Student/clinical rotation jobs near me - 233 jobs

Requirements EEO #ind103

Reports to: Chief Executive Officer and/or Training Director Scope of work: Provides monitoring and clinical skills training & exposure to nurse practitioner and physician assistant students. Education: M.D. from accredited University or Medical School Completion of a Psychiatric Residency Program Experience: Has experience in mental health services Has medical license within the U.S. Responsibilities: Provide monitors and proctors nurse practitioner and physicians assistant students in psychiatric services Provides feedback and training on clinical skills development with NP and PA students

JOIN TEAM TRILOGY At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive pay, and exceptional benefits, Trilogy offers a work environment where you're supported, appreciated, and empowered to thrive in your career. If you're ready to join a team committed to your success, Trilogy is where you belong and thrive! POSITION OVERVIEW The Clinical Liaison is a member of the Sales & Growth Team, supporting a cluster of health campuses. They develop and manage communications between patients, families, and care professionals to increase admissions from assigned hospitals to local Trilogy Health Services campuses. The Clinical Liaison conducts pre-admission assessments and aids in establishing eligibility for care at a Trilogy Campus. Key Responsibilities * Collaborates with discharge planners to prioritize referrals and identify patients for transition to a Health Center campus. * Establishes patients' eligibility for care, communicates closely with families, and interacts with a wide array of staff members from case managers to physicians. * Conducts pre-admission assessments to gather clinical documentation and reviews the documentation to ensure they support the insurance requirements for approval. * Responds immediately to patient referrals from hospital case managers, physicians, and managed care organizations. * Educates hospital staff about Trilogy Health Services' clinical capabilities and matches patients to the best-suited facility and services based on their unique needs. * Educate patients and family members about services offered and address questions and concerns prior to admission, as well as explain the spectrum of available care options. * Develops relationships within the community on behalf of Trilogy Health Services and its campuses. * Participates in hospital and ACO meetings to foster deep partnerships with key contacts. Qualifications * Associate's degree or; * 1-3 Years of relevant experience preferred related to discharge planning, nursing, case management and/or utilization management. * Previous experience in a hospital, medical facility, or skilled nursing care setting. * Valid and unencumbered driver's license required; ability to pass a Motor Vehicle Record Search and a minimum age of 25 for insurance purposes. LOCATION US-OH-Columbus Columbus, OH Columbus OH BENEFITS Our comprehensive Thrive benefits program focuses on your well-being, offering support for personal wellness, financial stability, career growth, and meaningful connections. This list includes some of the key benefits, though additional options are available. * Medical, Dental, Vision Coverage - Includes free Virtual Doctor Visits, with coverage starting in your first 30 days. * Get Paid Weekly + Quarterly Increases - Enjoy weekly pay and regular quarterly wage increases. * Spending & Retirement Accounts - HSA with company match, Dependent Care, LSA, and 401(k) with company match. * PTO + Paid Parental Leave - Paid time off and fully paid parental leave for new parents. * Inclusive Care - No-cost LGBTQIA+ support and gender-affirming care coordination. * Tuition & Student Loan Assistance - Financial support for education, certifications, and student loan repayment. ABOUT TRILOGY HEALTH SERVICES Since our founding in 1997, Trilogy has been dedicated to making long-term care better for our residents and more rewarding for our team members. We're proud to be recognized as one of Fortune's Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. At Trilogy, we embrace who you are, help you achieve your full potential, and make working hard feel fulfilling. As an equal opportunity employer, we are committed to diversity and inclusion, and we prohibit discrimination and harassment based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. NOTICE TO ALL APPLICANTS (WI, IN, OH, MI & KY): for this type of employment, state law requires a criminal record check as a condition of employment. The Clinical Liaison is a member of the Sales & Growth Team, supporting a cluster of health campuses. They develop and manage communications between patients, families, and care professionals to increase admissions from assigned hospitals to local Trilogy Health Services campuses. The Clinical Liaison conducts pre-admission assessments and aids in establishing eligibility for care at a Trilogy Campus. Key Responsibilities * Collaborates with discharge planners to prioritize referrals and identify patients for transition to a Health Center campus. * Establishes patients' eligibility for care, communicates closely with families, and interacts with a wide array of staff members from case managers to physicians. * Conducts pre-admission assessments to gather clinical documentation and reviews the documentation to ensure they support the insurance requirements for approval. * Responds immediately to patient referrals from hospital case managers, physicians, and managed care organizations. * Educates hospital staff about Trilogy Health Services' clinical capabilities and matches patients to the best-suited facility and services based on their unique needs. * Educate patients and family members about services offered and address questions and concerns prior to admission, as well as explain the spectrum of available care options. * Develops relationships within the community on behalf of Trilogy Health Services and its campuses. * Participates in hospital and ACO meetings to foster deep partnerships with key contacts. Qualifications * Associate's degree or; * 1-3 Years of relevant experience preferred related to discharge planning, nursing, case management and/or utilization management. * Previous experience in a hospital, medical facility, or skilled nursing care setting. * Valid and unencumbered driver's license required; ability to pass a Motor Vehicle Record Search and a minimum age of 25 for insurance purposes. At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive pay, and exceptional benefits, Trilogy offers a work environment where you're supported, appreciated, and empowered to thrive in your career. If you're ready to join a team committed to your success, Trilogy is where you belong and thrive!

