating telehealth platforms, troubleshoot technical issues, and ensure a seamless virtual connection for appointments.
Facilitate patient telehealth scheduling, provide education on virtual visits to patients and staff as needed.
Administer all aspects of wound care as per evidence based practice and facility policies, including dressing changes and rounds.
Maintain strict adherence to patient confidentiality and privacy regulations, including HIPAA compliance, during all telehealth interactions and documentation processes.
Submit orders for wound care products.
Qualifications:
Graduate of an accredited school of nursing required. Must possess current CPR certifications. Minimum of one (1) year of Wound Care experience required, (2) years preferred. Wound care certification is preferred. Must possess a current, unencumbered, active license to practice as a RN or LPN in state of practice.
Excellent communication skills with the ability to convey medical information clearly to physicians, staff, patients and family
Empathy, patience, and a genuine desire to provide quality healthcare services to patients at the bedside as well as through telehealth technology.
Commitment to maintaining patient confidentiality, privacy, and data security in accordance with healthcare regulations (e.g., HIPAA).
Ability to multitask, and adapt to changing telehealth workflows, job requirements, and patient populations.
Prior experience in SNF, LTC, or Assisted Living preferred.
Travel to assigned facilities using your personal car, valid driver's license, and mileage reimbursement offered.
Role starts out Part-Time with the opportunity to be Full-Time.
Auto-ApplyPGY1 Managed Care Resident
Remote job
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Applications Due January 5th, 2026
Position Summary:
The PGY1 Managed Care Resident helps to ensure safe and cost-effective medication therapy for our members, supports initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients, and plays an active role in the development and maintenance of formularies and clinical programs as part of their learning experience.
Position Responsibilities:
Support initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients
Play an active role in the development and maintenance of formularies for multiple lines of business
Analyze pharmacy cost of care, trends, and coordinate the development of appropriate utilization management edits including step therapy, prior authorization, and quantity limits
Design pharmacy benefits for populations of patients based on client-specific elections
Create pharmaceutical pipeline newsletters / publications / presentations
Provide clinical resource including support of the prior authorization unit and clinical call center
Analyze utilization data and creates reports for group plan sponsors (i.e., employers, labor unions, etc.)
Participate in the development and maintenance of clinical programs such as drug utilization review, medication therapy management, adherence, and disease management programs
Evaluate industry data to improve existing clinical programs and make recommendations with a focus on clinical offerings and value proposition
Support the clinical client management team, as needed
Observe and participate in committee activities related to the pharmacy program
Design, manage, and complete a clinical residency project for presentation at a conference with the intent to publish research findings
Supervise pharmacy students and further develop the student program, including coordination with preceptors as needed
Support quality improvement projects, as needed
Support request for information and request for proposal submissions, as needed
Support general business needs and operations, as required
All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
Minimum Qualifications:
Doctor of Pharmacy (PharmD) Degree from an accredited School of Pharmacy completed prior to start of residency program
Strong academic performance with a minimum of 2.8 GPA and successful completion of all APPE rotations
Licensed Pharmacist or eligible for licensure (must be licensed by September 30th of the residency year)
Proficient in Microsoft office Suite with emphasis on Microsoft Excel
Ability to balance multiple complex projects simultaneously
Excellent communication and interpersonal skills, and ability to work with team members, executive management, and business partners in a polished and professional manner
Ability to work independently, virtually, and in a team environment to produce solutions from concept to final deliverables required
Familiarity working with large data sets
Exceptional written and verbal communication skills
Extremely flexible, highly organized, and able to shift priorities easily
Attention to detail and commitment to delivering high quality work product
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Salary Range$50,000-$50,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************
Auto-ApplyNurse Liaison - Remote
Remote job
Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and coordination of admission to care for substance use disordered patients referred from a hospital setting. To be considered for the position, you must live within the Pittsburgh, PA area or surrounding counties.
Responsibilities
Assesses admission candidates' medical and psychiatric appropriateness for treatment.
Determines level of care placement based on ASAM criteria.
Pre-certifies admissions as required.
Discusses treatment options with referral sources.
Acts as liaison between Gateway and outside referral sources.
Coordinates patient transfers from other facilities to Gateway Aliquippa/Westmoreland.
Responds to needs of referral sources and managed care representatives.
Interacts with the physician through coordination of patient assessments. Attends GRC mandatory training and in-services.
Other duties as required.
Knowledge, Skills, and Abilities
Strong communication skills required.
Able to work independently with minimal oversight.
Knowledge of skilled nursing
Requirements
Pennsylvania RN or LPN licensure
3+ years nursing experience preferred.
Experience identifying/treating drug and alcohol addictions.
Experience in conducting assessments and evaluations.
Additional Requirements
Pass PA Criminal Background Check
Obtain PA Child Abuse and FBI Fingerprinting Clearances.
Pass Drug Screen
TB Test
Access to reliable and dependable internet connection.
Work Conditions
Favorable working conditions.
Minimal physical demands
Significant mental demands include those associated with working with patients with addictive disorders and managing multiple tasks.
GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.
Remote HEDIS Nurse Consultant
Remote job
HEDIS work typically includes requesting records, abstracting/overreading medical records, performing claims research, preparing medical records for the NCQA HEDIS Auditor, etc. Abstracts medical record data from practitioner's files to support annual Healthcare Effectiveness Data and Information Set (HEDIS) reporting for company's accredited products
Conducts medical record reviews to support the annual reporting and responds to inquiries from provider, and their office staff, regarding the HEDIS initiative
Review and abstract 40-50 medical records per day, based on NCQA and HEDIS technical specifications
Document information clearly and concisely from patient record to paper document abstraction tool, or into company's electronic HEDIS application
Ensure Health & Care Management are in compliance with HEDIS audit and technical specification standards
Participate in the training of NCQA (national committee quality assurance) requirements with completion of Inter-Rater Reliability compliance
Communicate with internal and external stakeholders by making appropriate follow-up phone calls for additional medical information to complete reviews
Comply with regulatory standards, accreditation standards and internal guidelines
Remain current and consistent with the standards pertinent to the Quality Management team
Qualifications
* Active and Unrestricted RN License with 4+ years of experience.
