Telemetry registered nurse work from home jobs - 369 jobs

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together This is a Field Based role with a Home-Based office. Must be open to traveling up to 50 miles from home office based on business need. If you are located in or within commutable driving distance from South Austin, TX, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current and unrestricted Registered Nurse license in the state of Texas 2+ years of experience working within the community health setting or in a healthcare role Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and ability to use multiple web applications Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Valid driver's license, access to reliable transportation and the ability to travel in this 'assigned region' to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices Reside in or within commutable driving distance from South Austin, TX Preferred Qualifications: 1+ years of experience with long-term care services and support, Medicaid or Medicare Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations Proven ability to create, edit, save and send documents, spreadsheets and emails Reside in South Austin, TX *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Facility Name: Kindred Hospital Bay Area - St. Petersburg Schedule: Full Time Please note: The title 'Clinical Rehabilitation Specialist is functionally equivalent to the Clinical Liaison role. Both titles refer to the same position and may be used interchangeably. Your experience matters Lifepoint Rehabilitation is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Clinical Rehabilitation Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. How you'll contribute A Clinical Rehabilitation Specialist who excels in this role: Educate the community on rehabilitation to develop a census through face-to-face contacts Develop business based on the strategic goals of the rehabilitation program Face-to-face connections within territory to build relationships with referral sources to increase census Identifies barriers to the admission process and creates solutions with the assistance of the program director Ability to review patient medical charts and understand test results, therapy evaluations, pre-existing conditions, and have a general medical knowledge of the patient Ability to clearly and professionally interact with patients, families, and healthcare providers while gathering additional clinical information and past history Conduct thorough patient assessments to identify patients for potential admission into the rehabilitation program Complete detailed Pre-Admission Screens, as applicable, according to facility policies and procedures, Lifepoint policies and procedures, and payer requirements, as applicable. Schedules meetings and arrange in services for medical professionals including potential and existing referral sources, doctors, nurses, social workers and other health care professional. Provide patient updates to physicians, payers, case managers, social workers and other relevant persons. Maintain solid working relationships with new and existing referral sources by providing excellent after-sales service. Other duties as assigned 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: Comprehensive Benefits: Multiple levels of medical, dental and vision coverage - with medical plans starting at just $10 per pay period - tailored benefit options for part-time and PRN employees, and more. Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). Professional Development: Ongoing learning and career advancement opportunities. What we're looking for Clinical experience is required At a minimum, should be a graduate of a four-year college program with a bachelor's degree in a health related, business or marketing area of concentration, nursing or therapy preferred Ability to travel in the community to meet clients/customers at hospitals, SNFs, physician offices and other nontraditional referral sources. Valid driver's license and own reliable transportation required Communicate and demonstrate a professional image/attitude for patients, families, clients, co-workers, and others, demonstrating great customer service and listening skills Connect with a Recruiter Not ready to complete an application, or have questions? Please contact Fomeika Ingram by emailing at **********************************. EEOC Statement “Lifepoint Rehabilitation is an Equal Opportunity Employer. Lifepoint Rehabilitation is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.”

PSI is a leading Contract Research Organization with more than 30 years in the industry, offering a perfect balance between stability and innovation to both clients and employees. We focus on delivering quality and on-time services across a variety of therapeutic indications. Job Description We are looking for an Operating Room (OR) Nurse to join PSI as a Clinical Trial Liaison! In this role, a Clinical Trial Liaison: Acts as a specialized liaison to assist sites with a protocol-tailored approach to increase efficiency of the patient identification and recruitment process Assists sites in developing and implementing patient enrollment techniques Coordinates site specific patient recruitment and retention plans observing the planned metrics Provides information specific to the area of expertise to site team members involved in patient recruitment Identifies, tracks, and reports patient enrollment progress throughout the study Analyses the protocol in order to provide the site with the support needed to improve the patient pathway Provides support to the project teams to ensure proper documentation of study-specific assessments related to patient enrollment Assists and advises the site monitor in the area of patient enrollment This role requires travel. Qualifications Registered Nurse (RN) Degree A minimum of 5 years of experience as an OR Nurse Experience in operation and QC procedures related to the equipment used in the specialized area Additional Information All your information will be kept confidential according to EEO guidelines.