Are you a skilled, compassionate nurse looking for flexible work in clinical research? As a Clinical Research Nurse - Home Visits (PRN), you'll provide high-quality nursing care directly in patients' homes while supporting important research studies. This role is ideal for nurses who value flexibility, independence, enjoy local travel, and want to supplement their income with meaningful work. Key Points to Know: • You'll use your own vehicle to visit patients in their homes, typically within 1-2 hours of your location. • Shifts are PRN / per diem, meaning you'll work only when projects are available in your area; project frequency may vary. • Orientation, training, and project-specific instructions are provided before each assignment. • You will be compensated for all time spent on training, travel, and patient visits, including documentation. We are posting this role now and will be reviewing applications on a rolling basis between now and Christmas. Interviews will begin in the New Year , so you may experience a brief delay in hearing back from us during the holiday period. Thank you in advance for your patience - we look forward to connecting in January. Position: Clinical Research Nurse - Home Visits (PRN) Job Type: Contract, PRN, Per Diem Hourly Rate: $60/hr onsite and $50/hr travel time Work Location: Boston, Massachusetts; 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!

Ready to make your next career move? VieMed Healthcare Staffing is a premier staffing agency that specializes in connecting skilled professionals with healthcare facilities, ensuring seamless continuity of care and unparalleled service delivery. We are committed to quality, reliability, and integrity for both our candidates and clients. Join us in our mission to elevate healthcare staffing to new heights. We take care of you, so you can take care of others. VHS is looking for a qualified Registered Nurse - Oncology. City: Columbus State: OH Start Date: 2026-01-12 End Date: 2026-04-13 Duration: 13 Weeks Shift: 8 Hours Day shift Description: Job Title: RN Oncology - RN Endocrine Clinic - Oncology - Mon-Fri - 8A-4:30P First time travelers: Yes Skillset: Registered Nurse - Oncology 1 Year of Experience Required Float: Yes Patient Demographics: Adults Daily Census: 80-100 • Rooms: 16 • Documentation System: EPIC Certifications Required: BLS ACLS OCN are preferred Patient Diagnoses: • Chronic lymphocytic leukemia CLL • Chronic myelocytic leukemia CML • Hemoglobinopathies • Hodgkin's disease • Non-Hodgkin's lymphoma • Myeloproliferative disease • Thrombotic disorders • Aplastic anemia • Acute Lymphocytic Leukemia ALL • Acute Myeloid Leukemia AML • Myelodysplastic syndrome MDS Shift Info: Day 5x8-Hour 08:00 - 16:30 Notes: N/A W2 Pay Rate: $52.61 *Travel candidates only (50 miles or more from facility) Certification Requirements: Please confirm credential requirements with VHS upon application. At VieMed, Live Your Life isn't just a company tagline. It's a passionate commitment to improving the lives of every patient and employee. Benefits Include: Competitive Pay Packages Weekly Pay Schedule via Direct Deposit Comprehensive Medical Benefits (W-2) Robust Referral Bonus Program 24/7 Dedicated team committed to your success throughout your time with VHS Paid sick time in accordance with all applicable state, federal and local laws Licensure, certification, travel and other reimbursements when applicable **VHS is an Equal Opportunity Employer (“EEO”)/Protected Veterans/Individuals with Disabilities/E-Verify Employer and welcomes all to apply** #LiveYourLife