(Need to have the license in the state in which they live but does not need to be compact since they are not working directly with members in Iowa.)
* Strong clinical background and understanding of medical terminology, healthcare practices and electronic medical record systems. Ability to review medical records and technical specifications and draw defensible conclusions from available information.
* Experience In health insurance, health care, managed care, or a related setting. A strong clinical background could also be considered - e.g., hospital medical records or research.
* Excellent attention to detail and ability to analyze complex medical records, identify relevant data and abstract HEDIS measures accurately.
* Strong written and verbal communication skills with ability to communicate and/or present complex information to team members and stakeholders.
* Demonstrated success in roles that require strong time management and work-flow management skills. Ability to prioritize work independently, manage multiple assignments simultaneously, and meet deadlines.
* Flexibility to adapt to changing requirements, regulations, and technology platforms related to HEDIS reporting.
* Proficiency with Microsoft Office and Microsoft Teams. Technical aptitude to learn new systems quickly.
Preferred Qualifications:
* 2 years of experience in HEDIS abstraction and familiarity with HEDIS measure specifications.
* Prior work in utilization management, quality management/review, accreditation, outpatient clinic setting or related area.
Job Type & Location
This is a Contract position based out of Des Moines, IA.
Pay and Benefits
The pay range for this position is $40.00 - $41.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Jan 7, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
Nursing Administrator (RN), Full-time, Remote
Remote job
Nursing Administrator
The Center for Wound Healing & Hyperbaric Medicine, LLC (CFWH) provides management and consulting services to healthcare providers in the area of wound care and hyperbaric medicine. By focusing on the needs of the patients as well as the partners we serve, The Center for Wound Healing & Hyperbaric Medicine, LLC is able to bring advanced wound healing strategies to many communities around the country.
Our Core Values:
Compassion, Excellence, Passionate, Integrity, Dedication, Loyalty, Accountability, Enterprising.
Job Overview:
The Nursing Administrator assists with all patient care services, including but not limited to, case management, extensive chart reviews, utilization of services reviews and discharge planning. Ensures compliance with patient care quality standards as it relates to the care provided to all wound care and hyperbaric patients. Supports all clinical training initiatives for new and existing staff, which includes both hands-on and virtual training. This position reports to the Chief Nursing Officer (CNO).
What You'll be Doing:
Understands wound care and hyperbaric nursing protocols; ability to practice as required.
Participates in the chart review process to ensure patients qualify for treatment prior to appointment.
Communicates charting revisions to appropriate staff in a professional, helpful, and kind manner. Educate, as needed.
Partners with the HR & Training department on new hire training to provide educational assistance as needed. Requested clinical training from CA may be remote or in-person.
Works with the CNO to identify training needs for current staff. Creates appropriate training material/courses and educational aids. Provides training remotely or in-person.
Travels to wound centers across the U.S. to support on-going clinical education, coach and develop nursing staff, and to cover clinical shifts if/when required.
Supports new clinic openings as requested by the CNO. Support may be administrative, virtual and/or hands-on.
Works closely with clinic leadership to advise on patient scheduling, chart reviews, physician communication, and patient evaluations for HBO qualification.
Responsible for staying up to date on the standards of care related to wound care and hyperbaric oxygen therapy (local coverage determinations/LCDs) and education of such.
Partners closely with the Revenue Cycle Department on insurance verifications to get authorization in a timely and efficient manner.
Creates and/or updates clinical procedures for new and existing staff to adhere to. Communicates and trains on procedures as required.
Maintains close coordination with all departments to ensure continuity and collaboration of services.
Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) by safeguarding patient information and maintaining the highest level of confidentiality standards.
Maintains efficient and effective clinical operations while verifying compliance with all local, state and federal regulations, standards and protocols.
Consistently adheres to company, hospital, and accrediting body clinical, safety, and compliance standards.
Other duties as assigned.
Requirements for This Role:
Registered Nurse (RN) from an accredited school or college of nursing.
Current state licensure; no restrictions to obtain RN license in additional states.
Current Basic Life Support (BLS) from approved agency.
2+ years wound care experience required.
2+ years clinical training experience required.
Deep understanding of charting, billing and insurance authorizations.
Proficient in Microsoft Office or related systems.
Proficient in a minimum of one EMR system.
Strong verbal and written communication skills.
Ability to treat others with compassion and patience.
Ability to work in a fast-paced team-oriented environment.
Must possess excellent interpersonal skills.
All employees are required to comply with HIPAA policies and procedures.
Desired Qualifications for This Role:
Bachelor's Degree preferred.
CWS, WCC, WOCN and/or CHRN certification preferred.
Knowledge of Hyperbaric Oxygen Therapy preferred.
Experience in outpatient clinic and/or hospital operations preferred.
Proficiency with Microsoft 365 tools, particularly SharePoint preferred.
Travel:
This position requires frequent ground and/or air travel. This may result in travel up to 75% of the employee's time with occasional weekend travel.
Physical Demands:
The physical demands described are representative of those that must be met by a Nursing Administrator to successfully perform the essential competencies, duties, and requirements of this position. These include standing, walking, driving, lifting up to 50 pounds and sitting for extended periods of time and looking at a computer screen for extended periods of time. In addition, pushing, pulling, stooping, squatting and shifting heavy objects, as well as air travel, may be required. Employees should ask for assistance if needed.