Registered Nurse - PRN visits Leave Shift Work Behind Consider our per diem opportunity to earn additional income as a Nurse Interviewer visiting clients at their place of residence. Complete questionnaires on their medical, functional and cognitive status. Flexible scheduling - The nurses can schedule visits Monday - Sunday, mornings, afternoons or evenings based on the client's and nurse's schedule. Flexible work - you can cover up to a 75 mile radius and work as little or as much as you want per month based on available cases in your area. Extra income - Work with illumifin whenever you need a little extra money, even if you have another job. No blood draws or specimen collections required. About the Role: As a RN with illumifin, you will utilize your critical thinking and assessment skills to complete the following: Obtain thorough cognitive and health assessment information as required. Comply with all assessment instructions and accurately complete assessments. Communicate promptly with illumifin regarding file status and appointment times. Return the assessment within 24 hours after the appointment. Respond promptly to any follow-up and clarification questions on submitted assessments. With E-Assessments training, you can complete assessments electronically using your cell phone, tablet, iPad or Laptop

This is a contract assignment that will start right away and end on June 28th 2024 Remote in TX Must Live in TX SUMMARY DESCRIPTION: RN or LPN with clinical experience and will work under the supervision of the HEDIS Coordinator. They are a member of the medical record review team. The team is responsible for obtaining and performing accurate comprehensive reviews of medical records in support of The HEDIS Effectiveness Data and Information Set project. HEDIS reviews are completed in accordance with NCQA guidelines and technical specifications. JOB REQUIREMENTS: • Degree, Diploma or Certificate from a school of nursing with clinical experience. • Licensed in the State of Illinois • Knowledge of medical terminology • Data entry and/or typing experience. • Clear and concise written and verbal communication skills. • PC proficiency to include Word, Excel and Lotus Notes. • Auditing experience preferred. DUTIES AND RESPONSIBILITIES: • Accurately and efficiently over-read medical record abstractions performed by the HEDIS abstraction staff on a daily basis according to HEDIS specifications and company training guidelines. • Complete the IRR/over-read tool in the Software Application, including comments if errors are found. Correct errors identified through over-read process, including a re-review of charts that may contain similar errors. • Identify and report abstraction errors and provide measure re-education with for the abstractor. • Utilizes various software applications to support HEDIS operations by entering data and / or changing chase status for the identified chase(s). • Meets with HEDIS Coordinator and / or QI Specialists to discuss HEDIS efforts, any open issues and can include IRR results. • Maintains productivity level as determined by the HEDIS Coordinator/QI Department. • Maintain compliance with all HIPPA and patient confidentiality requirements. • All other duties as assigned.

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

As an RN - MICU you will assess, plan, perform, document, and evaluate professional independent nursing practice at Lakeview Hospital; to provide work direction for and oversight of the nursing care provided by unlicensed personnel; to perform and document functions such as carrying out the provider's medical orders; to assist providers with diagnostic and treatment procedures; to provide a safe and therapeutic environment; to coordinate, communicate, interpret, and explain patient care services to the patient ,his/her family, health professionals and important others; to perform related duties as assigned. Work Schedule: 24 hrs weekly / .6 FTE; Day/Eve shifts. 7am-3:30pm & 3-11:30pm every other weekend rotation Required Qualifications: Associate Degree in Nursing. Licensed as a RN by Minnesota Board of Nursing or has a Wisconsin RN License and Minnesota Boarder State Registry. Current BLS certification from American Heart Association or American Red Cross (CPR/AED for Professional Rescuer & Health Care Provider) Current ACLS certification. If not present at start, must obtain within 6 months of start date. Stroke Care (NIHSS) required within 6 months of start date. Minimum one year RN critical care (ICU or ED) experience required Preferred Qualifications: Baccalaureate or Master's degree in Nursing Associate Degree prepared nurses enrolled in Baccalaureate in Nursing program Charge nurse experience preferred. Telemetry experience.