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

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

At Hologic, we value professionals who combine clinical expertise with empathy, advocacy, and educational excellence. We are seeking a Nurse Advocate as a part of our Market Development team who can deliver outstanding support and guidance to our patients and providers, acting as a trusted advisor and resource. Role Responsibilities: Respond to patient inquiries via inbound and outbound communication, providing information and facilitating referrals to physicians. Educate prospective patients about Hologic products featured in awareness campaigns and help them prepare for conversations with their healthcare providers. Accurately record all interactions and referral activities in Salesforce.com. Mentor and assist new team members to uphold exceptional patient care standards. Travel as required to deliver onsite education, training, and support. Who You Are Knowledge & Experience Comprehensive understanding of nursing principles and patient care, with a focus on women's health and Sonata and Acessa treatments. Clinical knowledge of RFA products Acessa and Sonata preferred. Familiarity with healthcare compliance guidelines and business rules. Knowledge of effective patient education strategies and referral processes. Skills Strategic thinker with exceptional planning and organizational skills. Strong verbal and written communication, tailored to diverse audiences. Active listening and information gathering to understand patient needs. Exceptional organizational and multitasking skills, ensuring accurate documentation and follow-up. Proficient use of Microsoft Word and Excel for reporting and communication. Proficiency in CRM systems (Salesforce.com) and telecommunications. Advanced problem-solving and issue resolution abilities. Competency in mentoring and training new team members. Behaviors Demonstrates empathy and builds rapport quickly with patients and stakeholders. Maintains professionalism and exemplary phone etiquette at all times. Proactively facilitates communication between patients, physicians, and staff. Manages time effectively, prioritizing tasks and following through on commitments. Adheres strictly to compliance, safety, and emergency protocols. Actively seeks continuous professional development and training. Required Experience: Active RN license in good standing. Bachelor's Degree in Nursing (BSN) or equivalent. Minimum of 5 years' experience in patient care and education. Experience working in a healthcare or patient support environment. Proven ability to build and maintain strong relationships with stakeholders. Why Hologic? At Hologic, we're driven by a passion for innovation and a commitment to improving patient outcomes. As part of our team, you'll play a pivotal role in bringing breakthrough RFA technology to healthcare facilities, empowering clinicians, enhancing patient care, and transforming the standard of women's health. Here, your leadership will be valued, your ideas heard, and your growth supported The annualized base salary range for this role is $116,600-165,100 and is bonus eligible. Final compensation packages will ultimately depend on factors including relevant experience, skillset, knowledge, geography, education, business needs and market demand. Agency And Third Party Recruiter Notice Agencies that submit a resume to Hologic must have a current executed Hologic Agency Agreement executed by a member of the Human Resource Department. In addition, Agencies may only submit candidates to positions for which they have been invited to do so by a Hologic Recruiter. All resumes must be sent to the Hologic Recruiter under these terms or they will not be considered. Hologic's employees are subject to third-party COVID-19 vaccination requirements, including from customers and governmental entities. Hologic is an equal opportunity employer and consistent with federal, state, and local requirements, will consider requests for reasonable accommodation based on disability or sincerely-held religious beliefs where it is able to do so without undue hardship to the company. Hologic, Inc. is proud to be an Equal Opportunity Employer inclusive of disability and veterans. #LI-LB2

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position will split time between Grove City and McConnell Outpatient M-F, 8-5 No Call or Weekends The Advanced Practice Provider (APP), Physician Assistant (PA) or Advanced Practice Registered Nurse (APRN), including Clinical Nurse Specialist (CNS) or Nurse Practitioner (NP), work in collaboration with the physician primarily in the outpatient setting caring for acute, chronically ill or injured patients. Responsibilities will vary depending on specialty. Responsibilities And Duties: Works under direction and in consultation/collaboration with physician and may perform services authorized by the supervising/collaborating physician that are part of the physician's normal course of practice and expertise. Promotes quality outcomes and initiatives. Must have a Supervision Agreement (SA) or Standard Care Arrangement (SCA) with a physician in like practice. Practices within applicable state laws, appropriate boards, and in accordance with his/her/their SA/SCA and delineation of privileges. Minimum Qualifications: AANP - American Association of Nurse Practitioners - American Association of Nurse Practitioners Certification Board, APRN - Advanced Practice Registered Nurse License - State of Ohio Board of Nursing, NCCPA - National Commission on Certification of Physician Assistants - American Association of Physician Assistants, PA - Physician Assistant - National Commission on the Certification of Physician Assistants Additional Job Description: Work Shift: Day Scheduled Weekly Hours : 40 Department Neuro Spine Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment

The Community Based Care Coordinator, Duals Integrated Care is responsible for managing and coordinating care for dual-eligible beneficiaries, those who qualify for both Medicare and Medicaid. This position focuses on integrating health services and community resources to improve health outcomes and enhance the quality of life for individuals with complex health needs, including those who are eligible for waiver services. Essential Functions: Engage with the member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member. Function as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to ensure seamless communication and care transitions. Conduct comprehensive assessments to identify the physical, mental, and socials needs of dual-eligible individuals. Develop and implement individualized care plans based on unique needs of each member, considering their medical, social, and behavioral health requirements. Lead and collaborate with interdisciplinary care team (ICT) to create holistic care plans that address medical and non-medical needs. Assist members in accessing community resources, including housing, transportation, food assistance, and social services. Educate members about their benefits and available services under both Medicare and Medicaid. Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. Promote health lifestyle choices and self-management strategies. Regularly monitor member's health status and care plan adherence, adjusting, as necessary. Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information. Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services. Participate in care team meetings to discuss member progress and address barriers to care. Maintain accurate and up-to-date records of members interactions, care plans, and outcomes. Collect and analyze data to evaluate the effectiveness of care coordination efforts and identify areas of improvement. Advocate for the needs and preferences of dual-eligible beneficiaries within the healthcare system. Empower members to take an active role in their healthcare decisions. Evaluate member satisfaction through open communication and monitoring of concerns or issues. Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program. Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law. On-call responsibilities as assigned. Adherence to NCQA and CMSA standards. Perform any other job duties as requested. Education and Experience: Nursing degree from an accredited nursing program or bachelor's degree in a health care field or equivalent years of relevant work experience is required. Previous experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required. Prior experience in care coordination, case management, or working with dual-eligible populations is preferred Medicaid and/or Medicare managed care experience is preferred Competencies, Knowledge and Skills: Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries. Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers Ability to manage multiple cases and priorities while maintaining attention to detail. Adhere to code of ethics that aligns with professional practice. Awareness of and sensitivity to the diverse backgrounds and needs of the populations served Decision making and problem-solving skills. Licensure and Certification: Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned. Case Management Certification is highly preferred Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check and verified insurance. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need. May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer. Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. Compensation Range: $61,500.00 - $98,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-KG1

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

Remote - PFS Denial Nurse Auditor PFS Billing-Follow Up-Denials Full Time Status Day Shift Pay: $60,382.40 - $96,616.00 / year Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. The Denials Nurse Auditor works under the supervision of the manager of PFS Denials. The Denials Nurse Auditor is responsible for completing, appealing, tracking, and reporting clinical denial reviews to determine the appropriate actions for post-billing denials. This Individual will combine clinical, financial, and regulatory knowledge and skill to reduce financial risk and exposure caused by payer denials for rendered services. The Denials Nurse Auditor has highly developed knowledge and skills in areas of: Medical Necessity, Authorizations, Experimental/Investigational denials, payer audits and filing appeals as well as Government and Non-Government payor requirements with Denial Management. This position is employed by Mosaic Life Care. Completes clinical review of appropriate post-claim denials; prepares clinical discussion and appeal letters for denied accounts. Consults clinical and hospital appeal guidelines; provides appeal direction using payer guidelines to appropriate departments via monthly denials meetings. Ensures compliance with all federal, state, and local regulations governing rendered patient services and reimbursement. Reviews and analyzes specific audit information and provides education to other caregivers both internal and external to the PFS Denial Management team. Identifies, and initiates clinical and hospital quality improvement initiatives focused on improving both quality indicators and outcomes. Other duties as assigned. Bachelor's Degree - Graduate of school of nursing, BSN is required. Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure Registered Nurse license by the State of Missouri required. 5 Years of experience in health care as a registered nurse, preferably in revenue cycle is required. Excellent understanding of financial and health care strategies is required.