Equal Employment Opportunity:
The Center for Wound Healing & Hyperbaric Medicine, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type 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 recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
As an organization, we are committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation due to disability, please contact us at ***********************************.
Auto-ApplyNursing Administrator (RN), Full-time, Remote
Remote job
Job Description
Nursing Administrator
The Center for Wound Healing & Hyperbaric Medicine, LLC (CFWH) provides management and consulting services to healthcare providers in the area of wound care and hyperbaric medicine. By focusing on the needs of the patients as well as the partners we serve, The Center for Wound Healing & Hyperbaric Medicine, LLC is able to bring advanced wound healing strategies to many communities around the country.
Our Core Values:
Compassion, Excellence, Passionate, Integrity, Dedication, Loyalty, Accountability, Enterprising.
Job Overview:
The Nursing Administrator assists with all patient care services, including but not limited to, case management, extensive chart reviews, utilization of services reviews and discharge planning. Ensures compliance with patient care quality standards as it relates to the care provided to all wound care and hyperbaric patients. Supports all clinical training initiatives for new and existing staff, which includes both hands-on and virtual training. This position reports to the Chief Nursing Officer (CNO).
What You'll be Doing:
Understands wound care and hyperbaric nursing protocols; ability to practice as required.
Participates in the chart review process to ensure patients qualify for treatment prior to appointment.
Communicates charting revisions to appropriate staff in a professional, helpful, and kind manner. Educate, as needed.
Partners with the HR & Training department on new hire training to provide educational assistance as needed. Requested clinical training from CA may be remote or in-person.
Works with the CNO to identify training needs for current staff. Creates appropriate training material/courses and educational aids. Provides training remotely or in-person.
Travels to wound centers across the U.S. to support on-going clinical education, coach and develop nursing staff, and to cover clinical shifts if/when required.
Supports new clinic openings as requested by the CNO. Support may be administrative, virtual and/or hands-on.
Works closely with clinic leadership to advise on patient scheduling, chart reviews, physician communication, and patient evaluations for HBO qualification.
Responsible for staying up to date on the standards of care related to wound care and hyperbaric oxygen therapy (local coverage determinations/LCDs) and education of such.
Partners closely with the Revenue Cycle Department on insurance verifications to get authorization in a timely and efficient manner.
Creates and/or updates clinical procedures for new and existing staff to adhere to. Communicates and trains on procedures as required.
Maintains close coordination with all departments to ensure continuity and collaboration of services.
Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) by safeguarding patient information and maintaining the highest level of confidentiality standards.
Maintains efficient and effective clinical operations while verifying compliance with all local, state and federal regulations, standards and protocols.
Consistently adheres to company, hospital, and accrediting body clinical, safety, and compliance standards.
Other duties as assigned.
Requirements for This Role:
Registered Nurse (RN) from an accredited school or college of nursing.
Current state licensure; no restrictions to obtain RN license in additional states.
Current Basic Life Support (BLS) from approved agency.
2+ years wound care experience required.
2+ years clinical training experience required.
Deep understanding of charting, billing and insurance authorizations.
Proficient in Microsoft Office or related systems.
Proficient in a minimum of one EMR system.
Strong verbal and written communication skills.
Ability to treat others with compassion and patience.
Ability to work in a fast-paced team-oriented environment.
Must possess excellent interpersonal skills.
All employees are required to comply with HIPAA policies and procedures.
Desired Qualifications for This Role:
Bachelor's Degree preferred.
CWS, WCC, WOCN and/or CHRN certification preferred.
Knowledge of Hyperbaric Oxygen Therapy preferred.
Experience in outpatient clinic and/or hospital operations preferred.
Proficiency with Microsoft 365 tools, particularly SharePoint preferred.
Travel:
This position requires frequent ground and/or air travel. This may result in travel up to 75% of the employee's time with occasional weekend travel.
Physical Demands:
The physical demands described are representative of those that must be met by a Nursing Administrator to successfully perform the essential competencies, duties, and requirements of this position. These include standing, walking, driving, lifting up to 50 pounds and sitting for extended periods of time and looking at a computer screen for extended periods of time. In addition, pushing, pulling, stooping, squatting and shifting heavy objects, as well as air travel, may be required. Employees should ask for assistance if needed.
Equal Employment Opportunity:
The Center for Wound Healing & Hyperbaric Medicine, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type 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 recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
As an organization, we are committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation due to disability, please contact us at
***********************************
.
Nurse Coordinator (Remote, Digital Weight Loss)
Remote job
Compensation: $80,000-$95,000 + equity
This salary range reflects multiple experience levels and locations. Actual compensation within the range will be determined based on factors such as experience, skills, qualifications, and geographic location.
Schedule: Full-time, 5 days a week, Tuesday-Saturday
Location: Remote
Role Type: Full-time | Bilingual Spanish preferred but not required
About Bariendo
Bariendo is on a mission to cure obesity. Founded by Harvard Medical School professors, we are pioneering quick, non-surgical weight loss procedures that are 7x safer than surgery and more effective and affordable than the best medications. Our digital health platform combines telehealth, distributed clinics, and an expert care team in endoscopic weight loss to deliver lasting, affordable results for the 40% of Americans struggling with obesity.
We're growing rapidly-now in 8 cities after just 6 quarters of operations-with a vision to become the one-stop shop for obesity management, offering the most comprehensive set of interventions available online and via our distributed partner clinics. Join us to help patients reclaim their lives.
About This Role
We are looking for a people-centered, professional, and organized Nurse Patient Concierge to join our team and deliver Bariendo's signature 6-star care. You'll be the first point of contact for patients and a crucial part of making their weight loss journey feel smooth, supported, and stress-free. This is a role for someone who thrives in a fast-paced environment, has a concierge mindset, and finds joy in turning complex coordination into calm execution.