Become a part of our caring community and help us put health first The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability to obtain non compact licensure No less than 3 - 5 years of Medical Surgery, Heart, Lung or Critical Care Nursing experience required Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting Comprehensive knowledge of Microsoft Word, Outlook and Excel) Ability to work independently under general instructions and within a team Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required Must be passionate about contributing to an organization focused on continuously improving consumer experiences Must be willing to be in weekend rotation and possible holiday coverage. Preferred Qualifications 3 or more years' experience in a high volume and fast paced environment Previous experience in utilization management Education: BSN or bachelor's degree in a related field Health Plan experience Previous Medicare/Medicaid Experience a plus Call center or triage experience Bilingual is a plus Additional Information To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 02-12-2026 About us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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

Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions: Complete prospective, concurrent and retrospective review such as acute inpatient admissions, post-acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment Identify, document, communicate, and coordinate care, engaging collaborative care partners to facilitate transitions to an appropriate level of care Engage with medical director when additional clinical expertise if needed Maintain knowledge of state and federal regulations governing CareSource, State Contracts and Provider Agreements, benefits, and accreditation standards Identify and refer quality issues to Quality Improvement Identify and refer appropriate members for Care Management Provide guidance to non-clinical staff Provide guidance and support to LPN clinical staff as appropriate Attend medical advisement and State Hearing meetings, as requested Assist Team Leader with special projects or research, as requested Perform any other job related duties as requested. Education and Experience: Associates of Science (A.S) Completion of an accredited registered nursing (RN) degree program required Three (3) years clinical experience required Med/surgical, emergency acute clinical care or home health experience preferred Utilization Management/Utilization Review experience preferred Medicaid/Medicare/Commercial experience preferred Competencies, Knowledge and Skills: Proficient data entry skills and ability to navigate clinical platforms successfully Working knowledge of Microsoft Outlook, Word, and Excel Effective oral and written communication skills Ability to work independently and within a team environment Attention to detail Proper grammar usage and phone etiquette Time management and prioritization skills Customer service oriented Decision making/problem solving skills Strong organizational skills Change resiliency Licensure and Certification: Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required MCG Certification or must be obtained within six (6) months of hire required Working Conditions: General office environment; may be required to sit or stand for extended periods of time Travel is not typically required Compensation Range: $62,700.00 - $100,400.00 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): Hourly 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-JM1

Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity Why Join Us? ✅ Leadership opportunity with autonomy and support ✅ Competitive salary & comprehensive benefits package ✅ 10 days on/4 days off schedule - maximize your work-life balance ✅ Hands-on engagement with multiple teams Are You the Right Fit? ✔️ Active RN License ✔️ 5+ years previous experience as a Director of Nursing in a skilled nursing facility or experience as a District/Regional Nurse Consultant (Nursing home/long term care) ✔️ Strong background in building teams & cultivating a positive workplace culture ✔️ Certifications in Infection Prevention/Control and MDS (preferred) If you're a passionate nursing leader ready to make a significant impact, we'd love to hear from you! Apply today and take the next step in your career. Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility Medical, Dental, Vision insurance 401(k) Associate assistance program Employee discounts Referral program Early access to earned wages for hourly associates (outside of CA) Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility Paid Time Off Paid holidays Company provided life insurance Adoption benefit Disability (short and long term) Flexible Spending Accounts Health Savings Account Optional life and dependent life insurance Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Full-time associates in role are also eligible for an annual bonus incentive. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. Education and Experience Education as required to obtain state nursing license (RN). Five years of skilled nursing experience as a Director of Nursing (DON) or District/Regional Nurse Consultant required. Certification in Infection Prevention/Control and RAI process preferred. Basic typing skills, along with a working knowledge of personal computing and word processing software, are required, preferably in a Microsoft Windows environment. Certifications, Licenses, and Other Special Requirements RN license. Management/Decision Making Applies existing guidelines and procedures to make varied decisions within a department. Uses sound judgment and experience to solve moderately complex problems based on precedent, example, reasonableness, or a combination of these. Knowledge and Skills Possesses extensive knowledge of a distinct skill or function and a thorough understanding of the organization and work environment. Has a working knowledge of a functional discipline. Physical Demands and Working Conditions Standing Requires interaction with co-workers, residents or vendors Walking Sitting Occasional weekend, evening or night work if needed to ensure shift coverage. Use hands and fingers to handle or feel On-Call on an as needed basis Reach with hands and arms Possible exposure to communicable diseases and infections Climb or balance Potential injury from transferring, repositioning, or lifting residents Talk or hear Exposure to latex Taste or smell Ability to lift: Up to 50 pounds Possible exposure to blood-borne pathogens Possible exposure to various drugs, chemical, infectious, or biological hazards Subject to injury from falls, burns, odors, or cuts from equipment Requires Travel: Occasionally Vision Manages the day-to-day healthcare operations of the community to ensure resident's healthcare needs are met. Ensures residents are treated with respect and dignity and ensures quality care as residents' healthcare needs change. Supervises licensed nurses and other direct care staff within the community. Plans, organizes, develops, and directs the overall operations of the Clinical Services Department in accordance with federal, state and local standards. Responsible and accountable for maintaining the highest degree of quality care at all times. Travels 100% within the division as assigned to support management vacancies, start-ups, vacations, etc. Oversees the assessment of comprehensive nursing needs of each resident using acceptable long term care assessment tools and according to state and federal time frames. Coordinates the care plans for each resident. Participates in community surveys completed by authorized government agencies. Monitors the community Quality Indicators and survey reports. Assists with the development of success plans for identified areas of opportunity. Develops and implements a Clinical Services organizational structure. Determines staffing needs; recruits, selects, hires, and orients nursing staff/direct care personnel. Directly supervises community-based licensed nursing staff (LPN/LVN, RN), CNAs, and Med Techs/CMAs (if allowed/required by State Regulations). Also responsible to supervise nursing administrative associates. Assigns and directs work of subordinates, appraises performance, rewards and disciplines associates, and addresses complaints and resolves problems. Provides training, supervision, and monitoring of associates in the administration of medications as described/allowed in Nurse Practice Act, including auditing of medication administration records. Trains and educates resident care associates on an ongoing basis with classroom in- services, situation-specific training, and resident-specific training. Supervises the maintenance of resident charts and reviews documentation performed by caregiving staff. Assesses the health, functional and psycho-social status of residents, initiates individualized service plans, proactively manages care and services for each resident, evaluates effectiveness, and maximizes the resident's opportunity to remain in their environment. Manages the health care of residents, including the dissemination of information to families and associates. Ensures that family members are aware of residents' need for scheduled appointments. Participates in pre-admission screening of prospective new residents. Ensures that required documentation is completed prior to or upon resident admission, including nursing assessments, service plans, and other assigned forms. Updates assessments as required by policy and as described/allowed in Nurse Practice Act. Performs on-site evaluations of residents admitted to alternate care environments for treatment and maintains contact with resident families with the intent of returning the resident to Brookdale. Evaluates residents; documents changes in condition, and notifies executive director, physician, and resident's legally responsible party/family of resident's condition and reactions. Prepares the Physician Visit Form and reviews and updates the resident chart. Facilitates continuity of care for residents receiving home health care, hospice services, and other third party healthcare-related services. Ensures in-house ancillary medical services such as podiatrist visits, doctor visits, and dental visits, psych visits, lab tests, X-ray, ambulance, etc., are scheduled and followed through. Participates in, or leads, meetings relevant to resident care issues, such as Care Plan, Change of Condition, Clinical Stand-Up, and Collaborative Care meetings involving appropriate parties as needed. Participates in department quality improvement activities. Assists in keeping the environment safe for associates to reduce the occurrence of Workers' Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated. Shares on-call and manager-on-duty responsibilities/shifts as required. Supports other requirements within the division as assigned. This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.