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Job Summary: Join Acentra Health as an RN Clinical Reviewer and play a critical role in supporting priority populations while making a meaningful difference in the communities we serve. In this role, you will leverage your clinical expertise to review and assess medical records against established clinical criteria and contract requirements, helping ensure accurate, compliant, and high-quality outcomes. This is a Full-Time remote position offers the flexibility to work from your home office while contributing to work that truly matters. You'll be part of a mission-driven organization dedicated to improving health outcomes.Candidates must be available to work during regular business hours of 9:00 A.M. to 5:30 P.M. Eastern Time, with some flexibility for those located in the Central Time zone. Acentra Health provides the essential technology equipment for your home office, including a company-issued laptop Job Responsibilities * Ensure the accuracy, quality, and timeliness of all assigned case reviews in accordance with contract requirements and regulatory standards. * Effectively manage daily workloads and review queues, adjusting schedules as needed to meet departmental demands and turnaround times. * Collaborate with the Supervisor on quality monitoring and improvement initiatives to support compliance and performance excellence. * Maintain up-to-date knowledge of clinical practices, review criteria, and assessment processes to ensure informed and consistent decision-making. * Serve as a clinical liaison to providers, addressing customer service inquiries and supporting issue resolution in a professional and timely manner. * Perform all applicable review types as required based on workload volume and business needs. * Build and maintain positive, professional relationships with both internal teams and external stakeholders. * Participate in required training sessions and scheduled meetings to stay current on policies, procedures, and process updates. * Cross-train as needed to provide workforce flexibility and support evolving client and customer needs. * Understand and adhere to all corporate policies, including those related to HIPAA and its Privacy and Security Rules. * Maintain compliance with established workflows, regulatory requirements, and best-practice standards. Qualifications Required Qualifications & Experience * Active, unrestricted Registered Nurse (RN) license in good standing, with an Associate's degree (Bachelor's degree preferred) or completion of an accredited professional nursing diploma program. * Strong clinical assessment, analytical, and critical-thinking skills with the ability to make sound, evidence-based decisions. * Working knowledge of medical records review, medical terminology, and disease processes. * Strong written and verbal communication skills, with the ability to clearly document and explain clinical findings. * Detail-oriented with excellent organizational skills and the ability to prioritize and complete tasks efficiently within established timeline. Preferred Qualifications & Experience * Experience working for an Independent Review Organization (IRO) or in a similar clinical review setting. * Familiarity with URAC accreditation standards and regulatory requirements. * Knowledge of public mental health systems and government-sponsored medical programs is preferred. * Prior experience working in a remote or virtual clinical environment. * Proficiency in computer-based applications and the Microsoft Office Suite, including Word, Excel, Outlook, and Teams. Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at ******************************** EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Compensation The pay for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range USD $28.37 - USD $38.00 /Hr.

Healthcare companies are desperately looking for nurses able to work during the HEDIS season. HEDIS season starts next month for some healthcare companies. Nurses can work remotely from home, with equipment provided. Take advantage of our discounted courses and be connected with recruiters and staff agencies hiring for the HEDIS season. Program: HEDIS 2025 Course Overview: HEDIS Measures Self-Paced: 3 day Course Limited Price: $25.00 Course Completion: Direct recruiter connection Guaranteed Hourly Pay: $20/hr - $45/hr - based on credentials Hiring Deadline: 01/06/2025 Offer Ends Soon ******************************************************************* Code=HIRINGNOW