In this role, you will:
Deliver 6-Star Service: Be the warm, welcoming presence patients first encounter. Whether by phone, text, or email, you'll create a calm, organized, and exceptional experience that reflects Bariendo's high standards of care.
Be a Trusted Clinical Guide: Act as a primary point of contact for patients on clinical and care-related questions, escalating appropriately to providers and ensuring clear, timely communication so patients feel confident and supported throughout their treatment.
Ensure Clinical & Procedural Readiness: Partner closely with Bariendo's procedure centers to confirm accurate bookings, review patient charts for completeness and readiness, and coordinate outstanding requirements so every patient arrives fully prepared for their procedure.
Be a Concierge for Every Concern: Monitor incoming communications, answer phone calls, and anticipate patient needs before they arise. You'll be a responsive, empathetic problem-solver who builds trust with every interaction.
Drive Administrative Excellence: Maintain accurate records across our systems, ensure compliance with regulations like HIPAA, and support documentation workflows that enable smooth care delivery.
What We're Looking For
Clinical, Service-Driven Experience: Active RN license with 3+ years of patient-facing clinical experience, including experience delivering care or care coordination virtually (phone, text, telehealth). Ideally in procedural, ambulatory, or concierge-style settings where high-touch, white-glove support is the norm.
Experience in Weight Management or Bariatric Care (preferred): Prior exposure to obesity medicine, bariatric surgery, endoscopy, or medical weight-loss clinics is a strong plus, particularly in patient education, pre-procedure readiness, or longitudinal care coordination.
Fluent in Spanish (preferred, not required): Able to communicate clearly and professionally with Spanish-speaking patients across phone, email, and text.
Detail-Oriented & Reliable: Comfortable juggling complex logistics with accuracy. You stay organized, catch errors before they happen, and keep things moving smoothly under pressure.
Warm, Clear Communicator: You build trust quickly, make patients feel at ease, and bring empathy and professionalism to every interaction.
Operationally Sharp & Adaptable: Confident discussing pricing and payment options in a direct-pay model, comfortable navigating EHRs and new software, and energized by fast-paced, ever-evolving environments where proactive problem-solving is key.
What Makes This Job Amazing
Mission: Join a team of Harvard Medical School professors and healthcare innovators transforming thousands of lives. Watch our patient's stories.
Hybrid Environment: Work three days a week from our Market Street office and two days remotely, with some (infrequent) Saturday calls -all patient care is delivered virtually via telehealth.
Foundational Role in a Growing Startup: Be part of a fast-growing, mission-oriented team. Collaborate closely with teams like Product to help shape and innovate our virtual care experience.
Total Rewards
Competitive salary with equity in a high growth, seed-stage startup
Comprehensive health benefits (medical, dental, vision)
11 paid holidays, 15 personal vacation days, 10 wellness days
Hybrid work, 3 days in-office 2 days remote
Auto-ApplyPA/NP - Virtual Urgent Care - Remote (Night Shift)
Remote job
Our Virtual Urgent Care team is looking for an experienced Physician Assistant or Nurse Practitioner to join their team. In this role, you will be providing virtual medical care to patients of varying type and acuity. This is a full-time night shift position.
As we care for patients of all ages, we cannot consider Adult/Gerontology trained Nurse Practitioners.
Qualifications
Physician Assistant
* Required Master's Degree Graduate of an accredited Physician Assistant educational program
* LIC-Physician Assistant - STATE_MI State of Michigan Upon Hire required
* CRT-Physician Asst Certified (PA-C) - NCCPA National Commission on Certification of Physician Assistants Upon Hire required
* CRT-Basic Life Support (BLS) - AHA American Heart Association 90 Days required Or
* CRT-Basic Life Support (BLS) - ARC American Red Cross 90 Days required
* CRT-Pediatric Adv Life Support (PALS) - AHA American Heart Association 120 Days required
* CRT-Adv Cardiovascular Life Support (ACLS) - AHA American Heart Association 120 Days required
Nurse Practitioner
* Required Master's Degree Nurse Practitioners who obtained their education and certification after 2000 must show evidence of completion of a master's, post-master's or doctorate from a Nurse Practitioner program that is accredited by the Commission on the Collegiate of Nursing Education or the National League for Nursing Accrediting Commission
* 3 years of relevant experience current, relevant clinical experience
* Previous experience functioning in a collaborative role as a Nurse Practitioner
* LIC-Nurse Practitioner (NP) - State of Michigan
* CRT-Basic Life Support (BLS)
* CRT-Neonatal Resuscitation Program (NRP)
* CRT-Pediatric Adv Life Support (PALS)
Corewell Health West Medical Group
The Corewell Health West Medical Group is part of a not-for-profit health system serving 13 counties in West Michigan. Corewell Health West is a region of Corewell Health, formerly the BHSH System (Beaumont Health and Spectrum Health) that provides care and coverage with an exceptional team of 60,000+ dedicated people-including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving over 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.
Corewell Health
People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy, and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 65,000+ dedicated people-including more than 12,000 physicians and advanced practice providers and more than 15,500 nurses providing care and services in 21 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving more than 1.3 million members Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. For more information, visit corewellhealth.org.
How Corewell Health cares for you
* Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
* On-demand pay program powered by Payactiv
* Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
* Optional identity theft protection, home and auto insurance, pet insurance
* Traditional and Roth retirement options with service contribution and match savings
* Eligibility for benefits is determined by employment type and status
Primary Location
SITE - 515 Michigan St NE - Grand Rapids
Department Name
Virtual Urgent Care - CHMG West
Employment Type
Full time
Shift
Variable (United States of America)
Weekly Scheduled Hours
40
Hours of Work
Variable
Days Worked
Variable
Weekend Frequency
Every third weekend
CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling ************.