The incumbent in this role is expected to float based on the needs of the organization determined by the Home Therapies Operations Excellence Team. The expected geography may include Texas and all states west of Texas. In addition, floating assignments are at least six (6) weeks and require overnight stays. The incumbent is expected to perform all duties of the role as outlined in the job description (e.g. opening, closing, working weekends, etc.). The Home Therapy Registered Nurse -- Traveler, as qualified by federal and state regulations, travels to various U.S. Renal Care locations to provide patient training and ongoing support for all patients choosing a home dialysis modality. This position provides nursing relief/support for assigned programs on a temporary or short-term basis. Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned. GROWTH · Participate in and support corporate initiatives that promote improved care and increase growth of the home department. · Understand vendor product delivery methods and associated fees. Teach patients the importance of proper and timely order placement. Ensure patients receive all supplies in timely manner to not disrupt care. · Assist with clinic and patient supply inventory, ensuring usage is appropriate for patient prescriptions and place orders in timely manner to avoid fees and penalties. · May assist with equipment management including equipment tracking and retrieval as needed. · Perform duties as assigned to meet the patient care or operational needs of the program. OUTCOMES · May assist with improving patient outcomes through tracking and trending of program and patient performance, use of critical thinking skills and root cause analysis to improve patient and quality outcomes. May assist in obtaining data for the continuous quality improvement activities. · Obtain routine and non-routine laboratory tests as ordered and communicate critical lab values and urgent patient needs to the responsible physician or physician extender in a timely manner. · May complete and document monthly review of patient medication profiles as directed. Administer medications as ordered by the physician. · Provide patient education and follow up as needed. · Assist with program's target goals for patient outcomes in accordance with quality patient care and Company goals. OPERATIONAL READINESS OPERATIONAL READINESS (cont.) · Knowledge of and comply with federal, state, local laws and regulations, including health care professionals practice act requirements as they pertain to home dialysis program and patient care requirements. · Perform duties at all times within limitations established by and in accordance with company policy and procedures, applicable state and federal laws and regulations. · Train patient (and/or care partner) in the practice of self-care Peritoneal Dialysis or Hemodialysis upon meeting federal and state regulations governing Registered Nurse qualifications. · May conduct home visits to assess the patient's home environment per policy and as needed to improve care. · Inform (Direct Supervisor) and program Administrator of all incidents, conditions, and concerns related to patient care, staff and patient safety, and in accordance with company policy. · Document all nursing services in the Electronic Medical Record including but not limited to training sessions, routine and non-routine in-person interactions, and phone conversations. Documentation should accurately reflect the patient status and nursing interventions and be written to ensure continuity of care. · May assist with developing and implementing the patient plan of care with the interdisciplinary team. · Participate in infection control monitoring, implementation, and recording as requested. · Use personal protective equipment as necessary. · Be familiar with emergency equipment and all emergency operational procedures. Communicate and regularly review Emergency Preparedness procedures with all home patients, including but not limited to emergency disconnection from dialysis equipment, what to do and who to contact if displaced from home. · Communicate on-call system to patients and ensure patients have access to nursing support at all times. Teach patients the importance of timely communication. · May perform on call nursing services, nights and weekends, on a rotational basis as needed or assigned. · Flexible with staffing locations and hours to accommodate patient and USRC home program needs. · Regular and reliable attendance is required for the position. Home Hemodialysis Only: · May coordinate home evaluation with technical services department to ensure that the necessary electrical, plumbing and drainage requirements for proper equipment operation are met prior to patient acceptance into home program. · May assist with ensuring required and appropriate water sampling is complete per policy and product requirements. Monitor and report water sample and culture results. PARTNERSHIPS · Communicate results of patient assessment, reassessment, and ongoing monitoring to the physician, team members, and others as appropriate to the individual needs of the patient. · Maintain a positive/collaborative working relationship with physicians, state agencies and the community. · Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization. · Respond effectively to inquiries or concerns. STAFF DEVELOPMENT/ RETENTION · Participate in staff meetings as required. Attend in-service and continuing education offerings in compliance with company policy and procedure. · May delegate tasks to competent licensed and unlicensed staff per applicable state practice act. · Assist with staff training as requested. · Lead staff in team concepts and promote a team effort.