Clinical Care Coordinator - Memory Care Job Type: Full Time $3,000 Sign on Bonus Make a Difference-And Own Your Future At Wallick Senior Living, our team understands that senior living is not just a job, but a calling. We take pride in caring for and empowering our residents as they choose to enjoy their golden years with us. With 1,000+ employees and a mission to open doors to homes, opportunity, and hope, we take pride in fostering a supportive and collaborative work environment where every employee-owner plays a vital role. A Career with Wallick Senior Living Means… A Unique Approach to Senior Living: Our associate's power Wallick's approach to senior living that goes beyond care to ensure our residents live their best lives through meaningful activities, delicious meals and round-the-clock support. Pay-on-Demand: access your money as you earn it. Exceptional Benefit Package: Health, dental, vision insurance effective within 2 weeks of starting your new job. Other benefits like gym membership reimbursement, paid parental leave, 401K, and more! Work-Life Balance: Paid time off, including paid parental leave. Supportive Culture and Rewarding Work: A team-oriented environment where associates make a meaningful impact by helping individuals maintain independence and quality of life. Resident Stories That Stay with You: From Maurine, who found an “instant family” to Evelyn, who recently celebrated her 105th birthday with us, our residents enjoy a sense of community that is created by you! Career Growth: Tuition reimbursement, training, professional development, and advancement opportunities within a company that invests in its people. Employee Owned, Resident Focused: As a 100% employee-owned company, your daily work (supporting our residents) also contributes to your financial future by sharing in our profitability. What You'll Do Oversee all activities related to providing quality service to residents to include maintaining the facility, providing excellent food service, engaging activities, and a caring nursing staff Responsible to ensure that Resident Centered Care is in place for all residents by way of a personal care plan meeting the personal needs of each resident. Ensure all resident relations issues are addressed promptly and satisfactorily by maintaining a strong line of communication with residents and their families. Responsible for ensuring the facility is always adequately staffed. Responsible to ensure all mandatory training is completed for all staff. Responsible for ensuring that appropriate programming is in place for each individual unit. Creates a Memory Care Program Calendar monthly which addresses special social, physical, cognitive, and spiritual needs of residents. Responsible for annual budget projections, financial forecasting and the maintenance of such. Completion of reports required by government agencies, administrators, or the Company. Responsible for maintaining the community to Company standards. Perform other related duties as assigned. What We're Looking For Valid Ohio Nursing License. Three or more years of assisted living experience in memory care. Must have 3 or more years of proven success in operations. You must have excellent customer service and communication skills. Wallick's Mission & Values At Wallick Communities, we believe in opening doors to homes, opportunity, and hope for our residents, associates, and community. Our core values guide everything we do: Care - We show compassion and respect for everyone. Character - We do the right thing, even when no one is looking. Collaboration - We work together to achieve more. At Wallick, we celebrate Diversity, Equity, Inclusion + Belonging (DEI+B) in our workplace and communities, creating an environment where associates feel welcome, respected, and empowered to bring their authentic selves to the great work they do every day. For nearly 60 years, it has been at the core of our organization's culture that all Wallick associates come to a safe and inclusive place to work. Wallick does not discriminate based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit-based factors. Join Us and Become an Employee-Owner! If you're ready to make a difference in people's lives while securing your financial future, apply today! *Employment is contingent upon passing a pre-employment background check and drug screen.

Remote Nurse Advocate (Registered Nurse) Location: Remote Remote Status: Remote Job Id: 823 # of Openings: 0 Remote Nurse Advocate - Case Manager (RN) Schedule: Monday-Friday, rotating shifts between 8 AM-8 PM ET (11:30AM-8PM ET strongly preferred) Location: Remote (occasional travel may be necessary) Overview PharmaCord, a national leader in pharmaceutical patient support, is seeking Registered Nurses to serve as Nurse Advocates supporting oncology and specialty therapy patients. In this fully remote role, you'll guide patients from enrollment through treatment-providing education, emotional support, and assistance navigating barriers to care. Requirements * Active RN license (multistate or eligible for compact licensure). * Telehealth Experience Required. * 2-3 years of clinical experience; oncology, chronic disease, or case management strongly preferred. * Strong communication, empathy, and multitasking skills. * Bachelor's degree in nursing preferred. * Typing speed of at least 35 WPM with 97% accuracy. Perks & Benefits * Robust benefit package including Medical, Dental, Vision, and 401K * Company-paid short-term disability and life insurance * Professional development and advancement opportunities * Recognized as a Best Place to Work in Kentucky A Day in the Life of a Nurse Advocate * Serve as a consistent point of contact for patients, caregivers, and providers. * Educate patients on prescribed therapies, dosing, side effects, and treatment expectations. * Coordinate with payers to verify benefits, out-of-pocket costs, and financial assistance options. * Empower patients to manage stress and access additional social or clinical resources. * Document all interactions per SOPs and report adverse events as required. Note: PharmaCord will only contact candidates ******************* *************************** email addresses. The company will never request bank information or send checks for equipment purchases. Any offer of employment is contingent on completion of a background check to company standard. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. At PharmaCord, we don't just accept difference - we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer. PharmaCord is unable to sponsor employees at this time. Want to learn more about us? Find us on LinkedIn, Glassdoor, Twitter & Facebook! #INDNARN