Nurse Case Manager (Western Time Zone)
Remote job
Join us as we transform immunology and deliver medicines that help autoimmune patients get their lives back. argenx is preparing for multi-dimensional expansion to reach more patients through a rich pipeline of differentiated assets, led by VYVGART, our first-in-class neonatal Fc receptor blocker approved for the treatment of gMG, and with the potential to treat patients across dozens of severe autoimmune diseases.
We are building a new kind of biotech company, one that maintains its roots as a science-based start-up and pushes our commitment to innovate across all corners of our business. We strive to inspire and grow our company, our partnerships, our science, and our people, because when we do, we deliver more for patients.
The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. The NCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.
Roles and Responsibilities:
Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx products
Communicate insurance coverage updates and findings to the patient and/or caregiver
Review and educate the patients and/or caregivers on financial assistance programs that they may be eligible for. Coordinate logistical support for patient to receive therapy and manage their disease
Collaborate with argenx Patient Access Specialist, Case Coordinator, and Field Reimbursement Manager teams to troubleshoot and resolve reimbursement-related issues
Engage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basis
Provide patient-focused education to empower patients to advocate on their behalf
Develop relationships and manage multiple and complex challenges that patient and caregivers are facing
Ensure compliance with relevant industry laws and argenx's policies
Aligned regional travel will be required for patient education to support patient programs
Must be an excellent communicator and problem-solver
Demonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlines
Skills and Competencies:
Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal (written and verbal) skills - with demonstrated effectiveness to work cross-functional and independently
Demonstrated ability to develop, follow and execute plans in an independent environment
Demonstrated ability to effectively build positive relationships both internally & externally
Demonstrated ability to be adaptable to changing work environments and responsibilities
Must be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitude
Fully competent in MS Office (Word, Excel, PowerPoint)
Flexibility to work weekends and evenings, as needed
Participate in and complete required pharmacovigilance training
Comply with all relevant industry laws and argenx's policies
Travel requirements less than 50% of the time
Education, Experience and Qualifications:
Applicants must live in the desired Time Zone
Current RN License in good standing
Bachelor's degree preferred
5+ years of clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech
2-5+ years of case management
2+ years of experience in pharmaceutical/biotech industry a must
Reimbursement experience a plus
Must live in geographically assigned territory
Bilingual or multilingual a plus
#LI-Remote
For applicants in the United States: The annual base salary hiring range for this position is $136,000.00 - $204,000.00 USD. This range reflects our good faith estimate at the time of posting. Individual compensation is determined using objective, inclusive, and job-related criteria such as relevant experience, skills, demonstrated competencies and internal equity. This means actual pay may differ from the posted range when justified by these factors. Because market conditions evolve, pay ranges are reviewed regularly and may be adjusted to remain aligned with external benchmarks.
This job is eligible to participate in our short-term and long-term incentive programs, subject to the terms and conditions of those plans and applicable policies. It also includes a comprehensive benefits package, including but not limited to retirement savings plans, health benefits and other benefits subject to the terms of the applicable plans and program guidelines.
At argenx, all applicants are welcomed in an inclusive environment. They will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.
Before you submit your application, CV or any other personal details to us, please review our
argenx Privacy Notice for Job Applicants
to learn more about how argenx B.V. and its affiliates (“argenx”) will handle and protect your personal data. If you have any questions or you wish to exercise your privacy rights, please contact our Global Privacy Office by email at
privacy@argenx.com
.
If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at
****************
. Only inquiries related to an accommodation request will receive a response.
Auto-Apply50% Field and 50% Remote Opening as a Nurse Case Manager II - (Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties ): MI
Remote job
Job Title: Nurse Case Manager II Estimated Length of Assignment: 03+ Months with Possible Extension (The dates provided are only an estimate and not a guarantee) Negotiable Estd. Pay Range - $40.00/Hour to $45.00/Hour on W2 (USD) -All Inclusive
Work Type: Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties ): MI
Schedule -Monday-Friday 8am-5pm EST
Description:
Field and Telephonic
Add city/state, zip and county at the top of the resume
Candidates should be either in one of these counties or very close to it. They will be traveling to this region. Sourcing for Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties ): MI.
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Experience
3 years Clinical practice experience, e.G., hospital setting, alternative care setting such as home health or ambulatory care required.
Healthcare and/or managed care industry experience.
Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Typical office working environment with productivity and quality expectations?
Position Summary
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Requires an RN with unrestricted active license for MI.
Education
RN with current unrestricted state licensure for MI.
Case Management Certification CCM preferred
What days & hours will the person work in this position? List training hours, if different.
Monday-Friday 8am-5pm EST
Supervisor, Hospital Billing (Remote)
Remote job
At Children's Wisconsin, we believe kids deserve the best.
Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.
We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.
Please follow this link for a closer look at what it's like to work at Children's Wisconsin:
***********************************
Job Summary
Supervises the activities of the Hospital Billing Department relating to claims, follow-up, credits, variances, and denials for hospital based services. Primary responsibilities are for staffing plans, schedules, productivity, quality assurance, performance management, and coaching and development of staff. Works collaboratively with staff, peers, and department Manager to achieve goals set forth by Patient Financial Services leadership.
Essential Functions
Ensures adequate staffing for the Hospital Billing functions for claims, follow-up, credits, variance, and denials. Ensures adequate staffing by daily review of the PPL calendar and workqueue volumes. Monitors and approves PPL in accordance with organizational and departmental policy.
Provides resource support to staff related to department responsibilities and operations as well as computer systems and procedures.