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Registered Nurse, Nurse Line - 36 hours per week (Remote) Cost Center:301081199 Mfld-Nurse LineScheduled Weekly Hours:36Employee Type:RegularWork Shift:8-hour PM shifts, variable days (United States of America) Job Description: The Registered Nurse, Nurse Line is responsible for triaging incoming calls for patients, assessing needs, giving appropriate clinical options and facilitating requests to primary care providers, specialists, health care facilities, and community resources. The registered nurse functions as a part of an interdisciplinary team in providing healthcare and patient education when appropriate, regarding immediate care advice and preventive health behaviors. The individual will have the opportunity to work from home after an orientation period and demonstration of meeting productivity and quality expectations. Monday-Thursday, 2300-0700. No weekends. Holiday rotation. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: Graduate of an accredited school of nursing. Preferred/Optional: Bachelor of Science in Nursing (BSN). EXPERIENCE Minimum Required: Three years' recent clinical experience in acute or ambulatory care. Preferred/Optional: Experience with patient interaction on the phone. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Current State of Wisconsin Registered Nurse License or Nurse Compact License. Preferred/Optional: None Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states: Alabama (limitations in some counties) Arizona (limitations in some counties) Arkansas Colorado (limitations in some counties) Florida Georgia Idaho Illinois (limitations in some counties) Indiana Iowa Kansas Kentucky (limitations in some counties) Louisiana Maine (limitations in some counties) Michigan Minnesota (limitations in some counties) Mississippi Missouri Montana Nebraska Nevada New Hampshire (limitations in some counties) North Carolina North Dakota Ohio Oklahoma Oregon (limitations in some counties) Pennsylvania (limitations in some counties) South Carolina South Dakota Tennessee Texas (limitations in some counties) Utah Virginia Wisconsin Wyoming Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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. Benefits Tailored for You and Your Family Quarterly performance bonuses to reward your contributions Comprehensive medical, vision, and dental insurance for you and your dependents Flexible spending accounts for health and dependent care expenses 401(k) retirement plan to help secure your financial future PTO and Sick Time 6 weeks of paid parental leave for growing families Travel support with mileage reimbursement for community visits Company-issued iPhone for seamless communication Monthly wellness allowance to support your physical and mental health Professional development funding to advance your clinical expertise and career goals Robust clinical support: dedicated RNs and Care Coordinators handle operational tasks, allowing you to focus on patient care Team building through regular social events and off-sites 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.