Join Joyous in our mission to revolutionize mental health care. As pioneers, we leverage very low dose (VLD) ketamine, AI-powered treatments, and advanced technologies to make mental health care effective, accessible, and affordable. With a team of nearly 120 professionals, we've transformed over 60,000 lives, leading a mental wellness revolution for a future where everyone can thrive. Working with us offers more than a job; it's a chance to be part of a life-saving mission that promotes health and compassion worldwide. You'll push mental health care boundaries with AI innovations, contributing to meaningful change and experiencing significant professional growth. At Joyous, we're creating lasting impacts, one life at a time. The Role: The Medical Intake Nurse is the first point of contact for patients via telehealth video calls after they complete our qualifying intake form. This role blends patient advocacy, medical intake review, and an educational approach to engagement, ensuring that patients feel informed, excited, and ready to move forward with treatment. The ideal candidate is passionate about mental health, well-versed in the benefits of ketamine therapy, and comfortable leading engaging, educational video calls to guide patients through their initial steps. Location: This role will be hybrid at our HQ in Foster City, CA. Key Responsibilities: Telehealth Video Call-Based Patient Engagement & Advocacy Conduct initial intake of patients who qualify for treatment, providing them with an exceptional first-touch experience by answering initial questions and building trust. Address patient concerns, provide reassurance, and encourage them to move forward with the treatment process. Build trust and rapport while demonstrating empathy and enthusiasm for mental health care. Medical Intake Review Assess patient intake forms to verify eligibility and ensure all necessary information is collected. Identify any missing or unclear medical history details and follow up with patients accordingly. Work closely with our clinical team to escalate cases when necessary. Education & Communication Explain Joyous' microdose ketamine protocol in a way that is scientifically accurate yet accessible to patients. Answer non-medical patient questions regarding treatment expectations, logistics, and the onboarding process. Stay up to date with the latest research on ketamine therapy and its impact on mental health. Process & Compliance Maintain HIPAA compliance and uphold patient confidentiality in all patient interactions. Follow established telehealth protocols to ensure a smooth, professional workflow during all video calls. Accurately document patient interactions in the Electronic Health Record (EHR) system. Collaborate with internal teams to ensure a seamless patient experience and improve engagement and conversion rates. Operational & Administrative Support Maintain accurate and thorough documentation of patient interactions. Ensure a smooth handoff between intake and the clinical team for the next steps in the treatment process. Collaborate with internal teams to improve patient engagement and conversion rates. Qualifications: Registered Nurse (RN) with Compact License ( Required ) Bachelor's degree in Nursing (BSN), Social Work, Psychology, or a related healthcare field is required. 2+ years of experience in patient intake, medical support, roles in a medical setting. Experience working in mental health, telehealth, or psychedelic medicine is a strong advantage. Excellent video-based communication skills - ability to build rapport, educate, and reassure patients effectively. Strong empathy and patient-centric mindset - must be passionate about mental health and patient care. Ability to quickly learn new protocols and adapt to a fast-paced startup environment. Highly organized and detail-oriented, with the ability to manage multiple patient interactions via video. Passion for Mental Health: A genuine interest in mental health treatments and a commitment to advocating for innovative therapies. Joyous is an equal opportunity employer and we value diversity at our company. We are committed to providing equal employment opportunities for all candidates regardless of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, disability status or any other characteristic protected by applicable law. AGENCY AND THIRD PARTY RECRUITER NOTICE: Joyous does not accept unsolicited resumes from individual recruiters or third-party recruiting agencies in response to job postings. No fee will be paid to third parties who submit unsolicited candidates directly to our hiring managers or Recruiting Team. All candidates must be submitted via our Applicant Tracking System by approved Joyous vendors who have been expressly requested to make a submission by our Recruiting Team for a specific job opening. No placement fees will be paid to any firm unless such a request has been made by the Joyous Recruiting Team and such a candidate was submitted to the Joyous Recruiting Team via our Applicant Tracking System.