In collaboration with the department Manager, the Hospital Billing Supervisor develops productivity targets and reports to measure and assess the productivity of Hospital Billing staff. Reports out productivity measures to include unique accounts worked, account activity scoring, and dollars recovered per staff person. Assesses staff goals and makes adjustments based on business variables. Assesses individual staff performance related to productivity on a regular basis and utilizes action planning tools to help staff achieve productivity goals.
In collaboration with the Revenue Cycle Training and Education Services teams, ensures the quality audit process is effective and representative of individual staff performance. Works with the Revenue Cycle Training Team to develop quality markers for audit and assessment, and to develop and maintain the audit tool.
Responsible for the monitoring and delivery of performance feedback to Hospital Billing staff. Delivers productivity and quality feedback to staff on a regular (at least monthly) basis. Delivers feedback as well as training, business, and policy updates as needed. Utilizes the performance management tool to document performance throughout the year. Prepares staff reviews according to department practice and in collaboration with the department Manager. Delivers reviews to staff.
Prepares corrective action and performance improvement documents for staff when needed. Collaborates with and obtains approval from the department Manager and the Human Resources representative for corrective action and performance improvement documents. Delivers corrective action and performance improvement feedback and documents to staff.
Daily monitoring of billing reports and dashboards to ensure debit and credit receivables are worked in a timely and efficient manner. In particular the Hospital Billing Supervisor should on a daily basis review and interpret total candidate for bill, total denials, total credits, claim submissions including claim skips, claim runs, claim edits, and DNB's.
Participates in the interview team for all new employees and supplies input to the department Manager on the selection of new employees. Orients new employees to the policies and procedures specific to the Hospital Billing department.
Receives, investigates and responds to problems and/or questions from parents, physicians, payers and departments. Determines and initiates appropriate action or refers to appropriate personnel for follow-up.
Assists in the development and encourages the adoption of process improvement changes that enhance the billing experience.
Performs people management responsibilities for employees which may include but are not limited to: employee engagement, recruitment, performance management and development
People Management Responsibility
Performs people management responsibilities for employees which may include but are not limited to: employee engagement, recruitment, performance management and development
Education
Bachelor's Degree in Business Administration or a closely related field Preferred
Experience
2+ years of supervisory/lead experience in hospital or large physician office billing leading and working with teams and data collection and analysis, as well as the proven ability to manage multiple projects simultaneously. Required and
2+ years Requires proficiency in hospital patient accounting procedures usually acquired through two years of hospital accounts receivable collection experience. Required and
Computer related experience with spreadsheets. Required
Knowledge, Skills and Abilities
Requires the ability to analyze problems relating to the efficiency of the billing and collection functions as well as resolve employee relations issues.
Requires excellent communication skills in order to direct the work of, advise, and counsel employees.
Requires excellent communication skills in order to effectively interact and work with employees from other departments and payer representatives in the resolution of problems.
Analytical and critical thinking skills to make independent decisions in a complex fast paced environment.
Excellent organizational skills required for prioritizing workload.
Required for All Jobs
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
Employment is at-will. This document does not create an employment contract, implied or otherwise.
Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.
Certifications/Licenses:
Auto-ApplyTemporary Remote Registered Nurse (RN)
Remote job
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.
Auto-ApplyRegistered Nurse (RN) Clinical Documentation Denials Auditor
Remote job
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
Auto-ApplyClinical Care Coordinator
Remote job
Job Title: Clinical Care Coordinator (Remote) - Text-Based APCM Program
Department: Clinical Operations
Position Type: Full-Time
Our team is growing! Jaan Health is seeking dynamic and motivated Licensed Practical Nurses (LPNs) Clinical Care Coordinators to join our care team and will report to the Clinical Operations Manager. This role requires strong clinical knowledge, adaptability, and the ability to thrive in a fast-paced, patient-centered environment. The LPN will support chronic care management (CCM) and advanced primary care models (APCM) by providing direct patient engagement, care plan support, and clinical triage. This position is remote and offers health benefits as well as a retirement plan and paid days off.
Our company serves 90+ clients who care for over 50,000 patients. We are a rapid-growth B2b SaaS company that offers our clients a software platform called Phamily (********************* to provide connected care management to their patients. Phamily keeps patients in contact with their care manager, who regularly checks up on them and acts as a resource for any concerns they might have about their health in order to keep them happier and healthier for longer.
About the Role
We are seeking a compassionate, organized, and tech-savvy Clinical Care Coordinator to support patients with chronic conditions in our text-based Advanced Primary Care Management (APCM) program. This remote role focuses on delivering proactive, high-quality care through digital communication tools, driving better health outcomes for Medicare and older adult populations.
This position is ideal for healthcare professionals who thrive in a virtual care setting, value patient engagement, and are skilled in critical thinking and care coordination.
Candidates in other locations may apply, but applications will be held until there are additional resources needed outside of the initial target areas.
Key Responsibilities
Serve as the first line of communication for patients via a secure, text-based platform
Monitor and respond to patient messages and check-ins in a timely, compassionate, and professional manner
Identify, assess, and triage clinical concerns, SDOH needs, and care coordination barriers
Develop and update personalized care plans for patients with chronic conditions (e.g., hypertension, diabetes, COPD)
Develop, implement, and revise care coordination workflows or protocols to support the evolution of the care model to improve efficiency and scalability
Analyze patient data or trends to identify care gaps or improve outcomes
Independently making decisions on patient outreach priorities, resource allocation, or escalation paths
Lead quality improvement initiatives or case review meetings
Serve as a liaison for payer utilization management, interpreting policy, and advising on compliance
Track engagement, log care time, and document all communication per HIPAA and program guidelines
Identify and troubleshoot issues that arise during new program iterations, escalating to leadership when there are critical impacts or opportunities for system-wide improvements
Collaborate with RNs, NPs, and Social Workers to ensure timely escalation and follow-through
Key Skills & Qualifications
2+ years of experience in a clinical or care coordination role (primary care, chronic care management, home health, etc.)