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

Full time Shift: 12 Hour Day Shift (United States of America) Hours per week: 36 Job Information Exemption Status: Non-Exempt Medical/Surgical virtual nursing is a specialty within the nursing profession that encompasses the care of individuals across the life span who present with physical, emotional, or psychological alterations of health. Medical/Surgical virtual nursing is care of acute and chronic illnesses in nature and occurs in a variety of care settings. Medical/Surgical nursing encompasses care that ranges from cardiac, oncology, stroke, joint, spine, post-surgical, palliative, psychiatric and end-of-life issues. It includes the care of patients greater than age 12 and all health conditions. Medical/Surgical nurses have adapted nursing process to include components of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation of human responses when caring for patients. Education Qualifications Bachelors of Science: Nursing (BSN) Preferred Skills and Abilities Demonstrates awareness and sensitivity to rights of patient/significant other, as identified within the institution. (Required proficiency) Demonstrates awareness and application of safety issues as identified within the institution. (Required proficiency) Demonstrates awareness of legal issues in all aspects of patient care and departmental functioning. Strives to manage situations in a manner, which minimizes risk to the patient and the institution. (Required proficiency) Demonstrates competency in selected psychomotor skills. (Required proficiency) Ability to communicate effectively using verbal, non-verbal and written methods. (Required proficiency) Ability to perform mathematical calculations related to medication administration and equipment calibration. Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. (Required proficiency) Licenses and Certifications Registered Nurse - KSBN A multistate license with the ability to practice within the State of Kansas is also accepted. Required RQI, CPR or ACLS certifications may be required in lieu of or in addition to BLS depending on department. What you will do Collects pertinent data and information relative to the patient, situation, or setting. Analyzes assessment data to determine actual or potential problems, and issues. Identifies expected outcomes for a plan individualized to the patient or situation. Develops a collaborative plan encompassing strategies to achieve expected outcomes. Collaborates virtually with physicians, nurses and other health care team members implementing identified plan through coordination of care and employs strategies to promote health and wellness. Virtually evaluates progress toward attainment of goals and outcomes through coordination with patient and review of medical record. Virtually monitors and preemptively gets ahead of subtle signs and symptoms of clinical deterioration or status changes in coordination with multidisciplinary care team. Delivers professional nursing care guided by Jean Watson's Theory of Human Caring illustrated by creating caring relationships, taking time to have uninterrupted moments with patients and displaying unconditional acceptance and respect. Promotes a mutually respectful environment that encourages the exchange of ideas and supports the effectiveness of professional relationships and integrates ethics in all aspects of practice. Demonstrates advocacy in all roles and settings. Practices Diversity, Equity and Inclusion principles in their daily work by respecting others' uniqueness, perspectives, backgrounds or beliefs. Communicates effectively in all areas of professional practice. Mentors nurses new to their role for the purpose of ensuring successful enculturation, orientation, competence, and emotional support. Supports students to enhance their knowledge, skills, and abilities. Commits to lifelong learning through critical thinking, self-reflection, and inquiry for personal growth and development. Demonstrates willingness to participate and lead nursing practice in process evolution the scope of the Stormont Vail Health professional practice model Utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, and financially responsible, and used judiciously. Required for All Jobs Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health Performs other duties as assigned Patient Facing Options Position is Not Patient Facing Remote Work Guidelines Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards. Stable access to electricity and a minimum of 25mb upload and internet speed. Dedicate full attention to the job duties and communication with others during working hours. Adhere to break and attendance schedules agreed upon with supervisor. Abide by Stormont Vail's Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually. Remote Work Capability Full-Time Scope No Supervisory Responsibility No Budget Responsibility Physical Demands Balancing: Occasionally 1-3 Hours Carrying: Occasionally 1-3 Hours Climbing (Ladders): Rarely less than 1 hour Climbing (Stairs): Occasionally 1-3 Hours Crawling: Rarely less than 1 hour Crouching: Occasionally 1-3 Hours Eye/Hand/Foot Coordination: Frequently 3-5 Hours Feeling: Frequently 3-5 Hours Grasping (Fine Motor): Frequently 3-5 Hours Grasping (Gross Hand): Frequently 3-5 Hours Handling: Frequently 3-5 Hours Hearing: Occasionally 1-3 Hours Kneeling: Occasionally 1-3 Hours Lifting: Occasionally 1-3 Hours up to 50 lbs Operate Foot Controls: Rarely less than 1 hour Pulling: Occasionally 1-3 Hours up to 50 lbs Pushing: Occasionally 1-3 Hours up to 50 lbs Reaching (Forward): Occasionally 1-3 Hours up to 25 lbs Reaching (Overhead): Occasionally 1-3 Hours up to 25 lbs Repetitive Motions: Occasionally 1-3 Hours Sitting: Occasionally 1-3 Hours Standing: Frequently 3-5 Hours Stooping: Occasionally 1-3 Hours Talking: Frequently 3-5 Hours Walking: Frequently 3-5 Hours Working Conditions Burn: Rarely less than 1 hour Chemical: Rarely less than 1 hour Combative Patients: Occasionally 1-3 Hours Dusts: Rarely less than 1 hour Electrical: Rarely less than 1 hour Explosive: Rarely less than 1 hour Extreme Temperatures: Rarely less than 1 hour Infectious Diseases: Occasionally 1-3 Hours Mechanical: Rarely less than 1 hour Needle Stick: Frequently 3-5 Hours Noise/Sounds: Frequently 3-5 Hours Other Atmospheric Conditions: Rarely less than 1 hour Poor Ventilation, Fumes and/or Gases: Rarely less than 1 hour Radiant Energy: Rarely less than 1 hour Risk of Exposure to Blood and Body Fluids: Occasionally 1-3 Hours Risk of Exposure to Hazardous Drugs: Occasionally 1-3 Hours Hazards (other): Rarely less than 1 hour Vibration: Rarely less than 1 hour Wet and/or Humid: Rarely less than 1 hour Stormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment. Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.

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

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

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!