Full-time Description Under the direct supervision of the Quality Assurance (QA) Director, the QA Nurse is responsible for conducting systematic audits of random Utilization Review (UR) cases to evaluate conformance with established guidelines; focus is on continuous quality improvement. Essential Job Functions: • Review and evaluate a random sample of completed UR cases daily against client specific requirements, contractual guidelines, Federal, State, and local regulations, and/or evidence-based practice using established parameters • Review completed UR cases, prior to physician review, to identify errors or other opportunities for process improvement (i.e., use of correct clinical criteria, impediments to meeting TAT, clear and concise denial language, and criteria, etc.) • Assist in the development of UR policies, procedures, training, and QA projects based on data collected from case reviews • Assist in the collection and analysis of data against defined metrics • Identify, track and trend discrepancies used to initiate and identify needed corrective action plans • Responsible for high-quality, cyclical, professional QA reports free of grammar or spelling errors submitted to QA leadership • Reports include at a minimum: total number of clarifications by UR nurse; categories of clarifications; percentages; comparison by month/quarter/year; and detailed performance improvement feedback • Assist the QA Director to develop recommendations and follow-up activity based on root cause analysis with a focus on improved quality and efficiency • Complete mandatory daily quota of audits with a high degree of accuracy: Reach and maintain a 15-20 average daily case load (combination of Peer Reviews and internal case/file reviews) within a specified timeframe with at least a 97% accuracy rate • Communicate with QA Management on urgent issues, objectives and areas of needed improvement that require immediate attention • Use logic and reasoning to interpret, analyze, and apply appropriate guidelines to medical-legal reviews and supporting clinical documentation • Use evidenced-based research to review and comprehend medical/surgical modalities and imaging techniques to evaluate the standards of care identified. • Apply pre-approved criteria and guidelines to validate medical necessity/appropriateness of treatment (e.g., ODG, MTUS, Milliman Care Guidelines, InterQual • Maintain appropriate discretion with regard to confidential or sensitive information. Refrain from discussing with unauthorized people • Maintain and expand professional competence in quality assurance and auditing • Perform a low to moderate amount of research on a case-by-case basis • Electronically file and retrieve corporate documents, records, and reports • Participates in an interdisciplinary health care team environment • Effectively communicate with internal and external customers (both orally and in writing) • Compose and prepare correspondence • Regular and consistent attendance required • Other duties as assigned Requirements Knowledge and Abilities Requirements: • Must be extremely detail-oriented, quality driven; able to follow a detailed checklist systematically and develop own system as needed for organizing/tracking work processes • Previous experience in UR or auditing in a managed care or healthcare setting • Expert level written and verbal communication skills • Proficiency in English with an aptitude for spelling and grammar • Ability to work in high pressure, deadline driven environment with strong time management skills • Must be capable of performing routine job functions with minimal supervision • Strong ability to review clinical charts and documents for accuracy and completion • Demonstrated ability to problem solve complex, multifaceted, situations • Professional demeanor; ability to build rapport amongst staff and to provide constructive feedback • Maintain a positive attitude and outstanding customer service while working closely internally with Nexus staff, panel physicians, and clients • Must be able to give clear and accurate information with polite, persistent follow-up • Ability to use Microsoft products; Word, Excel, PowerPoint, Outlook • General Typing Skills at 45wpm Education and Experience: • Active RN licensure required; BSN is preferred • 2-3 years of workers compensation management, clinical review & QA clinical review is required License and Certification: • Active & Unrestricted RN license required Driving Essential: No Position Demands: This position requires sitting, bending, and stooping for up to 8 hours per day in an office setting. Ability to lift and move objects weighing up to 10 lbs. Ability to learn technical material. The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc. Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc. The person in this position frequently communicates with guests, team members, and vendors and must be able to exchange accurate information. Equal Employment Opportunity (Our EEO Statement): The Company is a veteran-owned Company and provides Equal Employment Opportunities (EEO) to all Team Members and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender (including gender identity), pregnancy, childbirth, or a medical condition related to pregnancy or childbirth, national origin, age, disability, genetic information, status as a covered veteran in accordance with applicable federal, state, and local laws, or any other characteristic or class protected by law and is committed to providing equal employment opportunities. The Company complies with applicable state and local laws governing non-discrimination in employment. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, promotion, discharge, pay, fringe benefits, membership, job training, classification, and other aspects of employment. Team Members who believe they are the victims of discrimination should immediately report the concern to their Supervisor and Human Resources Department. Discrimination and harassment will not be tolerated. We are committed to creating an inclusive environment for all Team Members and applicants. We value the unique skills and experiences that veterans bring to our team and encourage veterans to apply. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel. All company team members may be required to perform duties outside of their normal responsibilities from time to time, as needed.

Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************