LPN w/ compact license strongly preferred
Strong critical thinking and problem-solving skills in a fast-paced environment
Ability to independently manage a digital patient panel and prioritize escalations effectively
Excellent written communication and documentation skills
Comfort using EMRs, care coordination platforms, and digital messaging tools
Knowledge of Medicare CCM/APCM programs a plus
Bilingual (Spanish) is a bonus but not required
Must be located within the continental United States and have access to reliable internet and ability to work in a specified time zone - either CST, EST, or PST depending on client and candidate location
Access to Internet 5G
Schedule & Work Environment
Full-time, Monday-Friday
Flexible remote schedule across CST, EST, or PST time zones
1-hour lunch break, daily huddles with manager/team
Ongoing support from a multidisciplinary care team
Why Join Us?
Mission-driven organization focused on health equity and innovative digital care
Collaborative, diverse, and growth-focused culture
Opportunities for professional development and internal promotion
Competitive compensation and benefits package
Be part of redefining how care is delivered-one text at a time
Auto-ApplyBilingual Remote Triage Nurse (Full-Time)
Remote job
Diana Health is a network of modern women's health practices working in partnership with hospitals to reimagine the maternity and women's healthcare experience. We are restructuring the traditional approach to care to create an experience that is good for patients and good for providers. We do that by combining a tech-enabled, wellness-focused care program that women love with a clinical system that helps us drive continuous quality improvement and ensure work-life balance for our care team. We work with clients across all life stages to empower and support them to live happier, healthier, more fulfilling lives. With strong collaborative care teams; passionate administrators and a significant investment in operational support, Diana Health providers are well-supported to bring their very best to the work they love.
We are an interdisciplinary team joined together by our shared commitment to transform women's health. Come join us!
Description
We are looking for a full-time LPN passionate about all aspects of women's health to provide direct patient care as part of an interdisciplinary care team and to serve as the first line of communication with patients in our clinical phone and messaging triage during office hours. The ideal candidate thrives in a busy practice, loves women's health and building relationships with patients, is an excellent problem-solver and communicator, and is able to multi-task easily. Bilingual skills preferred with a preference for Spanish language, open to other languages.
What you'll do
Patient Care
Act as the first line of call in clinical communications for patients, within guidelines/protocols
Administer injections and medications
Provide direct clinical care as needed for minor check in visits or lab draws
Provide supporting paperwork and education for patients
Support clinic visits as appropriate and per training when needed
Administrative
Support the everyday flow of clinic acting as back up support for MA
Maintaining logs
Cleaning of rooms as needed and sterilization of instruments
Obtaining and transcribing patient medical records
Additional workflow items as the need arises
Qualifications
Current certification as a Tennessee Licensed Practical Nurse
2+ years of experience in an outpatient preferred
Excellent communication, interpersonal, and organizational skills
Strong computer skills and familiarity with EMRs
Lactation certification (IBCLC, CLC, CLE) preferred, but not required
Bilingual, Spanish skills preferred
Benefits
Competitive compensation
Health; dental & vision, with an HSA/FSA option
401(k) with employer match
Paid time off
Paid parental leave
Diana Health Culture
Having a growth mindset and striving for continuous learning and improvement
Positive, can do / how can I help attitude
Empathy for our team and our clients
Taking ownership and driving to results
Being scrappy and resourceful
Auto-ApplyRemote Triage Nurse
Remote job
Medcor is looking to hire a full-time Registered Nurse for our remote 24/7 Occupational Health triage call center! The hours for this position include 8-hour or 10-hour shifts between the hours of 12pm and 2am CST.
Job Type: Full-time - 40 hours per week
Salary: $28 per hour with additional shift differential pay available for evenings, nights & weekends.
By joining our nursing team, you will be helping thousands of employers better manage their workplace injuries and improve the quality of healthcare for their employees. Nurses who are successful in this position must be able to talk on the phone for long periods while typing and navigating through various software applications simultaneously. Our nurses must be able to visualize an injury while on the phone and clarify details about the injury while following our propriety algorithms to guide the triage of the injured worker.
Training:
Training for this role will last 5-6 weeks, with 2.5 weeks of classroom instruction and 2.5 weeks of precepting. These first 5-6 weeks of training are held Monday through Friday, from 8a-4p CST. The training schedule is non-negotiable, and all training must be successfully completed within the 6-week time frame. Following training, you will transition to your permanent schedule between the hours of 12p and 2a CST with an every-other-weekend requirement and holiday rotation. Changes to the permanent schedule are not allowed within the first 12 months of employment.
A typical day in the life of a Medcor Triage RN:
Manage a rapid flow of incoming telephone calls from Medcor customers in a call center environment
Document each call efficiently and accurately
Monitor and track individual as well as call center goals, productivity metrics, and statistics
Reflect all shift activities using the phone system and be responsible for personal schedule adherence
Provide superior customer service to Medcor s clients and employees
Complete accurate assessment of symptoms and/or concerns utilizing Medcor s Triage Algorithms
Follow HIPAA Compliance Policies
You Must
Be bilingual, fluent in both the English and Spanish language
Have a valid RN license and current BLS (CPR) certification
Be able to handle a high volume of consecutive calls
Have strong technological skills as well as a typing speed of at least 30 WPM
Work a major U.S. holiday rotation
Work every other weekend
Have effective written, verbal, and interpersonal communication skills. Ability to read, analyze, and interpret triage tools and information along with care instructions to injured employees and their managers.
Be able to talk and/or hear. You are required to sit and use your hands. Specific vision abilities required by this job include close vision for computers and written work with the ability to adjust focus
Be able to work on a computer for long periods
Have a private space in your home with 4 walls and a door for patient privacy
Have access to high-speed internet (no satellite) within your primary residence
Be able to receive and apply feedback
It's a Plus If
You have call center experience
You have occupational health experience
At Medcor, we re passionate about caring for our advocates as much as you are passionate about caring for your patients! Join our team and receive the support you need to be successful in your practice and to focus on your patients. In addition to a collaborative work environment, we offer great pay and benefits and emphasize your wellness.
Here s why people love working for Medcor:
Stability! We ve been around since 1984.
Potential for retention and performance incentives
Opportunities galore! Medcor has a lot more to offer than just this job. There are opportunities to move vertically, horizontally, and geographically. Annually, 20% of our openings are filled by internal employees. The fact is, opportunity exists here!
Training! We believe in it and we ll train and support you to be the best you can be. We feel we offer more training than most other companies.
We have an open-door policy. Do you have something to say? Speak your mind! We encourage it and we look forward to how you can help our organization.
Benefits
We don t just advocate for our clients and our patients; we also advocate for ourselves. Our benefits include paid time off, health and dental insurance, 401K with match, education reimbursement, and more.
To learn more about Medcor s Culture click
here
.
Medcor Philosophy
Medcor embraces a set of simple, interconnected practices that everyone can tailor to their own life and work. To preserve our pioneering, entrepreneurial spirit, we impart our values through the ongoing Better@Medcor campaign: encouraging our advocates to make a conscious choice to practice our values, to celebrate and recognize each other via our peer recognition program, and to support one another during tough times.
Medcor is a tobacco-free and smoke-free workplace!
EOE/M/F/Vet/Disability
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
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Clinical Research Nurse - Home Visits (PRN)
Remote job
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.
Position: Clinical Research Nurse - Home Visits (PRN) Job Type: Contract, PRN, Per Diem Work Location: 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!
Auto-ApplyStudent Nurse Extern I, PRN
Remote job
Schedule: PRN | various shifts
Job Type: In-person
Your experience matters
Sovah Health is a part of Lifepoint Health. At Lifepoint, we are committed to empowering and supporting a diverse and determined workforce that can drive quality, scalability, and significant impact across our hospitals and communities. As a member of the Health Support Center (HSC) team, you'll support those who are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of making communities healthier .
More about our team
The Student Nurse Extern (SNE 1) program provides nursing students with practical work experiences to facilitate their transition into the role of a registered nurse. Throughout the paid program, learning and nursing engagement occur on a 24-hour per unit basis in a broad range of acute care, critical care, emergency care, psychiatry, women's, & surgical/outpatient areas. SNEs gain hands-on experience in Patient Care. Teamwork, Critical Thinking, Communication Skills, and Professional Development.
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
What we're looking for
The right candidate will, under the supervision of an RN, assist in assuring optimal patient care, while continuing as a Nursing Student in good standing. The SNE I may perform acts that are routine for any nursing assistant job description. SNE I may also perform additional acts that have been taught in their nursing education program, provided they are individually educationally prepared and clinically competent to perform these acts. Such acts include phlebotomy and straight catheterization.
Professional Development: Ongoing learning and career advancement opportunities.
How you'll contribute
A Student Nurse Extern I who excels in this role:
Performs clinical skills according to hospital policy and procedures.
Performs technical skills according to policy and procedure.
Maintains hospital and patient confidentiality.
Demonstrates concern for patient welfare by performing activities other than primary care needs.
Applies knowledge of age-related factors appropriately to patients, utilizing appropriate policies and procedures.
Responds promptly to patient requests by answering call lights, greeting patients in a cheerful, positive manner, answering questions or fulfilling needs, and alerting the Registered Nurse as necessary.
Tidies rooms, changes bed linens, and ensures rooms are clean, neat, and orderly.
Assists with stocking items in rooms. Sets up oxygen flow meter, humidifier, and nasal cannula as requested.
Performers courier duties to the lab and other hospital departments to deliver lab specimens (Urine, stool, sputum), or deliver and retrieve other requested items.
Transports patients to and from various areas as needed.
Answers phones and greets patients and visitors. Performs other related duties as assigned that will facilitate the achievement of quality patient care.
Takes and records vital signs (blood pressure, temperature, pulse, and respiration), measures and records intake and output, and weighs patient as assigned. Observes patient's physical appearance, attitude, response to medications and treatments, appetite, etc., and reports observations to Registered Nurse.
Performs or assists with routine procedures such as enemas, sitz baths, surgical preps, and turning patients, and explains procedures to patients to facilitate understanding and reduce anxiety. Gives bedpans, urinals, or assists patient to commode or bathroom.
Assists patient with meals by preparing the patient's proper positioning, moving the tray, and feeding the patient as necessary. Ensures nourishments and water are given to the patient in accordance with the established schedule of as requested.
Helps patients in and out of bed and/or wheelchair. Performs back rubs, converses with patients in a positive, friendly manner to reduce anxiety and encourage communication.
Participates in various in-service and staff activities to contribute to the ongoing development of knowledge and to improve techniques.
Performs age-specific patient assessment, demonstrating awareness of growth and development for each age group.
Demonstrates knowledge of age-specific assessment, recognizing psychosocial levels and developmental patterns.
Provides for age-appropriate stimulation and learning needs.
Adheres to the Hospital's Standards of Performance.
Minimum Education:
High school diploma or equivalent required.
Must be enrolled in a professional school of nursing program for "Registered Nurse" and have completed their first semester (Fundamentals of Nursing, including clinicals).
Required Certifications/Licenses:
Basic Life Support (BLS) American Heart Association is required.
EEOC Statement:
SOVAH Health - Martinsville is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status, or any other basis protected by applicable federal, state, or local law.
Equal opportunity and affirmative action employers are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran
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